Beta tryptase levels are not elevated in patients undergoing liver transplantation

Reperfusion syndrome during liver transplantation and anaphylaxis are clinical syndromes that share similarities in physiological responses. The liver and intestine contain a variety of immunologically active cells, including mast cells. The purpose of this study is to investigate the possibility that mast-cell degranulation occurs routinely during transplantation and thereby contributes to hemodynamic instability and coagulopathy. Beta tryptase, an enzyme released by mast cells during degranulation, is a reliable marker for mast-cell-mediated events. Six patients undergoing liver transplantation had beta tryptase levels assayed in blood immediately before and after reperfusion of the liver. No patient showed an increase in beta tryptase levels at 15 or 60 minutes after reperfusion. In conclusion, it is unlikely that clinically significant mast-cell degranulation occurs routinely in patients undergoing liver transplantation.