title: Citrulline evaluation in bowel transplantation.
abstract: BACKGROUND
  The purpose of this study was to evaluate the correlation of plasma citrulline and rejection episodes in intestinal transplantation.
  
  
  METHODS
  From January 2007 until present, we performed citrulline assays on our small bowel patients. We investigated the correlation of these assays with the rejection status of the patients. The rejection status of the graft was defined based on graft biopsies.
  
  
  RESULTS
  Of 5195 citrulline samples, average serum citrulline levels decreased significantly when the patients presented a rejection episode. We found the following: no rejection, 17.38 microm/L; mild rejection, 13.05 microm/L; moderate rejection, 7.98 microm/L; and severe rejection, 6.05 microm/L. Our current emphasis is to determine the predictive power of citrulline with other biomarkers versus as a separate and isolated measurement.
  
  
  CONCLUSIONS
  In our study, citrulline levels correlated significantly with the rejection status of the graft. Serial follow-up of the patients using this assay may alert us to the possibility of increased alloreactivity and rejection episodes.
authors.affiliation: Department of Surgery, University of Miami School of Medicine, Miami, Florida, USA. pruiz@med.miami.edu
authors.forename: P
authors.initials: P
authors.lastname: Ruiz
authors.forename: P
authors.initials: P
authors.lastname: Tryphonopoulos
authors.forename: E
authors.initials: E
authors.lastname: Island
authors.forename: G
authors.initials: G
authors.lastname: Selvaggi
authors.forename: S
authors.initials: S
authors.lastname: Nishida
authors.forename: J
authors.initials: J
authors.lastname: Moon
authors.forename: A
authors.initials: A
authors.lastname: Berlanga
authors.forename: T
authors.initials: T
authors.lastname: Defranc
authors.forename: D
authors.initials: D
authors.lastname: Levi
authors.forename: A
authors.initials: A
authors.lastname: Tekin
authors.forename: A G
authors.initials: AG
authors.lastname: Tzakis
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000097:blood; D001706:Biopsy; D002648:Child; D002956:Citrulline / Q000097:blood*; D020345:Enterocolitis, Necrotizing / Q000453:epidemiology; D005260:Female; D020139:Gastroschisis / Q000453:epidemiology; D006084:Graft Rejection / Q000097:blood* / Q000473:pathology*; D006801:Humans; D007422:Intestines / Q000637:transplantation*; D016031:Liver Transplantation / Q000473:pathology; D008297:Male; D013058:Mass Spectrometry; D011183:Postoperative Complications / Q000453:epidemiology; D014184:Transplantation, Homologous / Q000473:pathology; D014781:Viscera / Q000637:transplantation*
chemical_list: D015415:Biomarkers; D002956:Citrulline