Activation of the plasma contact system and hemodynamic changes after graft revascularization in liver transplantation

Transplantation
T ScholzA O Aasen

Abstract

In this study, the relation between activation of the plasma contact system and hemodynamic changes during orthotopic liver transplantation was evaluated. Nineteen consecutive courses of OLT in 17 adult patients were investigated. Veno-venous bypass was used in all patients. Blood samples were drawn through all phases of the procedure, and analyzed for the following parameters using functional techniques (chromogenic peptide substrate assays): plasma kallikrein (KK), prekallikrein, functional plasma kallikrein inhibition, C1 inhibitor, and alpha 2-macroglobulin. Plasma high molecular weight kininogen (HK) degradation was evaluated using the immunoblotting technique. An abrupt rise in KK activities occurred within 1 min after portal reperfusion of the liver graft (7-16 U/L, P < 0.05). Simultaneously, proteolytic breakdown of HK was seen. The elevated KK activities were maintained the next 1 1/2 hr. Ten min after graft reperfusion, a significant increase in cardiac output compared with the anhepatic phase (7.2-12.4 L/min, P < 0.05) was found. At the same time, systemic vascular resistance fell significantly (817-408 dynes x sec/cm-5, P < 0.05). The increase in plasma KK activities accompanied by simultaneous degradation of HK see...Continue Reading

Citations

Dec 10, 2002·International Immunopharmacology·Joichiro HayashiTony E Hugli
Oct 27, 2001·Liver Transplantation : Official Publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society·I Q MolenaarR J Porte
Jul 13, 2006·International Anesthesiology Clinics·Theo H N Groenland, Robert J Porte
Sep 16, 2004·Journal of Cardiothoracic and Vascular Anesthesia·Robert J PorteMaarten J h Slooff
Jan 1, 1997·Transplant International : Official Journal of the European Society for Organ Transplantation·T ScholzO Søreide
Jan 29, 2016·World Journal of Gastroenterology : WJG·Antonio SiniscalchiStefano Faenza

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