HISTOLOGICAL FEATURES PREDICTIVE OF RECURRENCE OF PRIMARY BILIARY-CIRRHOSIS AFTER LIVER-TRANSPLANTATION

Background. Recurrence of primary biliary cirrhosis (PBC) within liver allografts remains ar controversial issue. The aims of this study mer e to evaluate this risk and to determine the presence, if any, of a pr edictive histological feature. Methods. We reviewed the most recent an d the 1-year protocol liver biopsies of 69 patients who received trans plants for PBC and of 53 control patients. Histological features consi stent with PBC recurrence included nonsuppurative destructive cholangi tis, mixed portal infiltrate, fibrosis, and ductopenia. A complete eva luation was undertaken in each patient with these histological feature s. Results. These histological features were present in six patients w ho received transplants for PBC (8.7% vs. 0% in the control group) and occurred between 1 and 8 years after transplant. In five of the six p atients, anti-mitochondrial antibody-2 (anti-M2) antibodies remained a t high titers. Cholestasis was present in four patients, and clinical symptoms in two patients. All six patients were negative for hepatitis C antibodies and hepatitis C RNA in their serum. None had bile duct o bstruction. The presence of plasma cells ill the portal infiltrate at 1 year after transplant was predictive of this risk of recurrence. Con clusion. The risk of PBC recurrence is real (8.7%). The presence of pl asma cells in the portal infiltrate seems to be an early marker of rec urrence of PBC in patients transplanted for this indication.