ELISA-based detection of C4d after liver transplantation — A helpful tool for differential diagnosis between acute rejection and HCV-recurrence?

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• 作者：Maximilian Schmeding ; Stefan Kienlein ; Christoph Rö ; cken ; Ruth Neuhaus ; Peter Neuhaus ; Christoph Heidenhain ; Ulf P. Neumann
• 关键词：C4d ; ELISA ; Rejection ; Hepatitis-C ; Reinfection ; Differential diagnosis ; Liver transplantation
• 刊名：Transplant Immunology
• 出版年：2010
• 出版时间：August 2010
• 年：2010
• 卷：23
• 期：4
• 页码：156-160
• 全文大小：161 K

文摘

Hepatitis-C is the most common indication for liver transplantation. Recurrence of HCV is universal leading to graft failure in up to 40 % of all patients. The differentiation between acute rejection and recurrent hepatitis-C is crucial as rejection treatments are likely to aggravate HCV-recurrence. Histological examination of liver biopsy remains the gold standard for diagnosis of acute rejection but has failed in the past to distinguish between acute rejection and recurrent hepatitis-C.

In a retrospective study we have recently reported that C4d as a marker of the activated complement cascade is detectable in a hepatic specimen in acute rejection after liver transplantation and may serve as a valuable tool in differential diagnosis between ACR and HCV-recurrence.

We performed a prospective analysis by ELISA measurement of C4d concentration in cryo-preserved liver biopsies of LTX patients who had either experienced acute rejection, hepatitis-C recurrence or displayed no pathological alterations (controls).

Opposed to our immunohistologically based findings in paraffinized tissue we were unable to detect significant differences of C4d concentration in ELISA of cryo-preserved liver tissue.

Consequently the role and potential value of C4d as a diagnostic marker may not be determined using ELISA-based tissue evaluation.