{"id":{"repo_id":"aachen","oai_identifier":"oai:publications.rwth-aachen.de:51720"},"canonical_url":"https://search.dev.ndltd.org/etd/aachen/oai:publications.rwth-aachen.de:51720","repository":{"repo_id":"aachen","name":"RWTH Aachen University","base_url":"https://publications.rwth-aachen.de/oai2d"},"display":{"title":"Der ELISA-basierte Nachweis von C4d nach Lebertransplantation - ein hilfreicher Marker zur Differentialdiagnose zwischen akuter Abstoßung und rezidivierender Hepatitis-C-Infektion?","abstract":"Liver transplantation is known to be an established and validated treatment for a variety of liver diseases. Recently, there has been an enhancement in the outcome of these patients through pharmaceutical and therapeutical improvements like immunosuppressive protocols. Rejection reactions are mostly treated by steroid-pulse therapy and/or increased doses of calcineurin-inhibitors. MMF and sirolimus are also state of the art in treatment of rejection reactions. However, acute rejection accounts for the majority of complications (20-40%) in the process of liver transplantation. Hepatitis-C-induced liver cirrhosis is one of the most common causes for a LTX, but there exists a higher risk for developing a post-transplantation HCV-reinfection and successive fibrosis/cirrhosis of the transplanted liver. In clinical practice, the identification of a HCV infection arises a problem since the acute rejection often displays the same clinical parameters. These are rising serum transaminases, functional deficits of the liver despite of no perfusion deficiencies and elevated bilirubin levels. The gold standard for differential diagnosis still represents the liver-biopsy. Similar histological characteristics can be found for both HCV infection and acute tissue rejection. This is a problem when it comes to differentiation of these pathologies. The therapeutic steps for these pathologies are, however, completely different. Therefore it is critical to choose the right therapy based on an accurate diagnosis. Treating a patient with an HCV-reinfection with high-dose-steroid-pulsed therapy, due to false diagnosis, may severely increase HCV-virus activity and worsen the patient´s clinical state. To improve differential diagnosis, a specific marker, which is expressed only in cases of acute rejection, is needed. C4d, as a split-product of the activated classical complement cascade, could serve as such important marker. It has yet been proven to be an important diagnostic tool for the diagnosis of acute rejection in patients undergoing kidney transplantation. For that purpose, in a previous retrospectively study of our group, it was determined, if C4d may serve as a possible diagnostic marker for differential diagnosis of acute rejection and HCV-reinfection after liver transplantation. The results showed intensified C4d-staining in paraffinised tissue samples from patients, suffering from acute rejection. In the current prospective, double-blinded study with an increased study cohort and kryoconservated liver tissue samples, the possibility of immune-histochemical detection of C4d was examined based on results of our last study. Due morphological problems, caused by the kryoconservated tissue samples, another technique was used to prove the presence of C4d-protein. A quantitative detection of the C4d-protein was obtained by using proteinextraction-kits and a specific C4d-ELISA. These results were correlated to the histological standard-evaluation. Thus, it was the aim of this dissertation to determine, if the ELISA-based C4d detection could serve as differentiation tool between acute rejection and HCV-reinfection in patients having undergone liver transplantation.","abstract_html":"Liver transplantation is known to be an established and validated treatment for a variety of liver diseases. Recently, there has been an enhancement in the outcome of these patients through pharmaceutical and therapeutical improvements like immunosuppressive protocols. Rejection reactions are mostly treated by steroid-pulse therapy and/or increased doses of calcineurin-inhibitors. MMF and sirolimus are also state of the art in treatment of rejection reactions. However, acute rejection accounts for the majority of complications (20-40%) in the process of liver transplantation. Hepatitis-C-induced liver cirrhosis is one of the most common causes for a LTX, but there exists a higher risk for developing a post-transplantation HCV-reinfection and successive fibrosis/cirrhosis of the transplanted liver. In clinical practice, the identification of a HCV infection arises a problem since the acute rejection often displays the same clinical parameters. These are rising serum transaminases, functional deficits of the liver despite of no perfusion deficiencies and elevated bilirubin levels. The gold standard for differential diagnosis still represents the liver-biopsy. Similar histological characteristics can be found for both HCV infection and acute tissue rejection. This is a problem when it comes to differentiation of these pathologies. The therapeutic steps for these pathologies are, however, completely different. Therefore it is critical to choose the right therapy based on an accurate diagnosis. Treating a patient with an HCV-reinfection with high-dose-steroid-pulsed therapy, due to false diagnosis, may severely increase HCV-virus activity and worsen the patient´s clinical state. To improve differential diagnosis, a specific marker, which is expressed only in cases of acute rejection, is needed. C4d, as a split-product of the activated classical complement cascade, could serve as such important marker. It has yet been proven to be an important diagnostic tool for the diagnosis of acute rejection in patients undergoing kidney transplantation. For that purpose, in a previous retrospectively study of our group, it was determined, if C4d may serve as a possible diagnostic marker for differential diagnosis of acute rejection and HCV-reinfection after liver transplantation. The results showed intensified C4d-staining in paraffinised tissue samples from patients, suffering from acute rejection. In the current prospective, double-blinded study with an increased study cohort and kryoconservated liver tissue samples, the possibility of immune-histochemical detection of C4d was examined based on results of our last study. Due morphological problems, caused by the kryoconservated tissue samples, another technique was used to prove the presence of C4d-protein. A quantitative detection of the C4d-protein was obtained by using proteinextraction-kits and a specific C4d-ELISA. These results were correlated to the histological standard-evaluation. Thus, it was the aim of this dissertation to determine, if the ELISA-based C4d detection could serve as differentiation tool between acute rejection and HCV-reinfection in patients having undergone liver transplantation.","abstract_has_math":false,"creators":["Kienlein, Stefan"],"institution":"Publikationsserver der RWTH Aachen University","degree_name":null,"degree_level":null,"degree_discipline":null,"degree_department":null,"school":null,"contributors":["Schmeding, Maximilian"],"advisors":[],"committee_chairs":[],"committee_members":[],"year":2012,"date_issued":"2012","date_published":"2012","updated_at":"2026-07-30T19:40:42Z","subjects":["info:eu-repo/classification/ddc/610","Lebertransplantation","Hepatitis C","Hepatitis-C-Virus","Komplement <Immunologie>","Enzyme-linked immunosorbent assay","Differentialdiagnose","Medizin","C4d","akute Rejektion","akute Abstoßung","acute rejection","complement system"],"languages":["ger"],"rights":["info:eu-repo/semantics/openAccess"],"rights_urls":[],"identifier_entries":[{"key":"dc:identifier","label":"Identifier","values":["https://publications.rwth-aachen.de/search?p=id:%22RWTH-CONV-113981%22"],"render_values":[{"text":"https://publications.rwth-aachen.de/search?p=id:%22RWTH-CONV-113981%22","href":"https://publications.rwth-aachen.de/search?p=id:%22RWTH-CONV-113981%22","code":true}]}]},"links":{"outbound_url":"https://publications.rwth-aachen.de/record/51720","outbound_label":"Repository record","outbound_source":"dc:identifier"},"source_record":{"url":"https://publications.rwth-aachen.de/oai2d?verb=GetRecord&metadataPrefix=oai_dc&identifier=oai%3Apublications.rwth-aachen.de%3A51720","prefix":"oai_dc"},"metadata_groups":[{"id":"people","label":"People","entries":[{"key":"dc:contributor","label":"Contributor","values":["Schmeding, Maximilian"]},{"key":"dc:creator","label":"Author","values":["Kienlein, Stefan"]}]},{"id":"academic_context","label":"Academic Context","entries":[{"key":"dc:coverage","label":"Dc Coverage","values":["DE"]},{"key":"dc:date","label":"Dc Date","values":["2012"]},{"key":"dc:publisher","label":"Institution","values":["Publikationsserver der RWTH Aachen University"]},{"key":"dc:relation","label":"Dc Relation","values":["info:eu-repo/semantics/altIdentifier/urn/urn:nbn:de:hbz:82-opus-42555"]},{"key":"dc:type","label":"Dc Type","values":["info:eu-repo/semantics/doctoralThesis","info:eu-repo/semantics/publishedVersion"]}]},{"id":"subjects_keywords","label":"Subjects and Keywords","entries":[{"key":"dc:subject","label":"Dc Subject","values":["info:eu-repo/classification/ddc/610","Lebertransplantation","Hepatitis C","Hepatitis-C-Virus","Komplement <Immunologie>","Enzyme-linked immunosorbent assay","Differentialdiagnose","Medizin","C4d","akute Rejektion","akute Abstoßung","acute rejection","complement system"]}]},{"id":"language_rights","label":"Language and Rights","entries":[{"key":"dc:language","label":"Dc Language","values":["ger"]},{"key":"dc:rights","label":"Dc Rights","values":["info:eu-repo/semantics/openAccess"]}]},{"id":"identifiers","label":"Identifiers","entries":[{"key":"dc:identifier","label":"Identifier","values":["https://publications.rwth-aachen.de/record/51720","https://publications.rwth-aachen.de/search?p=id:%22RWTH-CONV-113981%22"]}]},{"id":"additional","label":"Additional Metadata","entries":[{"key":"dc:description","label":"Description","values":["Liver transplantation is known to be an established and validated treatment for a variety of liver diseases. Recently, there has been an enhancement in the outcome of these patients through pharmaceutical and therapeutical improvements like immunosuppressive protocols. Rejection reactions are mostly treated by steroid-pulse therapy and/or increased doses of calcineurin-inhibitors. MMF and sirolimus are also state of the art in treatment of rejection reactions. However, acute rejection accounts for the majority of complications (20-40%) in the process of liver transplantation. Hepatitis-C-induced liver cirrhosis is one of the most common causes for a LTX, but there exists a higher risk for developing a post-transplantation HCV-reinfection and successive fibrosis/cirrhosis of the transplanted liver. In clinical practice, the identification of a HCV infection arises a problem since the acute rejection often displays the same clinical parameters. These are rising serum transaminases, functional deficits of the liver despite of no perfusion deficiencies and elevated bilirubin levels. The gold standard for differential diagnosis still represents the liver-biopsy. Similar histological characteristics can be found for both HCV infection and acute tissue rejection. This is a problem when it comes to differentiation of these pathologies. The therapeutic steps for these pathologies are, however, completely different. Therefore it is critical to choose the right therapy based on an accurate diagnosis. Treating a patient with an HCV-reinfection with high-dose-steroid-pulsed therapy, due to false diagnosis, may severely increase HCV-virus activity and worsen the patient´s clinical state. To improve differential diagnosis, a specific marker, which is expressed only in cases of acute rejection, is needed. C4d, as a split-product of the activated classical complement cascade, could serve as such important marker. It has yet been proven to be an important diagnostic tool for the diagnosis of acute rejection in patients undergoing kidney transplantation. For that purpose, in a previous retrospectively study of our group, it was determined, if C4d may serve as a possible diagnostic marker for differential diagnosis of acute rejection and HCV-reinfection after liver transplantation. The results showed intensified C4d-staining in paraffinised tissue samples from patients, suffering from acute rejection. In the current prospective, double-blinded study with an increased study cohort and kryoconservated liver tissue samples, the possibility of immune-histochemical detection of C4d was examined based on results of our last study. Due morphological problems, caused by the kryoconservated tissue samples, another technique was used to prove the presence of C4d-protein. A quantitative detection of the C4d-protein was obtained by using proteinextraction-kits and a specific C4d-ELISA. These results were correlated to the histological standard-evaluation. Thus, it was the aim of this dissertation to determine, if the ELISA-based C4d detection could serve as differentiation tool between acute rejection and HCV-reinfection in patients having undergone liver transplantation."]},{"key":"dc:source","label":"Dc Source","values":["Aachen : Publikationsserver der RWTH Aachen University 71 S. : Ill., graph. Darst. (2012). = Aachen, Techn. Hochsch., Diss., 2012"]},{"key":"dc:title","label":"Title","values":["Der ELISA-basierte Nachweis von C4d nach Lebertransplantation - ein hilfreicher Marker zur Differentialdiagnose zwischen akuter Abstoßung und rezidivierender Hepatitis-C-Infektion?"]}]}],"canonical_facts":{"dc:contributor":["Schmeding, Maximilian"],"dc:coverage":["DE"],"dc:creator":["Kienlein, Stefan"],"dc:date":["2012"],"dc:description":["Liver transplantation is known to be an established and validated treatment for a variety of liver diseases. Recently, there has been an enhancement in the outcome of these patients through pharmaceutical and therapeutical improvements like immunosuppressive protocols. Rejection reactions are mostly treated by steroid-pulse therapy and/or increased doses of calcineurin-inhibitors. MMF and sirolimus are also state of the art in treatment of rejection reactions. However, acute rejection accounts for the majority of complications (20-40%) in the process of liver transplantation. Hepatitis-C-induced liver cirrhosis is one of the most common causes for a LTX, but there exists a higher risk for developing a post-transplantation HCV-reinfection and successive fibrosis/cirrhosis of the transplanted liver. In clinical practice, the identification of a HCV infection arises a problem since the acute rejection often displays the same clinical parameters. These are rising serum transaminases, functional deficits of the liver despite of no perfusion deficiencies and elevated bilirubin levels. The gold standard for differential diagnosis still represents the liver-biopsy. Similar histological characteristics can be found for both HCV infection and acute tissue rejection. This is a problem when it comes to differentiation of these pathologies. The therapeutic steps for these pathologies are, however, completely different. Therefore it is critical to choose the right therapy based on an accurate diagnosis. Treating a patient with an HCV-reinfection with high-dose-steroid-pulsed therapy, due to false diagnosis, may severely increase HCV-virus activity and worsen the patient´s clinical state. To improve differential diagnosis, a specific marker, which is expressed only in cases of acute rejection, is needed. C4d, as a split-product of the activated classical complement cascade, could serve as such important marker. It has yet been proven to be an important diagnostic tool for the diagnosis of acute rejection in patients undergoing kidney transplantation. For that purpose, in a previous retrospectively study of our group, it was determined, if C4d may serve as a possible diagnostic marker for differential diagnosis of acute rejection and HCV-reinfection after liver transplantation. The results showed intensified C4d-staining in paraffinised tissue samples from patients, suffering from acute rejection. In the current prospective, double-blinded study with an increased study cohort and kryoconservated liver tissue samples, the possibility of immune-histochemical detection of C4d was examined based on results of our last study. Due morphological problems, caused by the kryoconservated tissue samples, another technique was used to prove the presence of C4d-protein. A quantitative detection of the C4d-protein was obtained by using proteinextraction-kits and a specific C4d-ELISA. These results were correlated to the histological standard-evaluation. Thus, it was the aim of this dissertation to determine, if the ELISA-based C4d detection could serve as differentiation tool between acute rejection and HCV-reinfection in patients having undergone liver transplantation."],"dc:identifier":["https://publications.rwth-aachen.de/record/51720","https://publications.rwth-aachen.de/search?p=id:%22RWTH-CONV-113981%22"],"dc:language":["ger"],"dc:publisher":["Publikationsserver der RWTH Aachen University"],"dc:relation":["info:eu-repo/semantics/altIdentifier/urn/urn:nbn:de:hbz:82-opus-42555"],"dc:rights":["info:eu-repo/semantics/openAccess"],"dc:source":["Aachen : Publikationsserver der RWTH Aachen University 71 S. : Ill., graph. Darst. (2012). = Aachen, Techn. Hochsch., Diss., 2012"],"dc:subject":["info:eu-repo/classification/ddc/610","Lebertransplantation","Hepatitis C","Hepatitis-C-Virus","Komplement <Immunologie>","Enzyme-linked immunosorbent assay","Differentialdiagnose","Medizin","C4d","akute Rejektion","akute Abstoßung","acute rejection","complement system"],"dc:title":["Der ELISA-basierte Nachweis von C4d nach Lebertransplantation - ein hilfreicher Marker zur Differentialdiagnose zwischen akuter Abstoßung und rezidivierender Hepatitis-C-Infektion?"],"dc:type":["info:eu-repo/semantics/doctoralThesis","info:eu-repo/semantics/publishedVersion"]},"updated_at":"2026-07-30T19:40:42Z"}