title: Acute phase response after liver transplantation for fulminant hepatic failure and cirrhosis.
abstract: The hepatic acute phase response after orthotopic transplantation (OLT) was studied in patients with fulminant hepatic failure (FHF) and with cirrhosis, in relation to the pre-existing disease. Plasma levels of C-reactive protein (CRP) increased significantly on day 1 after OLT in both the FHF (delta = 58 micrograms/ml) and cirrhosis (delta = 94 micrograms/ml) groups and reached a peak 4-5 days post surgery. alpha 1-Antitrypsin reached normal levels on day 1 post-transplant and fibrinogen reached normal levels on the 3rd day. The main stimulator of acute phase protein synthesis IL-6 was significantly increased pre-OLT in plasma in both FHF (median 54 pg/ml) and cirrhosis (median 8.7 pg/ml) patients compared to controls (2.35 pg/ml, P < 0.05). After OLT, IL-6 decreased rapidly in patients with FHF, indicating either removal of the source of IL-6 or clearance by the transplanted liver. In patients with cirrhosis, plasma IL-6 remained low, except in three patients who developed infection/rejection and whose IL-6 levels rose above 100 pg/ml. In conclusion, there is a marked acute phase response in the liver graft after transplantation, irrespective of the aetiology of the liver disease for which the transplant was performed.
authors.affiliation: Institute of Liver Studies, King's College Hospital, London, UK.
authors.forename: S
authors.initials: S
authors.lastname: Izumi
authors.forename: R D
authors.initials: RD
authors.lastname: Hughes
authors.forename: P G
authors.initials: PG
authors.lastname: Langley
authors.forename: J R
authors.initials: JR
authors.lastname: Pernambuco
authors.forename: R
authors.initials: R
authors.lastname: Williams
mesh_terms: D000210:Acute-Phase Reaction / Q000209:etiology*; D000328:Adult; D002097:C-Reactive Protein / Q000096:biosynthesis; D005260:Female; D005340:Fibrinogen / Q000096:biosynthesis; D006501:Hepatic Encephalopathy / Q000378:metabolism / Q000601:surgery*; D006801:Humans; D015850:Interleukin-6 / Q000096:biosynthesis; D008103:Liver Cirrhosis / Q000378:metabolism / Q000601:surgery*; D016031:Liver Transplantation / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D000515:alpha 1-Antitrypsin / Q000096:biosynthesis
chemical_list: D015850:Interleukin-6; D000515:alpha 1-Antitrypsin; D005340:Fibrinogen; D002097:C-Reactive Protein