Obliterative portal venopathy: A histopathologic finding associated with chronic antibody-mediated rejection in pediatric liver allografts

Marjorie Anne R. Guerra, Bita V. Naini, Jason V. Scapa, Elaine F. Reed, Ronald W. Busuttil, Elaine Y. Cheng, Douglas G. Farmer, Jorge H. Vargas, Robert S. Venick, Sue V. McDiarmid, Laura J. Wozniak

Research output: Contribution to journalArticlepeer-review

15 Scopus citations

Abstract

The significance of post-transplant HLA DSA and chronic AMR in LT is an emerging field of study. Although OPV has previously been described as a histopathologic finding in DSA-positive adult LT recipients, it was not included in the recent Banff criteria for chronic AMR. Our aim was to describe the association between OPV and chronic AMR in pediatric LT recipients. A retrospective review of 67 liver biopsies performed between November 2014 and April 2016 in 45 pediatric LT recipients identified four patients with OPV. Clinical status, liver biochemistry, the presence of DSA, and available non-HLA antibody testing, as well as histopathologic features of chronic AMR, were assessed. All four patients with OPV had class II DSA and histopathologic features of chronic AMR based on the Banff criteria. Two patients were noted to have non-HLA antibodies. Three patients are undergoing treatment with IVIG but have persistent DSA. Two patients have graft failure and are awaiting retransplantation. In conclusion, OPV is a histopathologic finding associated with chronic AMR in pediatric LT recipients. Further studies are needed to elucidate whether OPV is reversible and/or amenable to medical therapy.

Original languageEnglish (US)
Article numbere13124
JournalPediatric Transplantation
Volume22
Issue number2
DOIs
StatePublished - Mar 2018

Keywords

  • HLA antibodies and/or donor-specific antibodies
  • chronic antibody-mediated rejection
  • liver transplantation
  • obliterative portal venopathy
  • pediatric

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Transplantation

Fingerprint

Dive into the research topics of 'Obliterative portal venopathy: A histopathologic finding associated with chronic antibody-mediated rejection in pediatric liver allografts'. Together they form a unique fingerprint.

Cite this