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A clinicopathological study of human liver allograft recipients harboring preformed IgG lymphocytotoxic antibodies

Demetris, AJ and Nakamura, K and Yagihashi, A and Iwaki, Y and Takaya, S and Hartman, GG and Murase, N and Bronsther, O and Manez, R and Fung, JJ and Iwatsuki, S and Starzl, TE (1992) A clinicopathological study of human liver allograft recipients harboring preformed IgG lymphocytotoxic antibodies. Hepatology, 16 (3). 671 - 681. ISSN 0270-9139

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Twenty‐six adult patients with preformed IgG donor lymphocytotoxic antibodies received primary liver allografts under FK 506 immunosuppression. The effect of the crossmatch‐positive state on early graft function and on the immunopathological and histopathological findings was compared with that of 52 crossmatch‐negative control recipients. The presensitized (crossmatch‐positive) patients had prolongation of early graft dysfunction, underwent more clinically indicated biopsies and had a higher incidence of cellular rejection, both overall (p < 0.05) and within 10 days of transplantation (p < 0.01). They also had a higher incidence of graft failure in the first 180 days (p < 0.01). Hyperacute rejection with necrotizing or neutrophilic arteritis was not seen in the crossmatchpositive grafts. However, histological findings associated with presensitization included platelet margination in central veins and sinusoids in biopsy specimens 60 to 90 min after graft revascularization. Later biopsy specimens had neutrophilic portal venulitis followed by cholangiolar proliferation, acute cholangiolitis and centrilobular hepatocyte swelling that mimicked preservation injury, endothelial activation of arteries with medial changes and relapsing episodes of acute cellular rejection. These clinicopathological observations suggest that lymphocytotoxic antibodies can have a deleterious effect on liver allograft function and survival, even if they do not precipitate immediate or hyperacute rejection. (HEPATOLOGY 1992;16:671–681.) Copyright © 1992 American Association for the Study of Liver Diseases


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Item Type: Article
Status: Published
CreatorsEmailPitt UsernameORCID
Demetris, AJ
Nakamura, K
Yagihashi, A
Iwaki, Y
Takaya, S
Hartman, GG
Murase, N
Bronsther, O
Manez, R
Fung, JJ
Iwatsuki, S
Starzl, TEtes11@pitt.eduTES11
Centers: Other Centers, Institutes, Offices, or Units > Thomas E. Starzl Transplantation Institute
Date: 1 January 1992
Date Type: Publication
Journal or Publication Title: Hepatology
Volume: 16
Number: 3
Page Range: 671 - 681
DOI or Unique Handle: 10.1002/hep.1840160310
Institution: University of Pittsburgh
Refereed: Yes
ISSN: 0270-9139
Other ID: uls-drl:31735062112754, Starzl CV No. 1484
Date Deposited: 08 Apr 2010 17:25
Last Modified: 27 Jan 2019 02:55


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