The Study On Description Of C4d, B Lymphocytes And Plasma Cells In Liver Allograft Rejection

Motive(objective) and significance of the study:Description of C4d, B lymphocytes and plasma cells in acute and chronic liver allograft rejection were detected to look for the related evidences of humoral rejection, to explore the substantial immunologic mechanism of acute and chronic liver allograft rejection, and to provide better methods for observation, diagnosis and therapy of the humoral liver allograft rejection. Method and technical line of the study:Immunohistochemical inspection of C4d, CD20~+B lymphocytes and CD138~+ plasma cells were performed in 34 liver biopsy specimens from 25 patients with hepatic injury. Then we compared the items as following:1,the change of C4d, CD20~+B lymphocytes and CD138~+ plasma cells in the liver biopsy specimens with acute and chronic liver allograft rejection, and with other pathologic diagnosis.2,the differience of C4d, CD20~+B lymphocytes and CD138~+ plasma cells with different degrees of hepatic injury.3,the presence of CD20~+B lymphocytes and CD138~+ plasma cells in liver biopsy specimens with C4d positive or negtive.4, the difficulties of clinical therapy with different presence of C4d, CD20~+B lymphocytes and CD138~+ plasma cells in the liver biopsy specimens. The results were as follows:CD20~+B lymphocytes were detected in a few pretransplant liver specimens (4/25, 16%). But C4d and CD138~+ plasma cells were not found in these specimens.There were C4d and CD20~+B lymphocytes in some liver biopsy specimens which haven't been diagnosed rejection. Therefore, CD138~+ plasma cells wasn't found in these biopsy specimens. The positive ratioes of C4d, CD20~+B lymphocytes and CD138~+ plasma cells in the acute rejection group were higher than in the non-rejection group( P=0.027, P=0.027 and P=0.005 ). The positive ratioes of C4d and CD20~+B lymphocytes in the chronic rejection group were also higher than in the non-rejection group ( P=0.046 and P=0.016) .There was no difference about CD20~+B lymphocytes between these two groups (P=0.134) . The degrees of hepatic injury couldn't influence the positive ratioes of C4d and CD138~+ plasma(P=0.447 and P=0.112) , but the positive ratioes of CD20~+B lymphocytes of heavy hepatic injury groups was higher than of slight hepatic injury groups( P=0. 012). And we found that CD20~+B lymphocytes and CD138~+ plasma cells were both related to C4d ( P=0.002 and P=0.027 ) . The effective power of steroid in the all-positive group lower than in the all-negative group ( P=0.014 ) . The conclusions we have drawn:1, Humoral immune maybe participate in some acute and chronic liver allograft rejection.2 It was more difficult to retrieve the liver allograft rejection when C4d, CD20~+B lymphocytes and CD138~+ plasma cells were all positive.3, It would be more favourable for observing and prewarming the hum oral rejection that C4d, CD20, CD38 and CD138 will be routinely immuno histochemical examined in liver biopsy specimens with hepatic injury after 1 iver transplantation. And It would be helpful for chooseing the therapeutic r egimen of liver allograft rejection.