الفهرس 
GENERAL ASPECTS OF LIVER TRANSPLANTATIONOnly 14 pages are availabe for public view
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Abstract
ACR is one of the most important factors for prognosis following liver transplantation, yet little is known about how to distinguish it from recurrency of HCV.
The diagnosis of ACR is influenced by many factors, most importantly clinical manifestations laboratory findings and histopathological manifestations.
The aim of this work is to study the role of using anti HCV antibody to detect the presence of HCV antigen in hepatocytes in core post transplant liver biopsies, and its role in distinguishing between the two most problematic outcome of liver transplantation, whether acute cellular rejection or recurrency of hepatitis C virus infection, aided by other complementary clinical and pathological parameters.
The material of this study included 60 patients who had performed living related liver transplantation for HCV induced cirrhosis, collected from the liver transplantation unit, Dar-El Fouad Hospital. Our 60 patients were subjected to the following:
Full clinical examination
Laboratory profile including serum bilirubin – both total and direct – liver enzymes including AST, ALT, cholestatic enzymes including GGT and alkaline phosphatase enzyme.
Liver core biopsies were subjected to routine paraffin sectioning, then each biopsy was subjected to the following:
1. Routine H and E stain.
2. Masson’s trichrome stain.
3. Immunohistochemical staining using HCV core Antigen, mouse monoclonal antibody.
The results have shown that; concerning ACR, most cases occurred in the early postoperative period, as early as the first few months, following transplantation, and ACR is very rare more than 12 months post transplantation.
70% of patients diagnosed as ACR proved negative when tested by anti-HCV antibody while 96.7% of patients diagnosed as recurrent HCV were positive for anti-HCV antibody.
There is a higher mean total and direct bilirubin levels among cases of ACR when compared to cases the HCV recurrency.
There is a higher mean GGT level among cases diagnosed as ACR compared to those diagnosed as HCV recurrency.
There is a higher mean level of alkaline phsophatase among cases diagnosed as ACR compared to those diagnosed as HCV recurrency.
There is a higher negativity for Masson’s trichrome stain among cases diagnosed as ACR compared to those diagnosed as HCV recurrency.
from this study we conclude that the use of anti HCV antibody may play a role in supporting the diagnosis of ACR over recurrency of HCV infection, when combined with higher mean bilirubin, GGT and Alkaline phosphatase levels, and higher negativity of MT stain as well as short duration since transplantation.