title: Immunological factors and liver fibrosis in pediatric liver transplant recipients.
abstract: BACKGROUND
  The aim of our study was to retrospectively assess any correlation between graft fibrosis and selected immunological factors in pediatric liver transplant recipients.
  
  
  METHODS
  The study was performed on 33 patients after living related donor transplantation, divided into 2 groups depending on history of acute rejection episodes after transplantation. We assessed liver biopsies for presence of fibrosis, signs of antibody-mediated rejection, inflammatory infiltrations, and changes in bile ducts. We correlated these findings with assessment of anti-HLA antibodies.
  
  
  RESULTS
  Among 14 patients with ACR, a history fibrosis was found in 8 patients (57%). In 19 patients without a history of ACR, fibrosis was found in 9 patients (47%). Anti-HLA antibodies were found in 47% of patients with fibrosis and in only 18.75% of patients without fibrosis. Among 3 patients with signs of antibody-mediated rejection, all had fibrosis in the graft 2 years after transplantation. We did not find any patient with chronic rejection or ductopenia.
  
  
  CONCLUSIONS
  We suggest that there is a correlation between ACR and development of graft fibrosis present in liver grafts from recipients with normal liver biochemistry. Anti-HLA antibodies class II seems to be most important in development of fibrosis.
authors.affiliation: Department of Pediatric Surgery and Organ Transplantation, Children's Memorial Health Institute, Warsaw, Poland.
authors.forename: Małgorzata
authors.initials: M
authors.lastname: Markiewicz-Kijewska
authors.affiliation: Department of Pediatric Surgery and Organ Transplantation, Children's Memorial Health Institute, Warsaw, Poland.
authors.forename: Piotr
authors.initials: P
authors.lastname: Kaliciński
authors.affiliation: Department of Pathology, Children's Memorial Health Institute, Warsaw, Poland.
authors.forename: Przemysław
authors.initials: P
authors.lastname: Kluge
authors.affiliation: Histocompatibility Laboratory, Children's Memorial Health Institute, Warsaw, Poland.
authors.forename: Barbara
authors.initials: B
authors.lastname: Piątosa
authors.affiliation: Department of Gastroenterology, Hepatology and Feeding Disorder, Children's Memorial Health Institute, Warsaw, Poland.
authors.forename: Irena
authors.initials: I
authors.lastname: Jankowska
authors.affiliation: Histocompatibility Laboratory, Children's Memorial Health Institute, Warsaw, Poland.
authors.forename: Aneta
authors.initials: A
authors.lastname: Rękawek
authors.affiliation: Histocompatibility Laboratory, Children's Memorial Health Institute, Warsaw, Poland.
authors.forename: Ewa
authors.initials: E
authors.lastname: Kostecka
authors.affiliation: Histocompatibility Laboratory, Children's Memorial Health Institute, Warsaw, Poland.
authors.forename: Przemysław N
authors.initials: PN
authors.lastname: Kurowski
mesh_terms: D001323:Autoantibodies; D002648:Child; D002675:Child, Preschool; D005260:Female; D006084:Graft Rejection / Q000276:immunology / Q000473:pathology*; D006680:HLA Antigens / Q000276:immunology*; D006801:Humans; D007223:Infant; D008099:Liver / Q000276:immunology / Q000473:pathology*; D008103:Liver Cirrhosis / Q000276:immunology / Q000473:pathology*; D016031:Liver Transplantation; D019520:Living Donors; D008297:Male; D012189:Retrospective Studies
chemical_list: D001323:Autoantibodies; D006680:HLA Antigens