title: Acute cellular rejection monitoring after intestinal transplant: utility of serologic markers and zoom videoendoscopy as support of conventional biopsy and clinical findings.
abstract: Acute cellular rejection (ACR) episodes in intestinal transplant recipients are diagnosed by histologic and clinical findings. We have applied zoom video endoscopy and the use of serologic markers granzyme B (GrB) and perforin (PrF) to monitor rejection together with conventional tools. Seven hundred eighty-two blood samples (obtained at the time of the biopsy) collected from 34 recipients for GrB/PrF upregulation were positive among 64.9% of ACRs during a 3-year follow-up. Considering only the first year results posttransplantation, it reached 73.1% of rejection events. Zoom videoendoscopy was used by our group in 29 recipients of isolated intestine (n = 24) or multivisceral transplantations (n = 5) to enable observation of villi and crypt areas. From more than 270 procedures, 84% of the zoom findings agreed with the histologic results, namely, a specificity of 95%. In fact, during ongoing ACR, villi were altered in 80% of cases. Both procedures were helpful to support conventional histologic findings and clinical symptoms of ACR in intestinal transplant recipients.
authors.affiliation: Liver and Multiorgan Transplant Unit, St.Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy. augustola@yahoo.com
authors.forename: A
authors.initials: A
authors.lastname: Lauro
authors.forename: A
authors.initials: A
authors.lastname: Altimari
authors.forename: M
authors.initials: M
authors.lastname: Di Simone
authors.forename: A
authors.initials: A
authors.lastname: Dazzi
authors.forename: M
authors.initials: M
authors.lastname: Cescon
authors.forename: C
authors.initials: C
authors.lastname: Zanfi
authors.forename: Z
authors.initials: Z
authors.lastname: Miklosova
authors.forename: B
authors.initials: B
authors.lastname: Corti
authors.forename: E
authors.initials: E
authors.lastname: Gruppioni
authors.forename: A
authors.initials: A
authors.lastname: D'Errico
authors.forename: N
authors.initials: N
authors.lastname: Cautero
authors.forename: G
authors.initials: G
authors.lastname: Giustozzi
authors.forename: L
authors.initials: L
authors.lastname: Ansaloni
authors.forename: G
authors.initials: G
authors.lastname: Ramacciato
authors.forename: S
authors.initials: S
authors.lastname: Gruttadauria
authors.forename: G
authors.initials: G
authors.lastname: Gruttadauria
authors.forename: A D
authors.initials: AD
authors.lastname: Pinna
mesh_terms: D000208:Acute Disease; D001706:Biopsy; D004724:Endoscopy; D006084:Graft Rejection / Q000276:immunology / Q000473:pathology*; D053804:Granzymes / Q000097:blood; D006801:Humans; D007111:Immunity, Cellular; D007422:Intestines / Q000637:transplantation*; D018715:Microscopy, Video; D015166:Monitoring, Immunologic / Q000379:methods; D008991:Monitoring, Physiologic; D054353:Perforin / Q000097:blood
chemical_list: D054353:Perforin; D053804:Granzymes