Cellular rejection and routine biochemical laboratory test results – if the cellular rejection itself has signiﬁcant impact on liver and kidney function in lung transplant recipients?
S Zeglen, J Wojarski, E Wozniak-Grygiel, E Kucewicz-Czech, R Buldak, E Herczakowska
Ann Transplant 2009; 14(1): 62-62
Background: Kidney and liver dysfunction at short/long term follow up are
complications almost always associated with lung transplantation (LTx) due
to ischemia, catecholamine's administration during the procedure and calcineurine inhibitors administration. But what is the impact of rejection itself to these organs still remains unclear. Therefore the aim of the study was to compare values of bilirubin (Bil; umol/L), aspartate (AspAt; IU/L) and alanine
(AlAt; IU/L) amionotransferases, creatine phosphokinase (CPK; IU/L), alkaline phosphatase (ALP; IU/L) and gamma-glutamyl transferase (GGT; IU/L) as well as creatinine (Cr; umol/L) and creatinine-based glomerular filtration rate (GFR; mL/min/1.73m2) in patients during rejection.
Material/Methods: The study group included 7 lung transplant recipients (2
women and 5 men, mean age 43.6±12.1 yr, BMI 21.0±7.1) at rejection episodes (n=10) before and after methylprednisolonum administration (group A and B, respectively). The control group (group C) included 10 stable lung transplant recipients (3 women and 7 men, mean age 46.6±14.5 yr, BMI 18.2±3.0). Serum values of all liver enzymes, Bil and Cr were measured using a Cobas Integra 400/800 instrument (Roche, USA). GFR was estimated by Cr predicted clearance based on MDRD (Modification of Diet in Renal Disease).
Results: No significant differences were found in Cr, GFR and liver enzymes
between analyzed groups. Significantly increased average Bil level in group A
was noted when compared to group C (14.1±7.6 vs. 7.0±4.0, p<0.05).
Conclusions: There was increase of bilirubin concentration during rejection
in lung transplant recipients. It could be casual result but it might encourage
to believe, that cellular rejection is systemic and complex reaction.
Keywords: Lung Transplantation