The expression of von Willebrand factor, soluble thrombomodulin, and soluble p-selectin during orthotopic liver transplantation

Transplant Proc. 2007 Jan-Feb;39(1):172-5. doi: 10.1016/j.transproceed.2006.10.027.

Abstract

Background: We evaluated von Willebrand factor (vWF), soluble thrombomodulin (sTM), and soluble P-selectin (sP-selectin) levels in ischemia/reperfusion injury during orthotopic liver transplantation (OLT).

Methods: The vWF, sTM, and sP-selectin were analyzed in 20 patients who underwent liver transplantation. Blood samples were drawn from the radial artery at serial times during surgery. Plasma levels of sTM and sP-selectin were detected by enzyme-linked immunosorbent assay (ELISA). The wWF activity was measured using the immuno-turbidimetric method. Plasma aspartate transaminase (AST) and alanine transaminase (ALT) were assayed by routine clinical chemistry testing.

Results: Marked elevation levels of plasma AST and ALT were released during the 15 minutes after reperfusion phase, with a peak on the first postoperative day (P < .01). The sTM level remained unchanged from preoperative to anhepatic phase (P > .05). In contrast, a mean 2.5-fold increase of sTM was observed during the 15-minute reperfusion stage compared with the preoperative value (P < .01). The vWF activity only showed significant increase during the 60-minute reperfusion stage compared with the preoperative value (P < .05). No significant increase occurred in sP-seletin levels during the reperfusion phase. Platelet count showed significant decrease during the entire observation period compared with the preoperative value (P < .01).

Conclusion: The endothelial reperfusion injury after OLT is characterized by increased vWF and sTM but not by sP-selectin in peripheral blood.

MeSH terms

  • Adult
  • Alanine Transaminase / blood
  • Aspartate Aminotransferases / blood
  • Female
  • Humans
  • Intraoperative Period
  • Liver Transplantation* / methods
  • Male
  • Middle Aged
  • Monitoring, Intraoperative
  • P-Selectin / blood*
  • Radial Artery
  • Reperfusion Injury / blood*
  • Thrombomodulin / blood*
  • von Willebrand Factor / metabolism*

Substances

  • P-Selectin
  • Thrombomodulin
  • von Willebrand Factor
  • Aspartate Aminotransferases
  • Alanine Transaminase