1. Evaluation of the coagulation and inflammatory responses in solid organ transplant recipients and donors.
- Author
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Levitsky J, Freifeld A, Lyden E, Stoner J, Florescu D, Langnas A, Brian Stevens R, Hardiman P, Hill L, and Kalil AC
- Subjects
- Adult, C-Reactive Protein metabolism, Female, Fibrin Fibrinogen Degradation Products metabolism, Follow-Up Studies, Graft Rejection blood, Humans, Male, Middle Aged, Pilot Projects, Postoperative Period, Prognosis, Prospective Studies, Protein C metabolism, Biomarkers blood, Blood Coagulation physiology, Inflammation blood, Kidney Transplantation, Liver Transplantation, Postoperative Complications blood
- Abstract
New strategies that modify the coagulation/inflammatory cascades may be applicable to solid organ transplant (SOT) recipients in the treatment of complications. However, data on kinetics of post-SOT cascades are needed before considering these strategies. Prospectively collected pre-transplant serum measurements of inflammatory (high-sensitive C-reactive protein, HS-CRP) and coagulation (d-Dimer, DD; protein C, PC) markers were compared to post-operative (day 1-90) values in deceased-donor liver (DDLT) and renal (DDRT) transplant recipients, living-related renal recipients (LRT) and donors (LRD). A total of 85 SOT were enrolled: 25 DDLT, 32 DDRT/LRT, 28 LRD. HS-CRP increased in all groups, mainly immediate post-SOT and in LRDs. DD had a similar pattern mainly in LRT and LRD. PC increased significantly over time in the DDLT group ( p < 0.01). Compared to those with no complications (infection, rejection or thrombosis), day 30 HS-CRP (p = 0.04) and DD (p = 0.06) were elevated in the DDRT/LRT group with complications; PC was decreased at day 7 (p = 0.04) and day 30 (p = 0.009) in DDLT and DDRT/LRT groups with complications, respectively. In conclusion, activation of the inflammatory/coagulation cascades occurs after SOT and is least pronounced in DDLT. This activation diminishes over time unless transplant complications occur. Our results support further research in approaches to altering these cascades in SOT recipients.
- Published
- 2009
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