title: Impact of Antibodies That React With Liver Tissue and Donor-Specific Anti-HLA Antibodies in Pediatric Idiopathic Posttransplantation Hepatitis.
abstract: The cause of late graft dysfunction has not been elucidated. Although an antibody-mediated reaction is suspected as a potential mechanism, the target antigens have not been clarified.
  
  
  
  To clarify the etiology of idiopathic posttransplantation hepatitis (IPTH), we simultaneously examined the presence of antibodies that react with liver tissue (ARLT) by means of indirect immunofluorescence staining, as well as the presence of donor-specific anti-human leukocyte antigen antibodies (HLA-DSA). A subanalysis of the IPTH group was also performed. Within the IPTH group, the correlation between ARLT titer and clinical data were analyzed.
  
  
  
  In the sera of patients with IPTH (30 patients), ARLT were found at a significantly higher frequency than in patients without IPTH (42 patients; P < 0.001). Moreover, the ARLT titer appeared to be correlated with the severity of hepatitis or hepatic injury. In contrast, the frequency of HLA-DSA was significantly lower in patients with IPTH than in patients without IPTH (P = 0.001).
  
  
  
  Our findings indicate that ARLT, and not HLA-DSA, profoundly influence the etiology of IPTH.
authors.affiliation: 1 Department of Surgery, Graduate School of Medicine, Kyoto University, Kyoto University Hospital, Kyoto, Japan. 2 Institute of Gastroenterology, Tokyo Women's Medical University, Shinjukuku, Tokyo, Japan. 3 Department of Transfusion Medicine and Cell Therapy, Kyoto University Hospital, Kyoto, Japan. 4 Department of Diagnostic Pathology, Kyoto University Hospital, Sakyo-ku Kyoto, Japan.
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Hirata
authors.forename: Atsushi
authors.initials: A
authors.lastname: Yoshizawa
authors.forename: Hiroto
authors.initials: H
authors.lastname: Egawa
authors.forename: Daisuke
authors.initials: D
authors.lastname: Ueda
authors.forename: Shinya
authors.initials: S
authors.lastname: Okamoto
authors.forename: Hideaki
authors.initials: H
authors.lastname: Okajima
authors.forename: Kimiko
authors.initials: K
authors.lastname: Yurugi
authors.forename: Rie
authors.initials: R
authors.lastname: Hishida
authors.forename: Hideyo
authors.initials: H
authors.lastname: Hirai
authors.forename: Aya
authors.initials: A
authors.lastname: Miyagawa-Hayashino
authors.forename: Taira
authors.initials: T
authors.lastname: Maekawa
authors.forename: Hironori
authors.initials: H
authors.lastname: Haga
authors.forename: Sinji
authors.initials: S
authors.lastname: Uemoto
mesh_terms: D000293:Adolescent; D000818:Animals; D001323:Autoantibodies / Q000097:blood*; D015415:Biomarkers / Q000097:blood; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006084:Graft Rejection / Q000276:immunology*; D006680:HLA Antigens / Q000276:immunology*; D006505:Hepatitis / Q000175:diagnosis / Q000276:immunology*; D006801:Humans; D007223:Infant; D007518:Isoantibodies / Q000097:blood*; D016031:Liver Transplantation; D008297:Male; D011183:Postoperative Complications / Q000175:diagnosis / Q000276:immunology*; D051381:Rats; D017208:Rats, Wistar
chemical_list: D001323:Autoantibodies; D015415:Biomarkers; D006680:HLA Antigens; D007518:Isoantibodies