title: Quantitative analysis of portal tract infiltrate allows for accurate determination of hepatic allograft rejection.
abstract: Changes in the qualitative character of the portal tract infiltrate of hepatic allografts can influence the diagnosis of acute rejection. Since qualitative data rely on subjective findings, the aim of this study was to perform a quantitative analysis of portal tract infiltrates to improve the accuracy of the diagnosis of acute rejection. A total of 431 serial hepatic biopsies in 58 consecutive adult patients were obtained. The average number of eosinophils, neutrophils, and lymphocytes in each portal tract were counted. The area of each portal tract was determined using an optical micrometer. Rejection was confirmed by an independent investigator using both clinical and histologic criteria. Using a backward stepwise logistic regression analysis, we found that eosinophils were the only variable predictive of rejection. Using this model, the probability of having rejection on a single biopsy can be determined with greater than 90% accuracy.
authors.affiliation: Rush Presbyterian St Lukes Medical Center, Chicago, Illinois 60612.
authors.forename: H
authors.initials: H
authors.lastname: Sankary
authors.forename: P
authors.initials: P
authors.lastname: Foster
authors.forename: K
authors.initials: K
authors.lastname: Novich
authors.forename: M
authors.initials: M
authors.lastname: Ashmann
authors.forename: A
authors.initials: A
authors.lastname: Bhattacharyya
authors.forename: J
authors.initials: J
authors.lastname: Coleman
authors.forename: J
authors.initials: J
authors.lastname: Williams
mesh_terms: D001706:Biopsy; D004804:Eosinophils / Q000473:pathology; D006084:Graft Rejection; D006801:Humans; D016031:Liver Transplantation; D008214:Lymphocytes / Q000473:pathology; D009504:Neutrophils / Q000473:pathology; D011168:Portal System / Q000473:pathology*