Phenotypic characterization of mononuclear infiltrate present in liver of biliary atresia.

The liver tissue of 26 children with biliary atresia was compared to that of 20 adults with autoimmune chronic active hepatitis, 20 adults with chronic hepatitis due to hepatitis B infection, and 5 children with alpha 1-antitrypsin deficiency in terms of the number and type of mononuclear cells in portal and lobular areas of each using a panel of specific monoclonal antibodies that recognize different cell surface epitopes. All of the tissues studied were obtained at time of liver transplantation. In addition the livers of 5 adults biopsied for hepatomegaly but found to have no histologic liver disease were used as normal controls for this study. The results demonstrate that liver tissue obtained from children with end-stage biliary atresia is more like normal liver in terms of the number and type of mononuclear cells present than in either of the two types of adult liver diseases. Moreover although the liver of children with end-stage alpha 1-antitrypsin deficiency is more like that of normal liver than either of the two adult liver diseases studied in terms of the number and type of mononuclear cells within the liver, it is less similar to that of normal adult liver than is liver tissue obtained from children with biliary atresia. These findings suggest that as a morphologic basis biliary atresia is unlikely to be due to either a viral or an autoimmune attack upon the liver.