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Evaluation of the coagulation and inflammatory responses in solid organ transplant recipients and donors
Author(s) -
Levitsky Josh,
Freifeld Alison,
Lyden Elizabeth,
Stoner Julie,
Florescu Diana,
Langnas Alan,
Brian Stevens R.,
Hardiman Penny,
Hill Lisa,
Kalil Andre C.
Publication year - 2009
Publication title -
clinical transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.918
H-Index - 76
eISSN - 1399-0012
pISSN - 0902-0063
DOI - 10.1111/j.1399-0012.2009.01038.x
Subject(s) - medicine , coagulation , c reactive protein , gastroenterology , thrombosis , inflammation , immunology , surgery
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.