Intragraft expression of recipient-type ABO blood group antigens: Long-term follow-up and histological features after liver transplantation
Intragraft expression of recipient-type ABO blood group antigens: Long-term follow-up and histological features after liver transplantation
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DOI：
10.1002/lt.20415
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发表时间：
2005-05-01
影响因子：
4.6
通讯作者：
Manabe, T
中科院分区：
文献类型：
--
作者：
Tanaka, Y;Haga, H;Manabe, T
同种异体肝移植物中的 ABO 组织血型抗原 (r-ABOAg)，可能代表真正的移植物内嵌合或其他事件，例如细胞损伤。对于影响移植物中 r-ABOAg 表达的时间和程度的因素知之甚少。我们检查了 65 名接受 ABO 异型活体肝移植的受者（61 名相容，4 名不相容）。 97 个术后标本（71 个发作活检、16 个方案活检和 10 个外植同种异体移植物）可用于 ABH 血型抗原的免疫组织化学评估。评估 r-ABOAg 表达与组织学和临床因素的关系。汇管束中的毛细血管是 r-ABOAg 表达的主要部位。随着移植后时间的延长，显示 r-ABOAg 表达的标本百分比增加。 28 例标本中只有 1 例 (4%) 在手术后 1 年内显示内皮有 r-ABOAg，但 35 例中有 10 例 (29%) 在移植后 1 至 5 年内出现，34 例中有 21 例 (62%) 在移植后 5 年以上出现。比例分析发现，慢性排斥反应是毛细血管中任何 r-ABOAg 表达的重要因素 (P = 0.006)，同种异体移植物门静脉纤维化是毛细血管中广泛 r-ABOAg 表达（见于三分之一以上的门静脉束）的重要预测因素 (P = 0.017)。性别不匹配、受体年龄、供者年龄、移植物/受体体重比以及慢性排斥和纤维化以外的组织学与r-ABOAg 的表达不相关。总之，这些观察结果表明，带有r-ABOAg的门静脉毛细血管是移植物损伤和修复的结果，其中一些可能是受体来源的新生血管。
ABO histo-blood group antigens (r-ABOAg) in the liver allograft, which may represent either true intragraft chimerism or other events such as cell injury. Little is known about factors that affect the timing and extent of r-ABOAg expression in the graft. We examined 65 recipients who underwent ABO nonidentical living donor liver transplantation (61 compatible, 4 incompatible). Ninety-seven postoperative specimens (71 episode biopsies, 16 protocol biopsies, and 10 explanted allografts) were available for evaluation with immunohistochemistry of ABH blood type antigens. The expression of r-ABOAg was assessed in relation to histological and clinical factors. Capillaries in the portal tracts were the primary sites of r-ABOAg expression. The percentage of specimens showing r-ABOAg expression increased with lengthening of the post-transplantation period. Only 1 (4%) of 28 specimens showed endothelium with r-ABOAg within 1 year after the procedure, but 10 (29%) of 35 did between 1 and 5 years after transplantation and 21 (62%) of 34 after more than 5 years. Proportional analysis found that chronic rejection was a significant factor (P = 0.006) for any r-ABOAg expression in the capillaries, and allograft portal fibrosis was a significant predictive factor for extensive r-ABOAg expression (seen in more than one third of the portal tracts) in the capillaries (P = 0.017). Sex mismatch, age of recipients, age of donors, graft/recipient body weight ratio, and histology other than chronic rejection and fibrosis did not correlate with the expression of r-ABOAg. In conclusion, these observations suggest that portal capillaries with r-ABOAg are the results of graft injury and repair, and some of them may be neovessels of recipient origin.