18 May 2015 : Original article
Immunological Factors and Liver Fibrosis in Pediatric Liver Transplant RecipientsMałgorzata Markiewicz-KijewskaABCDEF, Piotr KalicińskiABCDEFG, Przemysław KlugeBCDE, Barbara PiątosaBCDE, Irena JankowskaBD, Aneta RękawekBC, Ewa KosteckaBC, Przemysław N. KurowskiBC
Ann Transplant 2015; 20:279-284
BACKGROUND: The aim of our study was to retrospectively assess any correlation between graft fibrosis and selected immunological factors in pediatric liver transplant recipients.
MATERIAL AND METHODS: The study was performed on 33 patients after living related donor transplantation, divided into 2 groups depending on history of acute rejection episodes after transplantation. We assessed liver biopsies for presence of fibrosis, signs of antibody-mediated rejection, inflammatory infiltrations, and changes in bile ducts. We correlated these findings with assessment of anti-HLA antibodies.
RESULTS: Among 14 patients with ACR, a history fibrosis was found in 8 patients (57%). In 19 patients without a history of ACR, fibrosis was found in 9 patients (47%). Anti-HLA antibodies were found in 47% of patients with fibrosis and in only 18.75% of patients without fibrosis. Among 3 patients with signs of antibody-mediated rejection, all had fibrosis in the graft 2 years after transplantation. We did not find any patient with chronic rejection or ductopenia.
CONCLUSIONS: We suggest that there is a correlation between ACR and development of graft fibrosis present in liver grafts from recipients with normal liver biochemistry. Anti-HLA antibodies class II seems to be most important in development of fibrosis.
Keywords: Child, Fibrosis, Liver Transplantation
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