Quantification of C4d deposition and hepatitis C virus RNA in tissue in cases of graft rejection and hepatitis C recurrence after liver transplantation.
Histology is the gold standard for diagnosing acute rejection and hepatitis C recurrence after liver transplantation. However, differential diagnosis between the two can be difficult. We evaluated the role of C4d staining and quantification of hepatitis C virus (HCV) RNA levels in liver tissue. This was a retrospective study of 98 liver biopsy samples divided into four groups by histological diagnosis: acute rejection in patients undergoing liver transplant for hepatitis C (RejHCV+), HCV recurrence in patients undergoing liver transplant for hepatitis C (HCVTx+), acute rejection in patients undergoing liver transplant for reasons other than hepatitis C and chronic hepatitis C not transplanted (HCVTx-). All samples were submitted for immunohistochemical staining for C4d and HCV RNA quantification. Immunoexpression of C4d was observed in the portal vessels and was highest in the HCVTx- group. There was no difference in C4d expression between the RejHCV+ and HCVTx+ groups. However, tissue HCV RNA levels were higher in the HCVTx+ group samples than in the RejHCV+ group samples. Additionally, there was a significant correlation between tissue and serum levels of HCV RNA. The quantification of HCV RNA in liver tissue might prove to be an efficient diagnostic test for the recurrence of HCV infection.
Divisão de Transplante de Fígado e Órgãos do Aparelho Digestivo, Universidade de São Paulo.
Alice Tung Wan
AT
Song
Departamento de Patologia, Universidade de São Paulo.
Evandro Sobroza de
ES
Mello
Departamento de Patologia, Universidade de São Paulo.
Venâncio Avancini Ferreira
VA
Alves
Laboratório de Hepatites Virais - LIM 47, Universidade de São Paulo.
Norma de Paula
Nde P
Cavalheiro
Laboratório de Hepatites Virais - LIM 47, Universidade de São Paulo.
Carlos Eduardo
CE
Melo
Divisão de Transplante de Fígado e Órgãos do Aparelho Digestivo, Universidade de São Paulo.
Patricia Rodrigues
PR
Bonazzi
Laboratório de Hepatites Virais - LIM 47, Universidade de São Paulo.
Fatima Mitiko
FM
Tengan
Hospital das Clínicas, Universidade de São Paulo, SP, Brasil.
Maristela Pinheiro
MP
Freire
Laboratório de Hepatites Virais - LIM 47, Universidade de São Paulo.
Antonio Alci
AA
Barone
Divisão de Transplante de Fígado e Órgãos do Aparelho Digestivo, Universidade de São Paulo.
Luiz Augusto Carneiro
LA
D'Albuquerque
Divisão de Transplante de Fígado e Órgãos do Aparelho Digestivo, Universidade de São Paulo.
Edson
E
Abdala
D000293:Adolescent; D000328:Adult; D000368:Aged; D001706:Biopsy; D015935:Complement C4b / Q000032:analysis*; D003937:Diagnosis, Differential; D005260:Female; D006084:Graft Rejection / Q000276:immunology* / Q000473:pathology / Q000821:virology*; D016174:Hepacivirus / Q000235:genetics / Q000302:isolation & purification*; D006526:Hepatitis C / Q000276:immunology* / Q000473:pathology / Q000821:virology*; D006801:Humans; D007150:Immunohistochemistry; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D010446:Peptide Fragments / Q000032:analysis*; D011237:Predictive Value of Tests; D012367:RNA, Viral / Q000302:isolation & purification*; D012008:Recurrence; D012189:Retrospective Studies; D012720:Severity of Illness Index; D055815:Young Adult
D010446:Peptide Fragments; D012367:RNA, Viral; D015935:Complement C4b; C032261:complement C4d