Immunoglobulin and Complement Fragments in Liver
Tissue at the Time of Pre-reperfusion and
Feng changyin, Zheng
Pathology, Dongfang Hospitial, Fuzhou, Fujian,
Objective: To study IgG, IgM,
IgA, C3c, C4d, C1q changes pre-reperfusion and
liver and its impact on
liver rejection after transplantation.
Methods: 87 liver biopsy specimens were obtained
from the donors and recipients at the time of
transplantation from May 2007 to December 2008. The
median age at transplantation was 26 years (range
26–71) including 26 male and 3 female. All
recipients were hepatitis B
infectious, 15 cases with liver cancer, one case
with acute liver failure, one with sub-acute liver
failure, and the rest with chronic hepatitis B and
decompensated liver cirrhosis.
with 8 Hepatitis B virus-infected were dead with
traumatic brain injury. The median age of all
donors was 29
years (range 25–30 years). Each liver specimen have
at least six portal area. Specimens of
obtained from the subcapsular region without
hepatocellular carcinoma. Specimens of
obtained from the subcapsular region.
with moderate chronic hepatitis B were
as control group. All
biopsy specimens were 10% phosphate-buffered
formalin fixed and paraffin embedded for light
microscopy. Immunohistochemical staining using the
peroxidase method was carried out on each for IgG、IgM、IgA，the
C1q components of complement,
HBsAg and HBcAg. Some
specimens were stained with PAS and PASM. Optical
microscope was used to observe the deposition of
immunoglobulin and complement fragments in the
liver. Scoring of staining is based on the
percentage of stained tissue on IHC that has a
linear, circumferential staining pattern in both
vascular walls of portal area(PV) and hepatic
sinusoidal walls(HS): negative for 0,
1, 26 ~ 50% for 2, > 50% for 3. All recipients were
followed up for six months for post-transplantation
deposition of IgG, IgM, IgA, C1q statistically
significant increased in both vascular walls of
portal area and hepatic sinusoidal walls of
And the volume of increased were not associated with
their deposition in
recipients’ liver(all p>0.05).
liver with hepatitis
B-negative (n=21) had higher HS IgG (p = 0.044) and
PV C4d (p= 0.02) than the positive group (n=8)
before reperfusion, while their rejection rates
post-transplantation were not significant difference
(23.8% and 25% respectively, p = 0.647). Recipients
older than 50 years(n=13) had higher HS IgM(p=0.012),
the other recipients(n=16) after reperfusion. The
rejection rates were 30.77% and 18.75% respectively
which were not significant difference (p = 0.374).
Female recipients (3 cases) had higher HS
C4d(p=0.001)and HS C1q（P=0.026）than
male recipients after reperfusion. The rejection
rates were 33.33% and 23.08%, which were not
significant difference (P = 0.579).
The rejection rate of
group with mild organ preservation injury (n=23) was
not higher than the moderate organ preservation
injury group(30.43% and 0% respectively, p = 0.157).
We performed Logit multivariate analyses to
determine the impact of IgG, IgM, IgA, C3c, C4d, C1q
on post-transplantation rejection. A significant
predictor of rejection were pre-reperfusion HS IgA
(odds ratio [OR] = 2.184; P = 0.11),
IgG(odds ratio [OR] = 4.05; P = 0.039).
immunoglobulin and complement fragments depositing
in donors’ liver are different in different gender
and different age groups. The HBV infected donors’
livers have no effect on post-transplantation.
Pre-reperfusion HS IgA andΔPV
IgG are risk factors of rejection.