| Budget Amount *help |
¥1,100,000 (Direct Cost: ¥1,100,000)
Fiscal Year 2006: ¥400,000 (Direct Cost: ¥400,000)
Fiscal Year 2005: ¥700,000 (Direct Cost: ¥700,000)
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| Research Abstract |
Analysis of intrahepatic bile ducts and bile ductules are useful for diagnosis of various liver injuries. Few studies have been performed, however, on changes of the bile ductules in liver allograft biopsies. Our aims were to study the way of qualitative and quantitative assessment of bile ductular reactions after liver transplantation and to find useful immunohistochemical markers for histological diagnosis of liver diseases with ductular reactions. The three main results of our study were as follows:
1.Reinfection of hepatitis C virus is almost universal after liver transplantation for hepatitis C cirrhosis. Recurrent hepatitis C is sometimes associated severe cholestasis, which can be difficult for clinicians to differentiate from severe rejection. We found that evaluation of ductular reaction with cytokeratin 7 immunostaining was useful to differentiate recurrent hepatitis C from septic cholangitis or allograft rejection.
2.Some pediatric patients can achieve complete withdrawal of Immunosuppression several years after liver transplantation without having liver dysfunction. Histological evaluation of liver biopsies with clinical tolerance did not reveal typical features of chronic rejection, but cytokeratin 7 immunostaining showed a tendency toward bile duct atrophy and ductular proliferation, which can be a sign of indolent allograft damage.
3.Antibody-mediated rejection is rare in liver transplantation but can cause severe allograft damage. Unlike acute cellular rejection and chronic rejection, antibody-mediated rejection shows ductular reaction similar to cholangitis caused by sepsis or hepatic artery thrombosis. We demonstrated that immunohistochemisty of C4d, a complement degradation product, can be a useful marker of antibody-mediated rejection in liver transplantation.
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