title: Portal capillary C4d deposits and increased infiltration by macrophages indicate humorally mediated mechanisms in acute cellular liver allograft rejection.
abstract: Almost no data exist concerning the role of antibody-mediated mechanisms in human acute cellular liver allograft rejection (ACR). Therefore, the aim of this study was to determine whether ACR is associated with depositions of complement split products and increased infiltration by B-lymphocytes, plasma cells and macrophages. A total of 35 liver biopsy specimens (ACR n=22, controls n=13) were analyzed by immunohistochemical single and double staining. The average numbers of CD 20(+), CD 38(+) and CD 68(+) cells per portal tract were established while the presence of C4d and C3d deposits was evaluated semiquantitatively. Significantly greater numbers of CD 20(+) (P=0.029) and CD 38(+) (P=0.014) cells were found in the ACR specimens than in the control specimens. Additionally, 50% of patients diagnosed with ACR showed C4d deposits along portal capillaries, which was associated with a significantly increased portal infiltration by macrophages (P=0.007). Taken together these results support the involvement of humorally mediated mechanisms in some cases of ACR.
authors.affiliation: Institute of Pathology, University Hospital Charité, Humboldt-University, Schumannstrasse 20/21, 10117 Berlin, Germany.
authors.forename: Anja
authors.initials: A
authors.lastname: Dankof
authors.forename: Maximilian
authors.initials: M
authors.lastname: Schmeding
authors.forename: Lars
authors.initials: L
authors.lastname: Morawietz
authors.forename: Raphaela
authors.initials: R
authors.lastname: Günther
authors.forename: Manfred G
authors.initials: MG
authors.lastname: Krukemeyer
authors.forename: Birgit
authors.initials: B
authors.lastname: Rudolph
authors.forename: Martin
authors.initials: M
authors.lastname: Koch
authors.forename: Veit
authors.initials: V
authors.lastname: Krenn
authors.forename: Ulf
authors.initials: U
authors.lastname: Neumann
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D002196:Capillaries / Q000276:immunology / Q000473:pathology; D002452:Cell Count; D003167:Complement Activation / Q000276:immunology*; D015935:Complement C4b / Q000276:immunology*; D005260:Female; D006084:Graft Rejection / Q000276:immunology* / Q000473:pathology; D006801:Humans; D007111:Immunity, Cellular / Q000502:physiology; D007150:Immunohistochemistry; D016031:Liver Transplantation / Q000276:immunology*; D008264:Macrophages / Q000276:immunology* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D010446:Peptide Fragments / Q000276:immunology*; D011168:Portal System / Q000276:immunology* / Q000473:pathology
chemical_list: D010446:Peptide Fragments; D015935:Complement C4b; C032261:complement C4d