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Using an immune functional assay to differentiate acute cellular rejection from recurrent hepatitis C in liver transplant patients.

Abstract
In transplant recipients transplanted for hepatitis C, presentation of abnormal transaminases can herald the presentation of recurrent hepatitis C, cellular rejection, or both. Given the sometimes ambiguous histology with these 2 entities, the ability to distinguish them is of great importance because misinterpretation can potentially affect graft survival. We used an immune functional assay to help assess the etiology of abnormal liver function test results in liver transplant recipients. Blood samples for the immune functional assay were taken from 42 recipients prospectively at various times post-transplant and compared with clinical and histologic findings. In patients whose liver biopsy showed evidence of cellular rejection, the immune response was noted to be very high, whereas in those with active recurrence of hepatitis C, the immune response was found to be very low. This finding was found to be statistically significant (P < 0.0001). In those patients in whom there was no predominant histologic features suggesting 1 entity over the other, the immune response was higher than in those with aggressive hepatitis C but lower than in those with cellular rejection. In conclusion, these data show the potential utility of the ImmuKnow assay as a means of distinguishing hepatitis C from cellular rejection and its potential usefulness as a marker for outlining the progression of hepatitis C.
AuthorsRoniel Cabrera, Miguel Ararat, Consuelo Soldevila-Pico, Lisa Dixon, Jen-Jung Pan, Roberto Firpi, Victor Machicao, Cynthia Levy, David Nelson, Giuseppe Morelli
JournalLiver transplantation : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society (Liver Transpl) Vol. 15 Issue 2 Pg. 216-22 (Feb 2009) ISSN: 1527-6473 [Electronic] United States
PMID19177434 (Publication Type: Comparative Study, Journal Article)
Copyright(c) 2009 AASLD.
Topics
  • Adult
  • Aged
  • Diagnosis, Differential
  • Female
  • Graft Rejection (immunology, pathology)
  • Graft Survival
  • Hepatitis C (immunology, pathology)
  • Humans
  • Liver Function Tests
  • Liver Transplantation
  • Male
  • Middle Aged
  • Prospective Studies
  • Recurrence
  • Severity of Illness Index

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