Evaluation of the coagulation and inflammatory responses in solid organ transplant recipients and donors
Josh Levitsky
Northwestern University Feinberg School of Medicine, Chicago, IL
Search for more papers by this authorAlison Freifeld
University of Nebraska Medical Center, Omaha, NE, USA
Search for more papers by this authorElizabeth Lyden
University of Nebraska Medical Center, Omaha, NE, USA
Search for more papers by this authorJulie Stoner
University of Nebraska Medical Center, Omaha, NE, USA
Search for more papers by this authorDiana Florescu
University of Nebraska Medical Center, Omaha, NE, USA
Search for more papers by this authorAlan Langnas
University of Nebraska Medical Center, Omaha, NE, USA
Search for more papers by this authorR. Brian Stevens
University of Nebraska Medical Center, Omaha, NE, USA
Search for more papers by this authorPenny Hardiman
University of Nebraska Medical Center, Omaha, NE, USA
Search for more papers by this authorLisa Hill
University of Nebraska Medical Center, Omaha, NE, USA
Search for more papers by this authorAndre C. Kalil
University of Nebraska Medical Center, Omaha, NE, USA
Search for more papers by this authorJosh Levitsky
Northwestern University Feinberg School of Medicine, Chicago, IL
Search for more papers by this authorAlison Freifeld
University of Nebraska Medical Center, Omaha, NE, USA
Search for more papers by this authorElizabeth Lyden
University of Nebraska Medical Center, Omaha, NE, USA
Search for more papers by this authorJulie Stoner
University of Nebraska Medical Center, Omaha, NE, USA
Search for more papers by this authorDiana Florescu
University of Nebraska Medical Center, Omaha, NE, USA
Search for more papers by this authorAlan Langnas
University of Nebraska Medical Center, Omaha, NE, USA
Search for more papers by this authorR. Brian Stevens
University of Nebraska Medical Center, Omaha, NE, USA
Search for more papers by this authorPenny Hardiman
University of Nebraska Medical Center, Omaha, NE, USA
Search for more papers by this authorLisa Hill
University of Nebraska Medical Center, Omaha, NE, USA
Search for more papers by this authorAndre C. Kalil
University of Nebraska Medical Center, Omaha, NE, USA
Search for more papers by this authorThis study was supported by the Clinical Research Center at the University of Nebraska Medical Center
Abstract
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.
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