Banff schema for grading liver allograft rejection: Utility in clinical practice

Ormonde, Donald; Boer, W. Bastiaan de; Kierath, Anthony; Bell, Roger; Shilkin, K. B.; House, A. K.; Jeffrey, Gary P.; Reed, W. D.

doi:10.1002/lt.500050418

Cited by 117 publications

(74 citation statements)

References 21 publications

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“…Patients who did not develop rejection were classified as operationally tolerant as long as immunosuppressive drug cessation was maintained for at least 12 months and no histopathologic evidence of acute and/or chronic rejection were observed. Rejection was diagnosed by the combination of allograft dysfunction and characteristic liver biopsy findings according to Banff criteria (47). Of the 102 recipients participating in the trial, 75 from whom baseline liver samples had been cryopreserved were included in the current study.…”

Section: Methodsmentioning

confidence: 99%

Intra-graft expression of genes involved in iron homeostasis predicts the development of operational tolerance in human liver transplantation

Bohne

Martínez‐Llordella²,

Lozano³

et al. 2012

J. Clin. Invest.

187

209

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Following organ transplantation, lifelong immunosuppressive therapy is required to prevent the host immune system from destroying the allograft. This can cause severe side effects and increased recipient morbidity and mortality. Complete cessation of immunosuppressive drugs has been successfully accomplished in selected transplant recipients, providing proof of principle that operational allograft tolerance is attainable in clinical transplantation. The intra-graft molecular pathways associated with successful drug withdrawal, however, are not well defined. In this study, we analyzed sequential blood and liver tissue samples collected from liver transplant recipients enrolled in a prospective multicenter immunosuppressive drug withdrawal clinical trial. Before initiation of drug withdrawal, operationally tolerant and non-tolerant recipients differed in the intragraft expression of genes involved in the regulation of iron homeostasis. Furthermore, as compared with nontolerant recipients, operationally tolerant patients exhibited higher serum levels of hepcidin and ferritin and increased hepatocyte iron deposition. Finally, liver tissue gene expression measurements accurately predicted the outcome of immunosuppressive withdrawal in an independent set of patients. These results point to a critical role for iron metabolism in the regulation of intra-graft alloimmune responses in humans and provide a set of biomarkers to conduct drug-weaning trials in liver transplantation.

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Section: Methodsmentioning

confidence: 99%

Intra-graft expression of genes involved in iron homeostasis predicts the development of operational tolerance in human liver transplantation

Bohne

Martínez‐Llordella²,

Lozano³

et al. 2012

J. Clin. Invest.

187

209

View full text Add to dashboard Cite

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“…at the University of Miami who were blinded to the clinical information. ACR-labeled specimens were graded according to the Banff classification, [18][19][20] and the inflammatory grade and fibrosis stage for RHC were scored with the Histological activity index (HAI) system. 21 After the evaluation of these biopsy samples, prior to the gene profiling analysis, the investigators followed the patients and confirmed that those pathological diagnoses matched the clinical course of the patients.…”

Section: Histopathological Examination Of the Liver Biopsy Samplesmentioning

confidence: 99%

Differential transcriptome patterns for acute cellular rejection in recipients with recurrent hepatitis C after liver transplantation

et al. 2009

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Histopathological evaluation of the liver via biopsy remains the standard procedure for the diagnosis of both acute cellular rejection (ACR) and recurrent hepatitis C (RHC) after liver transplantation. Nevertheless, it is often difficult to diagnose ACR in hepatitis C virus–positive recipients because of changes in common and overlapping with RHC. The aim of this study was to identify potential target genes for ACR in recipients with RHC. We analyzed 22 liver biopsy samples obtained from 21 hepatitis C virus–positive recipients. The clinicopathological diagnosis based on biopsy examination was ACR‐predominant with superimposed RHC in 9 samples (ACR group) and RHC without ACR (non‐ACR group) in 13. Using oligonucleotide microarrays, we compared the transcriptional changes in the 2 groups and selected 2206 genes that were significantly modulated in ACR. We analyzed the regulatory networks in ACR with Ingenuity Pathway Analysis software, and we confirmed with quantitative real‐time polymerase chain reaction the reproducibility of caspase 8, apoptosis‐related cysteine peptidase and bone morphogenetic protein 2 up‐regulation in another group of validation samples, representing 2 genes from the core network as the target genes for ACR. Our results demonstrated novel transcriptome patterns for ACR with concurrent RHC that were distinct from those of recipients with only RHC, suggesting that gene expression profiling may be useful in the diagnosis of ACR in recipients with hepatitis C. Liver Transpl 15:1738–1749, 2009. © 2009 AASLD.

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“…Liver biopsy histology revealed mild portal inflammation and paucity of biliary ducts [13]. Immunohistochemistry for HBsAg and HBcAg on the liver specimen was negative.…”

Section: Case Reportmentioning

confidence: 98%

Successful pregnancy in a liver transplant recipient treated with lamivudine for de novo hepatitis B in the graft

Loreno

Senzolo

et al. 2004

Transplant Int

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Pregnancy is often successful after liver transplantation, despite the potentially toxic effects of immunosuppressive drug therapy. Liver transplant recipients with recurrent hepatitis C or hepatitis B nonetheless appear to be at risk of a worse graft function in the event of pregnancy, and antiviral drugs are generally contraindicated in pregnancy because of their teratogenic effects. A 33-year-old woman had undergone liver transplantation for Caroli's disease 6 years previously. Two years later the patient experienced de novo HBV hepatitis. Lamivudine treatment (1 00 mg/day) was started and clearance of HBsAg was documented 1 year later. Four years after starting antiviral treatmeht the patient became pregnant, despite of the risk of teratogenic

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Banff schema for grading liver allograft rejection: Utility in clinical practice

Cited by 117 publications

References 21 publications

Intra-graft expression of genes involved in iron homeostasis predicts the development of operational tolerance in human liver transplantation

Intra-graft expression of genes involved in iron homeostasis predicts the development of operational tolerance in human liver transplantation

Differential transcriptome patterns for acute cellular rejection in recipients with recurrent hepatitis C after liver transplantation

Successful pregnancy in a liver transplant recipient treated with lamivudine for de novo hepatitis B in the graft

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