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Prevalence of hepatitis C virus antibodies in orthotopic liver transplantation: A sequential study
PREVALEWCE OF RCPATITIS C VIRUS UJTIBODIESIll ORTEOTOPIC LIVERTRINSPLNlTATION : A SEWRIAL STUDY.
MULTIPLE hwLKAB DOTS ANFINXLi%R ANTIBODIES (f+JDANA) OF PRIMARYBILIARY CI-IS iFBCl REACT WITH 7%92kD AND 96-1OOkD PKYIEINS OF NUCLE4R BODIES.
A. Pranra, A. Coquette, JPJiquet, S. Bresscn-Sad& IL Lab, 0. iijoyr, SC. Becker, C. Rouget, G. Ilantion, II. Gillet. Liver Transplant nnit CSO25000 Besanpon Prance
M. fisco"i, F. Cassani. M. Cavoni*, A. Caselli. F. Farakgoli:. 0. Ballardini. M. Lenzi. D: Zauli Cattake di SemeioticaMed & F.B. Bi-hi. tIstitut0 di PatologiaGenerale, Univerky of Bologna, Italy.
Due to the large amount of blood and blood-derivates used during orthotopic liver transplantation (OLT) one light expect a bigb prevalence of C hepatitis in liver tramplanted patients. The ain of tbis retrospective study was to assess tbe prevalence of bepatitis C virus antibodies (SCv Ab) and their follow-up in a series of 61 OL? patients. The prevalence of serum antibodies to hepatitis C viW was assessed by ao ELISA test (Ortho D:qnostic System). Indications were cirrhosis in 26 cases, primarybiliary cirrhosis in 6 cases, liver cancer in 11 cases, fslainant hepatitis in 2 cases and alveolar echin-is in 17 cases. Sera ware tested before OLT and every tuo lontbs after. Twenty-nine patients anti-8Q negative before OL? remained negative after (group 1). Four patients seropositive before OLT reeained seropositire after (group I). Tueaty-eight patients seropositive before OLT, became seroneqativa after (group 2). and 3 patients seroneqatire before OLT became seropositive after (group 3). The prevalence of seroconversion ~1s 9.3 t (3/32). Tbe prevalence of seropositive patients after OLT was 11 t (I/(.4). The hisb nuaber of seropositive patients before OLT (1 patient out of 2) appeared related to false positive results due to a bypergamaqlobulinemia.
EFFECT OF ?:::RANGLGL 014 SPLANCHKIC ARTERIES, PORTAL VEIN &ID LEFT $.4S’!J:C VEII< BLDOD FLOW IN LIVER CIRRHOSIS SGalanl, ! &l;o?bl, 5LI Bassi, 6iironi. L.Rarbara. lstitutodi Cllnlca Yezhca e Gis:-renxo!og:&. Unlvers!tb di Bologna. 601ogna. Italy. in the present study tie mvestlg&d, by means of Doppler :.cnography, 2 CI:-r>o:~c ?a:ients with esophageal barices. seiectti on the bae!e oi !pe ootmal US visualization of 8hdOminal vessels ano iejsibl:i:., ai Sexier study. The fcilowing Doppler parameters were eramined beiors 2nd aiter an oral dose of 40 mg of propranolo:. 1) pejk systoiic flmv velxlty (PS) and resistivity mdex (RI = (PS diastolic f!ow LeloCItv‘I. /PS) !n the superior mesenteric (SMA). splenx (:;4! and l?pa!lc (H.4) arteries; 2) blood flow volume In !he portal rein (PY) and In the Iei! Fstric vgln (LGV) at its origin from the spielic \‘Lin The me*lmJ1 hemodqnamic effect was reached after ?D- 120 n;m ii Plnctd fiow Elgnlficantly &creased in the arterial bed PS fell frcm I X*2: to 107i 16 cmlsec in SMA (p’O.OS), from t32?25 to !00~13 cm/set in SA (~‘0 02). and from 107t33 to 87t23 cm/s% m H4. PI raised from 0.82*0 02 to 0.8460.03 In SKA (p,.Oi!5). from 0.73t0.06 to 0.76tO.06 in SA (~(0.02). while did net signif%an!ly char@ in HA. Venous flow volume oecrease: from 1 t 25tli: to 9Olt363 ml/min In PV (p\O 01) and from 303t257 ;3 2 I E.5 i 7:.m!/mtn in LGV (~(0.01 I. The percent decrease of verous b1ocm.i flow was higher but not stalis’,imlly sign:fxant ;n :GV tnan :n PV (-27.4% vs -22%). i1.e fa!! of ?,;:?hc I!% vilxty :PS) combined with the Increase of _:I ,>~mor:sira:~$ :,I, ‘ YNO !p,ai propranolol reduces splanchn,c arteraal :‘.i!l,w 3” o*;p?:si-No .“ mill. -‘ , c 3~1p!A A,\ and by :ncressing npienchmc j~t:rlqi i$::s:.?!‘ce T*? I!pher decvsse of blood flow irr LO\! IF ,:xh:.ar:;i~n * :‘:I F\r ::J+J+;!s tne pas~ible xtion of prclprinolal on ;*nous (c1”2:p:::: re:,~~:~n,;e
an iomnmofluorescence (IFL) pattern that their target antigen(s)could be located in the nuclear bodies (NB). To verify this hypathesis, we performed an ultrastructuraliuanuncnno~clogical Malysis by a prearkddingtechnique onTo cells (an hunan oviductalcarcinana line) with ion exchange chranatographypurified UC from e WDANA positive se_ (MND-ANAInO). UC reacted with structuresclosely resemblin8NB. Since N8 are honmxally inducibleorganelks, which an not endcmetrial cells nuclei, we p?sent in ilrmature InJected immature rats with diethylstilbestroland tested the uteri by IFL with WANA IgG. Treated uteri, which possessed NE (as assessed by electmn microscopy- W, wer-2positive, hllileuntreated ones, which did not show NE by PI, were "egative. To further characterizetheir target antigen(s). we studied 10 KVD-ANA positive sera, 6 ANA poeitive different from t+lD-ANAand 5 ANA negative control sere by inam+blotting with insoluble (I)
another band at 96-1OOkD. l&se reactivitieswere detected only with the I fraction. f%!D-AK% negetive sera uere unreactive. Antibodies eluted fmr the nitmcellulose portion of the blot containing these two be.nds showed by IFL the ?4.tD-ANApattern.
HISTOLOGICALCHANCES AND NOVELFlNDlNGS WDUCED IN TliB LIVER OF PATIENTS WlTH CHRONICACTIVEC HEFATlTlS TaEATsowrm
w.
OWERPIXON (Il7.Q.
J.M. PaipwR. Mm-it Pathology Service*. Hospital de Ie Princesa. Univcrshy. Madrid, Spain.
!&iaz and Aumnoma
Although IFN reduces serum ALT levels in patients with chronic C-hepatitis. changes induced in liver hi&logy have not bocn completely churcmizcd. We mmlircd these changer and noticed I& appearance of new hismlogiul findings d&G treatment with rlFN alpha-Zb (5 MU day/2 mo. 3 MU dw/4 mo. and 1 MU liw/S mo). This 1 year protocol included 26 palicnu wilh chronic active C hepmitis on biopsy upon entry: 22 (85%) were anti-HCV positive. Histology was classified according to Knodell Index (HAI). Mcee sewn ALT level before envy was 241 f 105 U/L. Twenty prlienu (77%) normalized ALT during treatmel. In 22 puiems a second biopsy was done and HA1 was compared (p < 0.001) before (mean 10.1. range 6-151 and after (mean 5.5. range l-111 IFN tremmcm. Mean; of improvemem in the 4 categ&er of HA1 wcro: l) fmm 3.0 to 0.9 , pc 0.601; ID from 2.0 lo 1.0. pcO.601; III) from 3.3 to 2.0. pcO.661: and IV) from 1.8 to 1.7. NS. Acidophilic bodies, lymphoid folticlcs. sinusoidal Irmshocrtosis. Kuoffer C. hwcmluia. bile-duct damaRe. and swilingw and muitinuclea::d~‘hc~r~ocyte~ improved wilh. IFN. In 9 palicms new hinologicd findings wore seen: 2 had noncase&g cpilhelioid g&ulnmas -4 microgranulomrr of Kupffer cells. 3 parenchimal nodular :ransformalion, and sinusoidal dileation insnxsed from 5 peicnts an entry to 15 after receiving 1FN. We concluded lhal rlFN alpha.2b is cffcclivc 1) in normalizing sxum ALT lcvcls. and 2) in improving HAI scores. In addhion. WC speculate thal some palhologicd changes m;ry k inducett in the liver due IO e toxic effcsc of IFN.
MULTIPLE hwLKAB DOTS ANFINXLi%R ANTIBODIES (f+JDANA) OF PRIMARYBILIARY CI-IS iFBCl REACT WITH 7%92kD AND 96-1OOkD PKYIEINS OF NUCLE4R BODIES.
A. Pranra, A. Coquette, JPJiquet, S. Bresscn-Sad& IL Lab, 0. iijoyr, SC. Becker, C. Rouget, G. Ilantion, II. Gillet. Liver Transplant nnit CSO25000 Besanpon Prance
M. fisco"i, F. Cassani. M. Cavoni*, A. Caselli. F. Farakgoli:. 0. Ballardini. M. Lenzi. D: Zauli Cattake di SemeioticaMed & F.B. Bi-hi. tIstitut0 di PatologiaGenerale, Univerky of Bologna, Italy.
Due to the large amount of blood and blood-derivates used during orthotopic liver transplantation (OLT) one light expect a bigb prevalence of C hepatitis in liver tramplanted patients. The ain of tbis retrospective study was to assess tbe prevalence of bepatitis C virus antibodies (SCv Ab) and their follow-up in a series of 61 OL? patients. The prevalence of serum antibodies to hepatitis C viW was assessed by ao ELISA test (Ortho D:qnostic System). Indications were cirrhosis in 26 cases, primarybiliary cirrhosis in 6 cases, liver cancer in 11 cases, fslainant hepatitis in 2 cases and alveolar echin-is in 17 cases. Sera ware tested before OLT and every tuo lontbs after. Twenty-nine patients anti-8Q negative before OL? remained negative after (group 1). Four patients seropositive before OLT reeained seropositire after (group I). Tueaty-eight patients seropositive before OLT, became seroneqativa after (group 2). and 3 patients seroneqatire before OLT became seropositive after (group 3). The prevalence of seroconversion ~1s 9.3 t (3/32). Tbe prevalence of seropositive patients after OLT was 11 t (I/(.4). The hisb nuaber of seropositive patients before OLT (1 patient out of 2) appeared related to false positive results due to a bypergamaqlobulinemia.
EFFECT OF ?:::RANGLGL 014 SPLANCHKIC ARTERIES, PORTAL VEIN &ID LEFT $.4S’!J:C VEII< BLDOD FLOW IN LIVER CIRRHOSIS SGalanl, ! &l;o?bl, 5LI Bassi, 6iironi. L.Rarbara. lstitutodi Cllnlca Yezhca e Gis:-renxo!og:&. Unlvers!tb di Bologna. 601ogna. Italy. in the present study tie mvestlg&d, by means of Doppler :.cnography, 2 CI:-r>o:~c ?a:ients with esophageal barices. seiectti on the bae!e oi !pe ootmal US visualization of 8hdOminal vessels ano iejsibl:i:., ai Sexier study. The fcilowing Doppler parameters were eramined beiors 2nd aiter an oral dose of 40 mg of propranolo:. 1) pejk systoiic flmv velxlty (PS) and resistivity mdex (RI = (PS diastolic f!ow LeloCItv‘I. /PS) !n the superior mesenteric (SMA). splenx (:;4! and l?pa!lc (H.4) arteries; 2) blood flow volume In !he portal rein (PY) and In the Iei! Fstric vgln (LGV) at its origin from the spielic \‘Lin The me*lmJ1 hemodqnamic effect was reached after ?D- 120 n;m ii Plnctd fiow Elgnlficantly &creased in the arterial bed PS fell frcm I X*2: to 107i 16 cmlsec in SMA (p’O.OS), from t32?25 to !00~13 cm/set in SA (~‘0 02). and from 107t33 to 87t23 cm/s% m H4. PI raised from 0.82*0 02 to 0.8460.03 In SKA (p,.Oi!5). from 0.73t0.06 to 0.76tO.06 in SA (~(0.02). while did net signif%an!ly char@ in HA. Venous flow volume oecrease: from 1 t 25tli: to 9Olt363 ml/min In PV (p\O 01) and from 303t257 ;3 2 I E.5 i 7:.m!/mtn in LGV (~(0.01 I. The percent decrease of verous b1ocm.i flow was higher but not stalis’,imlly sign:fxant ;n :GV tnan :n PV (-27.4% vs -22%). i1.e fa!! of ?,;:?hc I!% vilxty :PS) combined with the Increase of _:I ,>~mor:sira:~$ :,I, ‘ YNO !p,ai propranolol reduces splanchn,c arteraal :‘.i!l,w 3” o*;p?:si-No .“ mill. -‘ , c 3~1p!A A,\ and by :ncressing npienchmc j~t:rlqi i$::s:.?!‘ce T*? I!pher decvsse of blood flow irr LO\! IF ,:xh:.ar:;i~n * :‘:I F\r ::J+J+;!s tne pas~ible xtion of prclprinolal on ;*nous (c1”2:p:::: re:,~~:~n,;e
an iomnmofluorescence (IFL) pattern that their target antigen(s)could be located in the nuclear bodies (NB). To verify this hypathesis, we performed an ultrastructuraliuanuncnno~clogical Malysis by a prearkddingtechnique onTo cells (an hunan oviductalcarcinana line) with ion exchange chranatographypurified UC from e WDANA positive se_ (MND-ANAInO). UC reacted with structuresclosely resemblin8NB. Since N8 are honmxally inducibleorganelks, which an not endcmetrial cells nuclei, we p?sent in ilrmature InJected immature rats with diethylstilbestroland tested the uteri by IFL with WANA IgG. Treated uteri, which possessed NE (as assessed by electmn microscopy- W, wer-2positive, hllileuntreated ones, which did not show NE by PI, were "egative. To further characterizetheir target antigen(s). we studied 10 KVD-ANA positive sera, 6 ANA poeitive different from t+lD-ANAand 5 ANA negative control sere by inam+blotting with insoluble (I)
another band at 96-1OOkD. l&se reactivitieswere detected only with the I fraction. f%!D-AK% negetive sera uere unreactive. Antibodies eluted fmr the nitmcellulose portion of the blot containing these two be.nds showed by IFL the ?4.tD-ANApattern.
HISTOLOGICALCHANCES AND NOVELFlNDlNGS WDUCED IN TliB LIVER OF PATIENTS WlTH CHRONICACTIVEC HEFATlTlS TaEATsowrm
w.
OWERPIXON (Il7.Q.
J.M. PaipwR. Mm-it Pathology Service*. Hospital de Ie Princesa. Univcrshy. Madrid, Spain.
!&iaz and Aumnoma
Although IFN reduces serum ALT levels in patients with chronic C-hepatitis. changes induced in liver hi&logy have not bocn completely churcmizcd. We mmlircd these changer and noticed I& appearance of new hismlogiul findings d&G treatment with rlFN alpha-Zb (5 MU day/2 mo. 3 MU dw/4 mo. and 1 MU liw/S mo). This 1 year protocol included 26 palicnu wilh chronic active C hepmitis on biopsy upon entry: 22 (85%) were anti-HCV positive. Histology was classified according to Knodell Index (HAI). Mcee sewn ALT level before envy was 241 f 105 U/L. Twenty prlienu (77%) normalized ALT during treatmel. In 22 puiems a second biopsy was done and HA1 was compared (p < 0.001) before (mean 10.1. range 6-151 and after (mean 5.5. range l-111 IFN tremmcm. Mean; of improvemem in the 4 categ&er of HA1 wcro: l) fmm 3.0 to 0.9 , pc 0.601; ID from 2.0 lo 1.0. pcO.601; III) from 3.3 to 2.0. pcO.661: and IV) from 1.8 to 1.7. NS. Acidophilic bodies, lymphoid folticlcs. sinusoidal Irmshocrtosis. Kuoffer C. hwcmluia. bile-duct damaRe. and swilingw and muitinuclea::d~‘hc~r~ocyte~ improved wilh. IFN. In 9 palicms new hinologicd findings wore seen: 2 had noncase&g cpilhelioid g&ulnmas -4 microgranulomrr of Kupffer cells. 3 parenchimal nodular :ransformalion, and sinusoidal dileation insnxsed from 5 peicnts an entry to 15 after receiving 1FN. We concluded lhal rlFN alpha.2b is cffcclivc 1) in normalizing sxum ALT lcvcls. and 2) in improving HAI scores. In addhion. WC speculate thal some palhologicd changes m;ry k inducett in the liver due IO e toxic effcsc of IFN.