Plasma proteolytic activity in liver transplant rejection.
In this study, we evaluated the role of proteolytic enzymes belonging to the coagulation, fibrinolytic, and plasma contact systems in the early postoperative phase after orthotopic liver transplantation (OLT). Twenty-nine patients were studied at the time of OLT and during the first 2 postoperative weeks. Blood samples were collected daily after OLT and analyzed for kallikrein-like activity (KK), functional kallikrein inhibition (KKI), plasmin-like activity (PL), and alpha2-antiplasmin (AP). In addition, prekallikrein (PKK), prothrombin (PTH), antithrombin III (AT III), plasminogen (PLG), prothrombin/antithrombin III complexes (TAT), prothrombin fragment 1 + 2 (F1 + 2), and plasmin/alpha2-antiplasmin complexes (PAP) were measured. Nineteen patients experienced biopsy-verified acute rejections (AR) and ten patients had uneventful courses and served as controls. Plasma analyses showed that the contact, coagulation, and fibrinolytic systems were activated during OLT. Following OLT, continuous thrombin and plasmin generation was observed, and these effects were more pronounced in the group having an uneventful course than in patients with AR. Factors that could possibly affect plasma proteolytic activity, such as blood product usage during and after OLT and cold ischemia time of the liver graft, did not differ between the groups, nor did the routine liver function tests, alanine aminotransferase (ALT) and aspartate aminotransferase (AST).
Scholz
T
T
Institute for Surgical Research and Surgical Department B, Rikshospitalet, The National Hospital, Oslo, Norway.
Gallimore
M J
MJ
Bäckman
L
L
Mathisen
O
O
Bergan
A
A
Klintmalm
G B
GB
Aasen
A O
AO
D000293:Adolescent; D000328:Adult; D000933:Antifibrinolytic Agents; D000990:Antithrombin III / Q000378:metabolism; D001779:Blood Coagulation Factors / Q000032:analysis*; D002648:Child; D005260:Female; D005341:Fibrinolysin / Q000378:metabolism; D006084:Graft Rejection / Q000097:blood*; D006801:Humans; D007610:Kallikreins / Q000378:metabolism; D016031:Liver Transplantation / Q000276:immunology / Q000502:physiology*; D008297:Male; D008875:Middle Aged; D010447:Peptide Hydrolases / Q000378:metabolism; D010958:Plasminogen / Q000378:metabolism; D011184:Postoperative Period; D011288:Prekallikrein / Q000378:metabolism; D011516:Prothrombin / Q000378:metabolism; D012189:Retrospective Studies; D012697:Serine Endopeptidases / Q000097:blood*; D000979:alpha-2-Antiplasmin / Q000378:metabolism
D000933:Antifibrinolytic Agents; D001779:Blood Coagulation Factors; D000979:alpha-2-Antiplasmin; C046193:antithrombin III-protease complex; C037742:plasmin-plasmin inhibitor complex; D000990:Antithrombin III; D011516:Prothrombin; D010958:Plasminogen; D011288:Prekallikrein; D010447:Peptide Hydrolases; D007610:Kallikreins; D012697:Serine Endopeptidases; D005341:Fibrinolysin