Tissue factor expression demonstrates severe sinusoidal endothelial cell damage during rejection after living-donor liver transplantation.
OBJECTIVE
Since it is well known that endothelial cells may be important targets during rejection after living-donor liver transplantation, in this study we investigated liver sinusoidal endothelial cell (SEC) damage during rejection by focusing on thrombomodulin (TM) and hyaluronic acid (HA) as plasma markers of SEC damage. We also examined tissue factor (TF) expression in SECs, because damage to endothelial cells leads to immediate activation of the coagulation system, with the damage being triggered mainly by TF.


METHODS
Living-donor liver transplantation was performed at Mie University Hospital between March 2002 and December 2007; there were 8 patients with rejection (4 with acute cellular rejection and 4 with chronic rejection) and 32 patients without rejection. Liver biopsy tissue was immunostained with an anti-TF antibody, and assessed for SEC damage. In addition, total RNA was extracted from liver biopsy tissue and tested for TF mRNA expression by reverse-transcription polymerase chain reaction (RT-PCR).


RESULTS
The plasma TM level was significantly higher in the rejection group than in the non-rejection group. TF expression was observed in SECs, in infiltrating inflammatory cells, and in the vascular endothelium in the rejection group. TF mRNA expression was significantly higher in the rejection group than in the non-rejection group.


CONCLUSIONS
We demonstrated that TF expression revealed severe SEC damage in grafted liver during both acute cellular rejection and chronic rejection.
Usui
Masanobu
M
Department of Hepatobiliary Pancreatic and Transplant Surgery, Graduate School of Medicine, Mie University, Tsu, Mie, 514-8507, Japan. m-usui@clin.medic.mie-u.ac.jp
Kuriyama
Naohisa
N
Kisawada
Masashi
M
Hamada
Takashi
T
Mizuno
Shugo
S
Sakurai
Hiroyuki
H
Tabata
Masami
M
Imai
Hiroshi
H
Okamoto
Kohji
K
Uemoto
Shinji
S
Isaji
Shuji
S
D000328:Adult; D042783:Endothelial Cells / Q000473:pathology*; D005260:Female; D006084:Graft Rejection / Q000378:metabolism* / Q000473:pathology*; D006801:Humans; D006820:Hyaluronic Acid / Q000097:blood; D007150:Immunohistochemistry; D008099:Liver / Q000378:metabolism*; D016031:Liver Transplantation; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D020133:Reverse Transcriptase Polymerase Chain Reaction; D018180:Thrombomodulin / Q000097:blood; D013925:Thromboplastin / Q000378:metabolism*
D018180:Thrombomodulin; D006820:Hyaluronic Acid; D013925:Thromboplastin