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Acute phase proteins and liver allograft rejection
C P Maury1, A M Teppo, K Höckerstedt
1Fourth Department of Medicine, University of Helsinki, Finland.
Liver
|April 1, 1988
Summary
Acute liver transplant rejection causes significant changes in acute phase reactants. Specific proteins like orosomucoid and alpha 1-antichymotrypsin reliably indicate rejection, while others show varied responses.
Area of Science:
- Transplantation immunology
- Clinical biochemistry
- Graft rejection monitoring
Background:
- Orthotopic liver transplantation is a complex procedure with potential for acute rejection.
- Monitoring graft health post-transplantation is crucial for patient outcomes.
- Acute phase reactants (APRs) are proteins whose plasma concentrations change significantly in response to inflammation.
Purpose of the Study:
- To investigate sequential changes in specific serum proteins following liver transplantation.
- To correlate these protein level changes with acute liver allograft rejection episodes.
- To assess the utility of various acute phase reactants in detecting and monitoring rejection.
Main Methods:
- Serum samples were collected from nine adult patients undergoing orthotopic liver transplantation.
- Concentrations of positive APRs (orosomucoid, alpha 1-antichymotrypsin, alpha 1-antitrypsin, haptoglobin, C-reactive protein) and negative APRs (prealbumin) were measured.
- Levels of alpha 2-macroglobulin and beta 2-microglobulin were also analyzed.
- Changes were correlated with documented episodes of acute liver rejection.
Main Results:
- Synchronous increases in five positive APRs were observed during acute rejection episodes, with orosomucoid and alpha 1-antichymotrypsin showing statistically significant elevations.
- C-reactive protein levels did not increase in 44% of rejection episodes.
- Prealbumin and alpha 2-macroglobulin levels tended to decrease post-rejection.
- Beta 2-microglobulin levels increased during the post-transplant period and markedly during rejection episodes.
Conclusions:
- Plasma protein concentrations undergo significant changes associated with acute liver allograft rejection.
- The kinetics of serum APRs in liver transplant rejection resemble those seen in general inflammation and tissue injury.
- Specific APRs, particularly orosomucoid and alpha 1-antichymotrypsin, show promise as reliable biomarkers for acute liver rejection.