[Values of soluble thrombomodulin and von Willebrand factor judging reject reaction in liver transplantation].
OBJECTIVE
To find sensitive and specific laboratory examination items for early diagnosing and monitoring liver transplantation reject reaction.


METHODS
Randomly investigate 41 liver transplantation patients, among them there were 16 patients with reject reaction (including 12 with acute rejection, 4 with chronic rejection). Plasma soluble thrombomodulin (STM) and von Willebrand factor (vWF) levels were measured before operation and every other day after operation.


RESULTS
Plasma STM level increased significantly after operation, two days before rejection and after acute rejection (5.58 ng/ml +/- 0.42 ng/ml, 5.93 ng/ml +/- 0.45 ng/ml, and 7.88 ng/ml +/- 0.29 ng/ml, respectively), so did vWF level (101.2% +/- 4.68%, 104.3% +/- 5.78%, and 127.7% +/- 5.74%, respectively). STM level was much higher in acute rejection than that in chronic rejection (7.88 ng/ml +/- 0.29 ng/ml vs. 6.35 ng/ml +/- 0.54 ng/ml, t = 2.46, P < 0.05), in no reaction group after impacting therapy than in effective group (8.30 ng/ml +/- 0.19 ng/ml vs. 3.82 ng/ml +/- 0.22 ng/ml, t = 12.98, P < 0.01), and in dead group after treatment than in living group (7.98 ng/ml +/- 0.18 ng/ml vs. 6.51 ng/ml +/- 0.41 ng/ml, t = 3.39, P < 0.01).


CONCLUSIONS
Plasma STM and vWF can be taken as laboratory items for monitoring liver transplantation rejection. Plasma STM can act as not only an early prognosticating marker, but also suitable to distinguish acute from chronic reject reaction, and as a marker for monitoring impacting therapy effect and judging prognosis.
Wen
Chun-guang
CG
Department of Hematology, First Affiliated Hospital, Sun Yat-Sen University, Guangzhou 510080, China.
Luo
Shao-kai
SK
He
Xiao-shun
XS
Li
Juan
J
Liu
Min
M
Zou
Wai-yi
WY
Peng
Ai-hua
AH
D000293:Adolescent; D000328:Adult; D015415:Biomarkers / Q000097:blood; D005260:Female; D006084:Graft Rejection; D006801:Humans; D016031:Liver Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D018180:Thrombomodulin / Q000097:blood*; D014841:von Willebrand Factor / Q000032:analysis*
D015415:Biomarkers; D018180:Thrombomodulin; D014841:von Willebrand Factor