Email updates

Keep up to date with the latest news and content from Diagnostic Pathology and BioMed Central.

Open Access Research

Local distribution analysis of cytotoxic molecules in liver allograft is helpful for the diagnosis of acute cellular rejection after orthotopic liver transplantation

Long Cheng12, Fuzhou Tian2, Lijun Tang2, Shuguang Wang3, Geng Chen3, Guangjie Duan1 and Xiaochu Yan1*

Author Affiliations

1 Institute of Pathology, Southwest Hospital, Third Military Medical University, Chongqing, 400038, China

2 Department of General Surgery, General Hospital of Chengdu Military Command, Chengdu, 610083, China

3 Institute of Hepatobiliary Surgery, Southwest Hospital, Third Military Medical University, Chongqing, 400038, China

For all author emails, please log on.

Diagnostic Pathology 2012, 7:148  doi:10.1186/1746-1596-7-148

Published: 30 October 2012

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.

Virtual slides

The virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/2292255038100487 webcite

Keywords:
Liver transplantation; Acute cellular rejection (ACR); Rejection activity index (RAI); Perforin; Granzyme B; T-cell intracellular antigen-1