Study of liver allograft : immune mediated fibrosis post-transplant (LIFT), predicting fibrogenesis and digital quantification of histological characteristics

Protocol biopsies (PB) from stable liver transplant (LT) recipient children frequently exhibit idiopathic fibrosis. We have limited understanding about the natural history of allograft fibrosis progression, its predisposing factors, role of humoral immune response and possibility to predict future fibrogenesis. The aim of this PhD study was to analyze these aspects in stable pediatric LT recipients using serial PB’s and to develop methodology for digital fibrosis quantification. The study was structured to first analyze the natural history of allograft fibrosis progression, then evaluating the predisposing factors, defining clinically valid cut off values for these factors and finally devising methods to predict the fibrogenesis. Simultaneously we developed novel digital histological evaluation protocols for the liver.