ELISA-based detection of C4d after liver transplantation--a helpful tool for differential diagnosis between acute rejection and HCV-recurrence?
Hepatitis-C is the most common indication for liver transplantation. Recurrence of HCV is universal leading to graft failure in up to 40% of all patients. The differentiation between acute rejection and recurrent hepatitis-C is crucial as rejection treatments are likely to aggravate HCV-recurrence. Histological examination of liver biopsy remains the gold standard for diagnosis of acute rejection but has failed in the past to distinguish between acute rejection and recurrent hepatitis-C. In a retrospective study we have recently reported that C4d as a marker of the activated complement cascade is detectable in a hepatic specimen in acute rejection after liver transplantation and may serve as a valuable tool in differential diagnosis between ACR and HCV-recurrence. We performed a prospective analysis by ELISA measurement of C4d concentration in cryo-preserved liver biopsies of LTX patients who had either experienced acute rejection, hepatitis-C recurrence or displayed no pathological alterations (controls). Opposed to our immunohistologically based findings in paraffinized tissue we were unable to detect significant differences of C4d concentration in ELISA of cryo-preserved liver tissue. Consequently the role and potential value of C4d as a diagnostic marker may not be determined using ELISA-based tissue evaluation.
Schmeding
Maximilian
M
Department of General, Visceral and Transplantation Surgery, Charité Campus Virchow Klinikum, Berlin, Germany. maximilian.schmeding@charite.de
Kienlein
Stefan
S
Röcken
Christoph
C
Neuhaus
Ruth
R
Neuhaus
Peter
P
Heidenhain
Christoph
C
Neumann
Ulf P
UP
D000208:Acute Disease; D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000378:metabolism; D015935:Complement C4b / Q000276:immunology / Q000378:metabolism; D003937:Diagnosis, Differential; D004797:Enzyme-Linked Immunosorbent Assay / Q000379:methods; D005260:Female; D006084:Graft Rejection / Q000175:diagnosis* / Q000276:immunology / Q000473:pathology / Q000503:physiopathology; D016174:Hepacivirus / Q000276:immunology* / Q000472:pathogenicity; D006526:Hepatitis C / Q000175:diagnosis* / Q000276:immunology / Q000473:pathology / Q000503:physiopathology; D006801:Humans; D008099:Liver / Q000276:immunology / Q000378:metabolism* / Q000473:pathology; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D010446:Peptide Fragments / Q000276:immunology / Q000378:metabolism; D012008:Recurrence; D012189:Retrospective Studies
D015415:Biomarkers; D010446:Peptide Fragments; D015935:Complement C4b; C032261:complement C4d