Acute phase proteins and liver allograft rejection

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Abstract
— We studied the sequential changes in the positive acute phase reactants orosomucoid, α1-antichymotrypsin, α1-antitrypsin, haptoglobin and C-reactive protein, and in the negative acute phase reactant, prealbumin, as well as in α2-macroglobulin and β2-microglobulin in serum following orthotopic liver transplantation in nine adult patients. Synchronous increases in all five positive acute phase reactants were observed in association with acute liver rejection episodes; the elevations were statistically significant for orosomucoid and α1-antichymotrypsin. In four out of nine well-documented rejection episodes C-reactive protein did not increase at all. Marked variations occurred in post-transplant prealbumin and α2-macroglobulin levels; both proteins tended to decrease 2–3 days after the rejection was diagnosed. The circulating levels of β2-microglobulin were raised during the post-transplant period and markedly increased in association with acute graft rejection episodes. The results demonstrate marked changes in plasma protein concentrations in association with acute liver allograft rejection episodes; the kinetics of serum acute phase reactants is very similar to that found in inflammation and tissue injury in general.