title: Humoral immunity is involved in the development of pericentral fibrosis after pediatric live donor liver transplantation.
abstract: Although LT can be successful for treating end-stage liver disease in children, some patients develop fibrosis around the central vein area (PCF). This raises the possibility that PCF could lead to later cirrhosis and graft failure. Here, we report a retrospective immunohistochemical study of 28 patients who received a live donor liver transplant. We assessed the incidence and etiology of PCF using CD3, CD20, HLA-DR, and C4d-specific antibodies. Histological evidence of PCF was found in 13 cases (46.4%), of which 11 (84.6%) had experienced ACR and/or CP events post-transplant. Immunohistochemical evaluation revealed significantly stronger staining with these antibodies in the central vein area in PCF, especially for CD20 and C4d. This implies humoral immunopathology and suggests involvement of humoral immunity in the development of PCF. These results further imply that suppression of cellular immunity alone is insufficient to prevent PCF. We therefore suggest that suppression of both humoral and cellular immunity in combination would be required for prevention of PCF.
authors.affiliation: Department of Pediatrics, Osaka University Graduate School of Medicine, Osaka, Japan.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Yamada
authors.forename: Hiroki
authors.initials: H
authors.lastname: Kondou
authors.forename: Takeshi
authors.initials: T
authors.lastname: Kimura
authors.forename: Kayo
authors.initials: K
authors.lastname: Ikeda
authors.forename: Makiko
authors.initials: M
authors.lastname: Tachibana
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Hasegawa
authors.forename: Yuki
authors.initials: Y
authors.lastname: Kiyohara
authors.forename: Takehisa
authors.initials: T
authors.lastname: Ueno
authors.forename: Yoko
authors.initials: Y
authors.lastname: Miyoshi
authors.forename: Sotaro
authors.initials: S
authors.lastname: Mushiake
authors.forename: Keiichi
authors.initials: K
authors.lastname: Ozono
mesh_terms: D000293:Adolescent; D000328:Adult; D018951:Antigens, CD20 / Q000096:biosynthesis; D017252:CD3 Complex / Q000096:biosynthesis; D002648:Child; D002675:Child, Preschool; D015935:Complement C4b / Q000096:biosynthesis; D005260:Female; D005355:Fibrosis / Q000473:pathology*; D006684:HLA-DR Antigens / Q000378:metabolism; D006801:Humans; D007111:Immunity, Cellular; D056724:Immunity, Humoral / Q000502:physiology*; D007150:Immunohistochemistry / Q000379:methods; D007223:Infant; D016031:Liver Transplantation / Q000009:adverse effects / Q000379:methods*; D019520:Living Donors; D008297:Male; D010446:Peptide Fragments / Q000096:biosynthesis; D055815:Young Adult
chemical_list: D018951:Antigens, CD20; D017252:CD3 Complex; D006684:HLA-DR Antigens; D010446:Peptide Fragments; D015935:Complement C4b; C032261:complement C4d