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C4d: a marker for hepatic transplant rejection
1Hôpital de Pontchaillou, Service des Maladies du Foie, CHU Pontchaillou, 35033 Rennes cedex, France. richard.lorho@chu-rennes.fr
Insights
C4d deposition in liver transplants can help distinguish acute rejection from hepatitis C recurrence. This finding supports C4d as a reliable biomarker for identifying liver transplant rejection.
Area of Science:
- Transplantation immunology
- Gastroenterology
- Pathology
Background:
- Acute rejection is a frequent complication following liver transplantation.
- Diagnosing rejection can be challenging with co-existing hepatitis C virus infection.
- C4d deposition in portal capillaries may differentiate rejection from hepatitis C recurrence.
Purpose of the Study:
- To investigate the utility of C4d deposition as a marker for hepatic allograft rejection.
- To determine if C4d presence aids in differentiating acute rejection from hepatitis C recurrence.
Main Methods:
- Retrospective analysis of 36 liver transplant biopsies from 34 patients.
- Biopsies were selected based on suspicion of rejection, hepatitis C recurrence, or routine follow-up.
- Immunohistochemical staining for C4d deposition in portal capillaries was performed.
Main Results:
- C4d expression was detected in 33% of acute rejection cases and 100% of chronic rejection cases.
- No C4d deposition was observed in recurrent hepatitis C infections without rejection.
- C4d presence correlated significantly with rejection status.
Conclusions:
- C4d deposition serves as a valuable marker for identifying acute and chronic rejection in liver allografts.
- C4d can aid clinicians in differentiating between liver transplant rejection and hepatitis C recurrence.
- These findings align with existing literature, reinforcing C4d's role in post-transplant liver assessment.
Background:
Acute rejection is still a common complication of hepatic transplantation. The diagnosis, based on the histological examination of the graft, may be difficult to confirm in the setting of combined hepatitis C virus infection. The presence of C4d in the portal capillaries could facilitate differentiation between acute rejection and relapsed hepatitis C. The deposit of C4d provides evidence of activation of humoral immunity. To attempt to confirm this hypothesis, we searched for the presence of C4d in posttransplant hepatic biopsies.
Methods:
Thirty-six biopsies from 34 patients were analyzed retrospectively. The samples had been requested for one of the following reasons: suspected rejection, relapsed hepatitis C infection, or systematic check-up 1 year after the transplant.
Results:
C4d expression was common in biopsies classified as acute rejection (33%) and chronic rejection (100%). C4d was never detected in the event of recurrent hepatitis C infection without rejection.
Conclusion:
These results, which are comparable to recently published data, give credence to the theory that C4d could be used as a marker for rejection following hepatic transplantation.
