Histologic eosinophilia as an aid to diagnose acute cellular rejection after living donor liver transplantation

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Clinical Transplantation

Volume 21 Issue 2 Page 214 - March/April 2007

To cite this article: Yoji Kishi, Yasuhiko Sugawara, Sumihito Tamura, Junichi Kaneko, Yuichi Matsui, Masatoshi Makuuchi (2007) Histologic eosinophilia as an aid to diagnose acute cellular rejection after living donor liver transplantation Clinical Transplantation 21 (2), 214–218. doi:10.1111/j.1399-0012.2006.00625.x

Histologic eosinophilia as an aid to diagnose acute cellular rejection after living donor liver transplantation

Yasuhiko Sugawara MD, Artificial Organ and Transplantation Division, Department of Surgery, Graduate School of Medicine, University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan.Tel.: +81 3 3815 5411; fax: +81 3 5684 3989;e-mail: yasusuga-tky@...

: ACR, acute cellular rejection; AECb, absolute eosinophil count three d before biopsy; AECo, absolute eosinophil count on the day; Em, the maximum eosinophil counts per portal triad; Er, the rate of portal triads that included at least one eosinophil; LDLT, living donor liver transplantation.

Kishi Y, Sugawara Y, Tamura S, Kaneko J, Matsui Y, Makuuchi M. Histologic eosinophilia as an aid to diagnose acute cellular rejection after living donor liver transplantation.Clin Transplant 2007: 21: 214–218. © Blackwell Munksgaard, 2007

Abstract

Abstract: The significance of histologic eosinophilia in the diagnosis of acute cellular rejection (ACR) after living donor liver transplantation was evaluated. A retrospective analysis was performed on 185 liver biopsy specimens to determine the presence of eosinophil infiltration around the portal tracts. Data were collected and analyzed to determine whether there was a correlation between ACR and the maximum eosinophil counts per portal triad (Em) and the rate of portal triads that included at least one eosinophil (Er). A receiver operating characteristic curve revealed the best cut-off value of Em and Er as 2% and 8% respectively. The sensitivity and specificity of an Em of two to predict ACR were 54% and 84% respectively. The sensitivity and specificity of Er were 72% and 65% respectively. One-way analysis of variance revealed that both Em and Er correlated with ACR severity. Histologic eosinophilia can be a useful parameter for confirming the occurrence of ACR and for evaluating ACR severity.