{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T23:51:53Z","timestamp":1788911513601,"version":"build-2803163510"},"reference-count":49,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2023,4,25]],"date-time":"2023-04-25T00:00:00Z","timestamp":1682380800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Transplantation"],"published-print":{"date-parts":[[2023,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Acute antibody mediated rejection is increasingly identified in liver allografts as a unique form of alloimmune injury associated with donor specific antibodies (DSA). This manifests pathologically as microvascular injury and C4d uptake. Despite the liver allograft's relative resistance to alloimmune injury, liver allografts are not impervious to cellular and antibody\u2010mediated rejection.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>In this blinded control study, we evaluated CD163 immunohistochemistry and applied the Banff 2016 criteria for diagnosis of acute AMR on a group of indication allograft liver biopsies from DSA positive patients and compared them to indication biopsies from DSA negative controls.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Most DSA positive patients were females (75%, <jats:italic>p<\/jats:italic>\u00a0=\u00a0.027), and underwent transplantation for HCV infection. Significant histopathological predictors of serum DSA positivity were Banff H\u2010score (<jats:italic>p<\/jats:italic>\u00a0=\u00a0.01), moderate to severe cholestasis (<jats:italic>p<\/jats:italic>\u00a0=\u00a0.03), and CD163 score\u00a0&gt;\u00a02 (<jats:italic>p<\/jats:italic>\u00a0=\u00a0.029). Other morphologic features that showed a trend with DSA positivity include Banff portal C4d\u2010score (<jats:italic>p<\/jats:italic>\u00a0=\u00a0.06), bile ductular reaction (<jats:italic>p<\/jats:italic>\u00a0=\u00a0.07), and central perivenulitis (<jats:italic>p<\/jats:italic>\u00a0=\u00a0.07). The odds of DSA sMFI \u22655000 was 12.5 times higher in those with a C4d score\u00a0&gt;1 than those with a\u00a0C4d score\u00a0\u2264\u00a01 (<jats:italic>p<\/jats:italic>\u00a0=\u00a0.04). Incidence of definite for aAMR in the DSA positive cohort was 25% (<jats:italic>n<\/jats:italic>\u00a0=\u00a05), and 0% in the DSA negative cohort. A group of 5 DSA positive cases were not classifiable by the current scheme.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Sinusoidal CD163, Banff H\u2010score, and diffuse C4d are predictors of serum DSA, and facilitate recognition of histopathological features associated with serum DSA and tissue\u2013antibody interaction.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ctr.14997","type":"journal-article","created":{"date-parts":[[2023,4,25]],"date-time":"2023-04-25T10:29:08Z","timestamp":1682418548000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Morphologic and immunophenotypic evaluation of liver allograft biopsies with contemporaneous serum DSA measurements"],"prefix":"10.1111","volume":"37","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0177-9074","authenticated-orcid":false,"given":"Mohamed I.","family":"El Hag","sequence":"first","affiliation":[{"name":"Department of Anatomic Pathology Cleveland Clinic Foundation  Cleveland Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9950-1494","authenticated-orcid":false,"given":"Hugo","family":"Kaneku","sequence":"additional","affiliation":[{"name":"Department of Surgery \u2013 Immunology and Histocompatibility Laboratory University of Miami Miller School of Medicine  Miami Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dana","family":"Jorgensen","sequence":"additional","affiliation":[{"name":"Thomas E Starzl Transplantation Institute (STI) University of Pittsburgh Medical Center  Pittsburgh Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adriana","family":"Zeevi","sequence":"additional","affiliation":[{"name":"Thomas E Starzl Transplantation Institute (STI) University of Pittsburgh Medical Center  Pittsburgh Pennsylvania USA"},{"name":"Division of Hepatic and Transplantation Pathology, Department of Pathology University of Pittsburgh Medical Center  Pittsburgh Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heather L.","family":"Stevenson","sequence":"additional","affiliation":[{"name":"Department of Pathology University of Texas Medical Branch  Galveston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nour","family":"Yadak","sequence":"additional","affiliation":[{"name":"Department of Pathology Methodist University Hospital University of Tennessee  Memphis Tennessee USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohamed","family":"Hassan","sequence":"additional","affiliation":[{"name":"Department of Medicine University of Pittsburgh Medical Center  Pittsburgh Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaotang","family":"Du","sequence":"additional","affiliation":[{"name":"Department of Pathology University of Chicago  Chicago IL USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anthony J.","family":"Demetris","sequence":"additional","affiliation":[{"name":"Thomas E Starzl Transplantation Institute (STI) University of Pittsburgh Medical Center  Pittsburgh Pennsylvania USA"},{"name":"Division of Hepatic and Transplantation Pathology, Department of Pathology University of Pittsburgh Medical Center  Pittsburgh Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,4,25]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/MOT.0b013e328353584c"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/ajt.13909"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/ajt.12667"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1155\/2017\/3234906"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/lt.23707"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/tri.12654"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/petr.13611"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/ajt.12212"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1097\/TP.0000000000000796"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/lt.23534"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600\u20106143.2011.03593.x"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2018.08.023"},{"issue":"3","key":"e_1_2_8_14_1","first-page":"489","article-title":"Antibody\u2010mediated rejection of human orthotopic liver allografts. A study of liver transplantation across ABO blood group barriers","volume":"132","author":"Demetris aJ","year":"1988","journal-title":"Am J Pathol"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1097\/00007890-199504270-00009"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.21280"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00428\u2010005\u20101245\u2010z"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.healun.2012.12.017"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1097\/TP.0000000000000246"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1172\/JCI90597"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.1111\/ajt.14107"},{"key":"e_1_2_8_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.healun.2005.09.003"},{"key":"e_1_2_8_23_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.1840160310"},{"key":"e_1_2_8_24_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600\u20106143.2011.03786.x"},{"key":"e_1_2_8_25_1","doi-asserted-by":"publisher","DOI":"10.1002\/lt.23788"},{"key":"e_1_2_8_26_1","doi-asserted-by":"publisher","DOI":"10.1002\/lt.23948"},{"key":"e_1_2_8_27_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.humpath.2022.06.015"},{"key":"e_1_2_8_28_1","doi-asserted-by":"publisher","DOI":"10.1111\/ajt.13749"},{"key":"e_1_2_8_29_1","doi-asserted-by":"publisher","DOI":"10.3727\/000000006783982386"},{"key":"e_1_2_8_30_1","doi-asserted-by":"publisher","DOI":"10.1111\/ajt.13476"},{"key":"e_1_2_8_31_1","doi-asserted-by":"publisher","DOI":"10.1097\/TP.0000000000001802"},{"key":"e_1_2_8_32_1","doi-asserted-by":"publisher","DOI":"10.1111\/ajt.14708"},{"key":"e_1_2_8_33_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600\u20106143.2010.03414.x"},{"key":"e_1_2_8_34_1","doi-asserted-by":"publisher","DOI":"10.1053\/jhep.2001.24315"},{"key":"e_1_2_8_35_1","doi-asserted-by":"publisher","DOI":"10.1002\/lt.21404"},{"key":"e_1_2_8_36_1","doi-asserted-by":"publisher","DOI":"10.1111\/his.14058"},{"key":"e_1_2_8_37_1","doi-asserted-by":"publisher","DOI":"10.1002\/lt.25958"},{"key":"e_1_2_8_38_1","doi-asserted-by":"publisher","DOI":"10.1111\/his.14606"},{"key":"e_1_2_8_39_1","doi-asserted-by":"publisher","DOI":"10.1002\/lt.23403"},{"key":"e_1_2_8_40_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.humpath.2017.12.007"},{"key":"e_1_2_8_41_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.trim.2011.08.005"},{"key":"e_1_2_8_42_1","doi-asserted-by":"publisher","DOI":"10.1038\/modpathol.3800784"},{"key":"e_1_2_8_43_1","doi-asserted-by":"publisher","DOI":"10.1002\/lt.23789"},{"key":"e_1_2_8_44_1","doi-asserted-by":"publisher","DOI":"10.1002\/lt.22323"},{"key":"e_1_2_8_45_1","doi-asserted-by":"publisher","DOI":"10.4049\/jimmunol.1501686"},{"key":"e_1_2_8_46_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600\u20106143.2005.01074.x"},{"key":"e_1_2_8_47_1","doi-asserted-by":"publisher","DOI":"10.1002\/lt.21949"},{"key":"e_1_2_8_48_1","doi-asserted-by":"publisher","DOI":"10.1002\/lt.21447"},{"key":"e_1_2_8_49_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2012.01.030"},{"key":"e_1_2_8_50_1","doi-asserted-by":"publisher","DOI":"10.1002\/lt.21518"}],"container-title":["Clinical Transplantation"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ctr.14997","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,10]],"date-time":"2023-08-10T18:06:27Z","timestamp":1691690787000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/ctr.14997"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,4,25]]},"references-count":49,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2023,8]]}},"alternative-id":["10.1111\/ctr.14997"],"URL":"https:\/\/doi.org\/10.1111\/ctr.14997","archive":["Portico"],"relation":{},"ISSN":["0902-0063","1399-0012"],"issn-type":[{"value":"0902-0063","type":"print"},{"value":"1399-0012","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,4,25]]},"assertion":[{"value":"2022-02-02","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-04-09","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-04-25","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e14997"}}