| Heterogeneous inflammatory changes in liver graft recipients with normal biochemistry. | |
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MedLine Citation:
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PMID: 20134396 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Patients with established liver grafts may receive excessive immune suppression. Liver biopsies were analyzed in those with normal liver biochemistry to identify parameters that might identify such cases. METHODS: Patients with established grafts (>3 years from engraftment) and normal liver biochemistry (normal alanine transaminase, alkaline phosphatase, and bilirubin) were invited to undergo liver biopsy. Liver tissue was assessed by routine histopathology, a modified Ishak score, and immunohistochemistry for lymphocyte and cell-cycle markers. Circulating and intrahepatic lymphocytes were subjected to flow cytometry. Data were subjected to principal component analysis. RESULTS: Two hundred twenty-five (40%) patients under regular review had an established graft with normal liver biochemistry; liver tissue was obtained in 55. Liver histology was normal in eight cases (14.5%). The most common abnormalities were mild nonspecific hepatitis in 25 (45.4%) and disease recurrence in 14 (25.4%). Principal component analysis identified a cluster of variables that accounted for a significant degree of variation within the dataset. These were lobular inflammation, portal inflammation, interface hepatitis, and fibrosis. CONCLUSIONS: Inflammation persisted in established grafted livers in most patients with normal liver biochemistry. Systematic histological and lymphocyte phenotype analysis generated an index that distinguished patient groups. Those with least inflammation and the lowest alanine transaminase may have a reduced requirement for immune suppression. |
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Authors:
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William Gelson; Matthew Hoare; Esther Unitt; Christopher Palmer; Paul Gibbs; Nicholas Coleman; Susan Davies; Graeme J M Alexander |
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Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Transplantation Volume: 89 ISSN: 1534-6080 ISO Abbreviation: Transplantation Publication Date: 2010 Mar |
Date Detail:
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Created Date: 2010-03-23 Completed Date: 2010-04-08 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0132144 Medline TA: Transplantation Country: United States |
Other Details:
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Languages: eng Pagination: 739-48 Citation Subset: IM |
Affiliation:
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Department of Medicine, University of Cambridge, Cambridge, United Kingdom. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Alanine Transaminase / blood Alkaline Phosphatase / blood Bilirubin / blood Biological Markers / metabolism Biopsy Cell Cycle Proteins / metabolism Cell Proliferation Female Flow Cytometry Hepatitis / blood, etiology*, pathology Humans Immunohistochemistry Immunosuppressive Agents / administration & dosage* Inflammation Mediators / metabolism Liver Cirrhosis / blood, etiology*, pathology Liver Transplantation / adverse effects* Lymphocytes / metabolism, pathology Male Middle Aged Principal Component Analysis Severity of Illness Index Time Factors Transplantation, Homologous Treatment Outcome |
| Grant Support | |
ID/Acronym/Agency:
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//Wellcome Trust |
| Chemical | |
Reg. No./Substance:
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0/Biological Markers; 0/Cell Cycle Proteins; 0/Immunosuppressive Agents; 0/Inflammation Mediators; 635-65-4/Bilirubin; EC 2.6.1.2/Alanine Transaminase; EC 3.1.3.1/Alkaline Phosphatase |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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