Liver transplantation is currently the only effective therapy for ESLD. Rejection and recurrent HCV are considered the most common complications that affect liver transplantation. Many prognostic factors affect the outcome of liver transplantation such as presence of T cell subpopulation in both donor and recipient. A retrospective selected study of 38 needle liver biopsy specimens, 19 specimen before transplantation from donors and 19 after transplantation from recipients. Nine cases were taken for rejection and 10 cases for recurrent hepatitis C. All cases were Formalin-fixed and paraffin-embedded, examined routinely by hematoxylin and eosin and submitted for Immunohistochemical staining for CD4 and CD8. Immunohistological findings were correlated to RAI score according to the Banff schema (1997) and grade of recurrent hepatitis C according to modified knodell and Ishak score (1995) were compared. In cases of ACR, increased number of CD8+ cells than CD4+ cells in the donor increased the risk of acute cellular rejection after transplantation. In recipient, the number of CD8+ cells increased according to ACR grade whereas CD4+ cells tended to decrease.. In recurrent hepatitis C, the number of CD4+ cells increased with increase the grade of recurrent hepatitis whereas CD8+ cells tended to decrease. The results indicate that CD8+ cells play important roles in ACR severity of LRLT while, CD4+ play the major role in recurrent hepatitis C .Thus, the ratio between CD4 and CD8 in both donor and recipient can be helpful in the prediction of the outcome of liver transplantation.
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