title: Recipient levels and function of von Willebrand factor prior to liver transplantation and its consumption in the course of grafting correlate with hepatocellular damage and outcome.
abstract: Von Willebrand factor (vWF) is a major platelet adhesion molecule at sites of vascular injury, such as observed in ischemia/reperfusion injury following orthotopic liver transplantation (OLT). Thirty-three OLT patients were divided into groups with elevated or low markers of hepatocellular damage (high and low-HD). Whole-blood aggregometry was performed to evaluate platelet function. Multimeric analysis was utilized to evaluate functional vWF levels in the course of OLT. Donor and recipient demographics were comparable among groups. Low-HD patients demonstrated better preserved coagulation parameters on POD 1-6 if contrasted to high-HD patients. One year graft survival for the high-HD group was lower than low-HD patients (P = 0.037). Preoperative vWF-dependent platelet aggregation and functional vWF plasma levels correlated directly with alanine transaminase levels early after OLT as did the decrease of functional vWF to reperfusion. In summary, these data suggest that vWF may serve as a significant mediator of platelet recruitment and hepatocellular injury in the graft following reperfusion.
authors.affiliation: Department of General Surgery, Heinrich Heine University, Duesseldorf, Germany. jan.schulteamesch@uni-duesseldorf.de
authors.forename: Jan Schulte
authors.initials: JS
authors.lastname: am Esch
authors.forename: Roy Y
authors.initials: RY
authors.lastname: Tustas
authors.forename: Simon C
authors.initials: SC
authors.lastname: Robson
authors.forename: Stefan B
authors.initials: SB
authors.lastname: Hosch
authors.forename: Ayse
authors.initials: A
authors.lastname: Akyildiz
authors.forename: Dieter C
authors.initials: DC
authors.lastname: Bröring
authors.forename: Lutz
authors.initials: L
authors.lastname: Fischer
authors.forename: Wolfram T
authors.initials: WT
authors.lastname: Knoefel
authors.forename: Xavier
authors.initials: X
authors.lastname: Rogiers
mesh_terms: D000328:Adult; D000410:Alanine Transaminase / Q000097:blood; D015415:Biomarkers / Q000097:blood*; D001777:Blood Coagulation; D006085:Graft Survival; D006801:Humans; D008099:Liver / Q000473:pathology / Q000601:surgery; D008111:Liver Function Tests; D016031:Liver Transplantation; D008875:Middle Aged; D010974:Platelet Aggregation; D010976:Platelet Count; D015427:Reperfusion Injury / Q000097:blood* / Q000473:pathology; D014841:von Willebrand Factor / Q000378:metabolism*
chemical_list: D015415:Biomarkers; D014841:von Willebrand Factor; D000410:Alanine Transaminase