Document Detail


Mediators of leukocyte activation play a role in disseminated intravascular coagulation during orthotopic liver transplantation.
MedLine Citation:
PMID:  7509086     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Leukocytes play an important role in the development of disseminated intravascular coagulation (DIC). In the reperfusion phase of OLT a DIC-like situation has been described and has been held responsible for the high blood loss during this phase. We investigated the role of leukocytes in the pathogenesis of DIC in OLT by measuring the leukocytic mediators released upon activation (cathepsin B, elastase, TNF, neopterin) and the levels of thrombin-antithrombin III (TAT) complexes, seen as markers of prothrombin activation. Arterial blood samples were taken at 10 different time points during and after OLT. Samples were also taken of the perfusate released from the liver graft vein during the flushing procedure before the reperfusion phase. Aprotinin was given as a continuous infusion (0.2-0.4 Mill. KIU/hr) and its plasma levels were determined. Significantly elevated levels of neopterin (15-fold; P < 0.01), cathepsin B (440-fold; P < 0.01) in the perfusate, as compared with the systemic circulation, as well as their significant increases in the early reperfusion phase suggested that they were released by the graft liver. This was paralleled by elevated levels of elastase (1.3-fold, P < 0.05), TNF (1.5-fold, P = NS), and TAT complexes (1.4-fold; P < 0.1) in the perfusate. Significant correlations could be identified between the parameters of leukocyte activation and TAT complexes, whereas no correlation was observed between any of the parameters investigated and the aprotinin levels. Our results strongly indicate a release of leukocytic mediators from the graft liver during its reperfusion which seems to be related to the parallely increased prothrombin activation. No correlation could be seen between levels of aprotinin and levels of leukocytic mediators.
Authors:
G Himmelreich; M Jochum; W O Bechstein; W Machleidt; P Neuhaus; K J Slama; H Riess
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Transplantation     Volume:  57     ISSN:  0041-1337     ISO Abbreviation:  Transplantation     Publication Date:  1994 Feb 
Date Detail:
Created Date:  1994-03-24     Completed Date:  1994-03-24     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0132144     Medline TA:  Transplantation     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  354-8     Citation Subset:  IM    
Affiliation:
Department of Internal Medicine, University Hospital Rudolf Virchow, Berlin, Germany.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Antithrombin III / analysis
Aprotinin / blood
Biopterin / analogs & derivatives,  blood
Cathepsin B / blood
Disseminated Intravascular Coagulation / etiology*
Female
Humans
Leukocytes / physiology*,  secretion
Liver Transplantation / physiology*
Lymphocyte Activation / physiology*
Male
Middle Aged
Neopterin
Pancreatic Elastase / blood
Peptide Hydrolases / analysis
Tumor Necrosis Factor-alpha / analysis
Chemical
Reg. No./Substance:
0/Tumor Necrosis Factor-alpha; 0/antithrombin III-protease complex; 22150-76-1/Biopterin; 670-65-5/Neopterin; 9000-94-6/Antithrombin III; 9087-70-1/Aprotinin; EC 3.4.-/Peptide Hydrolases; EC 3.4.21.36/Pancreatic Elastase; EC 3.4.22.1/Cathepsin B

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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