title: c-Kit-positive mast cells in portal tracts cannot be used to distinguish acute cellular rejection from recurrent hepatitis C infection in liver allografts.
abstract: Cirrhosis secondary to chronic hepatitis C virus (HCV) is the most common indication for liver transplantation. Recurrence of HCV infection in the liver allograft occurs at a high rate. The differentiation of recurrent HCV infection from acute cellular rejection (ACR) represents a difficult challenge in transplantation pathology. The c-Kit receptor is a tyrosine kinase membrane protein encoded by the c-Kit proto-oncogene, which is expressed on mast cells and on hematopoietic stem and progenitor cells. Mast cells are important effector cells of a broad range of immune responses. Recently, c-Kit+ mast cells were shown to form part of the inflammatory infiltrate in acute liver allograft rejection. A strong relationship was found between c-Kit+ cell densities and increasingly severe rejection. The present study sought to determine whether the presence of c-Kit+ cells could be used to distinguish between ACR and recurrent HCV in liver allografts. Immunohistochemical staining for c-Kit was performed on 20 transplant biopsy specimens from 10 patients with mild to moderate ACR and 10 other patients with recurrent hepatitis C. The number of c-Kit+ cells per portal tract varied with the density of the overall inflammatory infiltrate. There was no significant difference between the number of c-Kit+ cells in the biopsy specimens that carried a diagnosis of ACR and those from patients who had been diagnosed as having recurrent HCV. It was concluded that immunohistochemical staining for the presence of c-Kit+ mast cells cannot be used to differentiate between ACR and recurrent HCV infection in liver allograft biopsy specimens.
authors.affiliation: Department of Transplant Surgery Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA. cataldo.doria@jefferson.edu
authors.forename: C
authors.initials: C
authors.lastname: Doria
authors.forename: F
authors.initials: F
authors.lastname: di Francesco
authors.forename: I R
authors.initials: IR
authors.lastname: Marino
authors.forename: C B
authors.initials: CB
authors.lastname: Ramirez
authors.forename: A
authors.initials: A
authors.lastname: Frank
authors.forename: M
authors.initials: M
authors.lastname: Iaria
authors.forename: S A
authors.initials: SA
authors.lastname: Galati
authors.forename: J L
authors.initials: JL
authors.lastname: Farber
mesh_terms: D001706:Biopsy; D006084:Graft Rejection / Q000175:diagnosis*; D006526:Hepatitis C / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery*; D006801:Humans; D016031:Liver Transplantation / Q000276:immunology / Q000473:pathology / Q000502:physiology*; D008407:Mast Cells / Q000473:pathology*; D011168:Portal System; D000090063:Proto-Oncogene Mas; D019009:Proto-Oncogene Proteins c-kit / Q000032:analysis*; D012008:Recurrence; D012189:Retrospective Studies; D014184:Transplantation, Homologous
chemical_list: C000715470:MAS1 protein, human; D000090063:Proto-Oncogene Mas; D019009:Proto-Oncogene Proteins c-kit