Change in composition of inflammatory infiltrate in the course of hepatitis C reinfection and concomitant acute rejection after orthotopic liver transplantation

Background: Hepatitis C virus (HCV) reinfection occurs in almost all patients after orthotopic liver transplantation (OLT) for HCV related liver cirrhosis and presents serious therapeutic challenge for a transplant team. The reinfection is concomitant with other posttransplant complications that influence presentation of the disease. Microscopic histological examination of a liver biopsy specimen remains the standard diagnostic procedure. The aim of the study was to analyze the composition of inflammatory infiltrate in HCV reinfection and determine whether its features may help in the differentiation between HCV reinfection and acute rejection (AR). Material/Methods: Seventy seven post-OLT liver biopsy specimens from patients after OLT for HCV related cirrhosis were examined. Characteristics of inflammatory infiltrate and changes in its composition related to a time interval between OLT and biopsy and concomitant AR were analyzed. Results: Significant differences in the composition of inflammatory infiltrate between the analyzed time intervals between OLT and biopsy were found. In the group of patients with HCV reinfection and concomitant AR the infiltrate was significantly more extensive than in the patients with HCV reinfection alone with predominantly CD8+ and CD5+ lymphocytes responsible for this finding. Conclusions: Significant changes in inflammatory infiltrate contents were found depending on the time period between OLT and graft biopsies.