Thomas E. Starzl Transplantation Institute, University of Pittsburgh Medical Center, Pittsburgh, PA 15261, USA.
Xenotransplantation. 2012 Jan-Feb;19(1):52-5. doi: 10.1111/j.1399-3089.2011.00686.x.
Aspartate transaminase (AST) and alanine transaminase (ALT) are measured following liver transplantation as indicators of hepatocellular injury. During a series of orthotopic liver allo-and xenotransplants, we observed that there was an increase in AST in all cases. The anticipated concomitant rise in ALT did not occur when a wild-type (WT) pig was the source of the liver graft, but did occur when a baboon or a genetically engineered (α1,3-galactosyltransferase gene-knockout [GTKO]) pig was the source of the graft. We hypothesized that the cience of Galα1,3Gal in GTKO pig livers may render pig hepatocytes similar to human and baboon hepatocytes in their response to hepatocellular injury. Reviewing the literature, after WT pig liver allotransplantation or xenotransplantation, in the majority of reports, although changes in AST were reported, no mention was made of changes in ALT, suggesting that there was no change in ALT. However, Ramirez et al. reported two cases of liver xenotransplants from hCD55 pigs, following which there were increases in both AST and ALT, suggesting that it is not simply the cience of expression of Galα1,3Gal that is the cause. We acknowledge that our observation is based on a small number of experiments, but we believe it is worth recording.
天冬氨酸转氨酶(AST)和丙氨酸转氨酶(ALT)在肝移植后作为肝细胞损伤的指标进行测量。在一系列同种异体和异种原位肝移植中,我们观察到所有病例的 AST 均升高。当供体肝脏来自野生型(WT)猪时,预期的 ALT 同时升高并未发生,但当供体肝脏来自狒狒或基因工程(α1,3-半乳糖基转移酶基因敲除[GTKO])猪时,ALT 确实升高了。我们假设 GTKO 猪肝脏中的 Galα1,3Gal 可能使猪肝细胞在对肝细胞损伤的反应中类似于人和狒狒肝细胞。在回顾文献后,在 WT 猪肝同种移植或异种移植后,在大多数报道中,尽管报告了 AST 的变化,但没有提到 ALT 的变化,这表明 ALT 没有变化。然而,Ramirez 等人报告了两例来自 hCD55 猪的肝异种移植,随后 AST 和 ALT 均升高,这表明并不是 Galα1,3Gal 的表达本身导致了这种变化。我们承认我们的观察结果基于少数实验,但我们认为值得记录。