Plasma proteolytic activity in liver transplant rejection

• Published in: Transplant international Vol. 12; no. 2; pp. 100 - 107
• Main Authors: Scholz, T., Gallimore, M. J., Bäckman, L., Mathisen, ∅, Bergan, A., Klintmalm, G. B., Aasen, A. O.
• Format: Journal Article
• Language: English
• Published: Oxford, UK Blackwell Publishing Ltd 01.03.1999; Blackwell Publishing
• Subjects: Adolescent; Adult; alpha-2-Antiplasmin - metabolism; Antifibrinolytic Agents; Antithrombin III - metabolism; Biological and medical sciences; Blood Coagulation Factors - analysis; Child; Female; Fibrinolysin - metabolism; Graft Rejection - blood; Humans; Kallikreins - metabolism; Liver Transplantation - immunology; Liver Transplantation - physiology; liver transplantation Liver transplantation; liver transplantation Rejection; Liver, biliary tract, pancreas, portal circulation, spleen; Male; Medical sciences; Middle Aged; Peptide Hydrolases - metabolism; Plasminogen - metabolism; Postoperative Period; Prekallikrein - metabolism; Proteolytic activity; Prothrombin - metabolism; rejection; Retrospective Studies; Serine Endopeptidases - blood; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of the digestive system; Human; Postoperative; Pathophysiology; Enzyme; Liver; Hepatic disease; Transplantation; Homotransplantation; Blood plasma; Rejection; Proteolysis; Surgery; Digestive diseases; Complication
• ISSN: 0934-0874; 1432-2277
• DOI: 10.1111/j.1432-2277.1999.tb00588.x

ABSTRACT In this study, we evaluated the role of proteolytic enzymes belonging to the coagulation, fibrinolytic, and plasma contact systems in the early postoperative phase after orthotopic liver transplantation (OLT). Twenty‐nine patients were studied at the time of OLT and during the first 2 postoperative weeks. Blood samples were collected daily after OLT and analyzed for kallikrein‐like activity (KK), functional kallikrein inhibition (KKI), plasmin‐like activity (PL), and α2‐anti‐plasmin (AP). In addition, prekallikrein (PKK), prothrombin (PTH), antithrombin III (AT III), plasminogen (PLG), prothrombin/antithrombin III complexes (TAT), prothrombin fragment 1+2 (F 1 + 2), and plasmin/α2‐antiplas‐min complexes (PAP) were measured. Nineteen patients experienced biopsy‐verified acute rejections (AR) and ten patients had uneventful courses and served as controls. Plasma analyses showed that the contact, coagulation, and fibrinolytic systems were activated during OLT. Following OLT, continuous thrombin and plasmin generation was observed, and these effects were more pronounced in the group having an uneventful course than in patients with AR. Factors that could possibly affect plasma proteolytic activity, such as blood product usage during and after OLT and cold ischemia time of the liver graft, did not differ between the groups, nor did the routine liver function tests, alanine aminotransferase (ALT) and aspartate aminotransferase (AST).