title: Local distribution analysis of cytotoxic molecules in liver allograft is helpful for the diagnosis of acute cellular rejection after orthotopic liver transplantation.
abstract: BACKGROUND
  As it is often difficult for a transplant pathologist to make a definite diagnosis of acute cellular rejection (ACR) by routine morphological analysis of liver allograft biopsy, supplementary methods and objective markers are needed to facilitate this determination.
  
  
  METHODS
  To evaluate the diagnostic value of cytotoxic molecules in ACR episodes, immunohistochemical staining for perforin, granzyme B and T-cell intracellular antigen-1 (TIA-1) were performed in liver allograft biopsies. The positive cells in the portal tract area and lobules were counted separately to investigate the distribution of the cytotoxic molecules.
  
  
  RESULTS
  The immunohistochemical study showed that the overall positive rates for the three markers were not significantly different between the ACR and non-ACR groups. However, in the portal tract area, perforin-, granzyme B- and TIA-1-positive cells in the ACR group were significantly more than those in the non-ACR groups. In the lobules, perforin- and granzyme B-positive cells in the ACR group were significantly more than those in the biliary complication and opportunistic infection groups, while TIA-1-positive cells was significantly fewer than those in non-ACR groups. The numbers of positive cells in the portal tract area correlated with the rejection activity index of ACR.
  
  
  CONCLUSIONS
  These results indicate that, though the overall positive rates have nonsense in ACR diagnosis, the quantification and local distribution analysis of cytotoxic molecule positive cells in liver tissue is helpful for differential diagnosis and severity evaluation of ACR following liver transplantation.
  The virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/2292255038100487.
authors.affiliation: Institute of Pathology, Southwest Hospital, Third Military Medical University, Chongqing, 400038, China.
authors.forename: Long
authors.initials: L
authors.lastname: Cheng
authors.forename: Fuzhou
authors.initials: F
authors.lastname: Tian
authors.forename: Lijun
authors.initials: L
authors.lastname: Tang
authors.forename: Shuguang
authors.initials: S
authors.lastname: Wang
authors.forename: Geng
authors.initials: G
authors.lastname: Chen
authors.forename: Guangjie
authors.initials: G
authors.lastname: Duan
authors.forename: Xiaochu
authors.initials: X
authors.lastname: Yan
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000032:analysis; D001706:Biopsy; D003602:Cytotoxicity, Immunologic; D003937:Diagnosis, Differential; D005260:Female; D006084:Graft Rejection / Q000175:diagnosis* / Q000276:immunology / Q000473:pathology; D053804:Granzymes / Q000032:analysis*; D006801:Humans; D007111:Immunity, Cellular; D007150:Immunohistochemistry; D008099:Liver / Q000276:immunology* / Q000473:pathology; D016031:Liver Transplantation / Q000009:adverse effects / Q000276:immunology*; D008297:Male; D008875:Middle Aged; D054353:Perforin / Q000032:analysis*; D039102:Poly(A)-Binding Proteins / Q000032:analysis*; D011237:Predictive Value of Tests; D012720:Severity of Illness Index; D000074019:T-Cell Intracellular Antigen-1; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D015415:Biomarkers; D039102:Poly(A)-Binding Proteins; D000074019:T-Cell Intracellular Antigen-1; C071558:TIA1 protein, human; D054353:Perforin; C509213:GZMB protein, human; D053804:Granzymes