Beschreibung:
<jats:title>Abstract</jats:title><jats:sec><jats:title>Background & Aims</jats:title><jats:p>Orthotopic liver transplantation (<jats:styled-content style="fixed-case">OLT</jats:styled-content>) is the sole therapeutic option to cure end‐stage liver diseases including <jats:styled-content style="fixed-case">HCV</jats:styled-content>‐related cirrhosis. Timely and precise differentiation of relevant acute <jats:styled-content style="fixed-case">HCV</jats:styled-content> reinfection from acute rejection after <jats:styled-content style="fixed-case">OLT</jats:styled-content> is vital for appropriate therapy. Aim of this study was to evaluate the usefulness of (non‐) invasive apoptosis (M30) and necrosis (M65) determination in the differential diagnosis of acute (and chronic) <jats:styled-content style="fixed-case">HCV</jats:styled-content> reinfection vs. acute rejection in liver allografts.</jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p>Serum samples and liver biopsy tissues were available from 76 patients including a control group (19× <jats:styled-content style="fixed-case">NAFL</jats:styled-content>, 19× <jats:styled-content style="fixed-case">NASH</jats:styled-content>, 16× acute rejection, 11× acute and 11× chronic <jats:styled-content style="fixed-case">HCV</jats:styled-content> reinfection) and were analysed using M30‐ and M65 <jats:styled-content style="fixed-case">ELISA</jats:styled-content>s (M30S, M65S) and M30‐immunohistochemistry (M30H). Clinical and serological data were collected.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>M30S, M65S and M30H were highly correlated with diagnostic groups in the total cohort (all <jats:italic>P</jats:italic> < 0.0001). M30S, M65S and M30H were independently able to differentiate acute <jats:styled-content style="fixed-case">HCV</jats:styled-content> reinfection from acute rejection (<jats:italic>P</jats:italic> = 0.048, <jats:italic>P</jats:italic> = 0.001, <jats:italic>P</jats:italic> = 0.010) with moderate to excellent diagnostic accuracy (sensitivity, specificity, cut‐off‐value in M30S: 70%, 75%, 1025 U/L; M65S: 100%, 92%, 1308 U/L; M30H: 73%, 88%, 0.3%).</jats:p></jats:sec><jats:sec><jats:title>Conclusions</jats:title><jats:p>M30‐, M65‐<jats:styled-content style="fixed-case">ELISA</jats:styled-content>s and M30‐immunohistochemistry are potential useful tools in differentiating acute <jats:styled-content style="fixed-case">HCV</jats:styled-content> reinfection from acute rejection facilitating both speed and accuracy of the diagnostic process for the clinician and hepatopathologist. In this context, M65S provided superior diagnostic characteristics compared to M30‐based methods. However, being the first analysis of (cleaved) <jats:styled-content style="fixed-case">CK</jats:styled-content>18 serum and tissue expression levels in this context, the results need to be verified in further studies.</jats:p></jats:sec>