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Diagnostic Pathology

, 8:168

First Online: 14 October 2013Received: 14 September 2013Accepted: 29 September 2013


ObjectiveLung transplant volume has been increasing. However, inaccurate and uncertain diagnosis for lung transplant rejection hurdles long-term outcome due to, in part, interobserver variability in rejection grading. Therefore, a more reliable method to facilitate diagnosing and grading rejection is warranted.

MethodRat lung grafts were harvested on day 3, 7, 14 and 28 post transplant for histological and immunohistochemical assessment. No immunosuppressive treatment was administered. We explored the value of interstitial T lymphocytes quantification by immunohistochemistry and compared the role of T cell immunohistochemistry with HandE staining in diagnosing and grading lung transplant rejection.

ResultsTypical acute rejection from grade A1 to A4 was found. Rejection severity was heterogeneously distributed in one-third transplanted lungs 14-40: lesions in apex and center were more augmented than in the base and periphery of the grafts, respectively. Immunohistochemistry showed profound difference in T lymphocyte infiltration among grade A1 to A4 rejections. The coincidence rate of HandE and immunohistochemistry was 77.5%. The amount of interstitial T lymphocyte infiltration increased gradually with the upgrading of rejection. The statistical analysis demonstrated that the difference in the amount of interstitial T lymphocytes between grade A2 and A3 was not obvious. However, T lymphocytes in lung tissue of grade A4 were significantly more abundant than in other grades.

ConclusionsRejection severity was heterogeneously distributed within lung grafts. Immunohistochemistry improves the sensitivity and specificity of rejection diagnosis, and interstitial T lymphocyte quantitation has potential value in diagnosing and monitoring lung allograft rejection.

Virtual slidesThe virtual slides for this article can be found here: http:-www.diagnosticpathology.diagnomx.eu-vs-1536075282108217.

KeywordsLung transplantation Immunohistochemistry T lymphocyte Electronic supplementary materialThe online version of this article doi:10.1186-1746-1596-8-168 contains supplementary material, which is available to authorized users.

Lin Cheng, Haizhou Guo contributed equally to this work.

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Autor: Lin Cheng - Haizhou Guo - Xinwei Qiao - Quan Liu - Jun Nie - Jinsong Li - Jianjun Wang - Ke Jiang

Fuente: https://link.springer.com/

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