Impact of acute cellular rejection on coagulation and fibrinolysis biomarkers within the immediate post-operative period in pediatric liver transplantation.
We studied restoration of the coagulation and fibrinolysis system in pediatric patients following liver transplantation and biomarkers of blood coagulation and fibrinolysis for suspecting the occurrence of acute cellular rejection. Coagulation activity recovered rapidly within two days following transplantation, but it took approximately 21-28 days for full recovery of the coagulation and fibrinolysis factors synthesized in the liver. PAI-1 levels were significantly higher in patients at the time of acute cellular rejection compared with levels after control of AR, and levels on days 14 and 28 in patients without AR. Plasma protein C and plasminogen levels at the time of rejection were significantly lower than those on day 14 in patients without AR. Statistical analysis suggested that an increase in plasma PAI-1 at a single time point in the post-operative period is a reliable marker among the coagulation and fibrinolysis factors for suspecting the occurrence of acute cellular rejection. These data suggested that appropriate anticoagulation may be required for 14 days after liver transplantation in order to avoid vascular complications and measurement of plasma PAI-1 levels may be useful for suspecting the occurrence of acute cellular rejection in pediatric patients following liver transplantation.
Division of Cell and Molecular Medicine, Center for Molecular Medicine, Jichi Medical University, School of Medicine, Shimotsuke, Tochigi-ken, Japan. mimuro-j@jichi.ac.jp
Jun
J
Mimuro
Koichi
K
Mizuta
Yoichi
Y
Kawano
Shuji
S
Hishikawa
Akiei
A
Hamano
Yuji
Y
Kashiwakura
Akira
A
Ishiwata
Tsukasa
T
Ohmori
Seiji
S
Madoiwa
Hideo
H
Kawarasaki
Yoichi
Y
Sakata
D000208:Acute Disease; D000925:Anticoagulants / Q000008:administration & dosage; D015415:Biomarkers / Q000097:blood; D001774:Blood Chemical Analysis; D001777:Blood Coagulation / Q000502:physiology*; D002648:Child; D005260:Female; D005342:Fibrinolysis / Q000502:physiology; D006084:Graft Rejection / Q000097:blood* / Q000503:physiopathology*; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage; D016031:Liver Transplantation; D016015:Logistic Models; D008297:Male; D017395:Plasminogen Activator Inhibitor 1 / Q000097:blood*; D011184:Postoperative Period; D011237:Predictive Value of Tests
D000925:Anticoagulants; D015415:Biomarkers; D007166:Immunosuppressive Agents; D017395:Plasminogen Activator Inhibitor 1