Jennings I, Calne R Y, Baglin T P
Department of Haematology, Addenbrookes Hospital, UK.
Transplantation. 1994 Apr 15;57(7):1046-51.
Acute cellular rejection and hepatic vessel thrombosis are significant postoperative complications of liver transplantation. The study investigated changes in endothelial cell-related hemostatic proteins in the peripheral circulation of patients after liver transplantation, and assays for hemostatic parameters were compared with data from routine hematologic and biochemical investigations, together with clinical information. Of the 12 patients, 8 underwent acute rejection episodes. No significant differences in any hemostatic parameter measured were seen between rejection and nonrejection groups, with the exception of the platelet count, which increased after treatment of the rejection episode. Two of the 12 patients suffered fatal hepatic vessel thrombosis during the study. A number of significant differences were found between these patients and those with no thrombotic complications, most notably and increase in the von Willebrand factor antigen to ristocetin cofactor ratio and thrombin-antithrombin complex generation. These changes occurred before clinical detection of thrombosis. Thus, measurement of these parameters may be of predictive value in the diagnosis and monitoring of post-transplant thrombosis.
急性细胞排斥反应和肝血管血栓形成是肝移植术后的重要并发症。该研究调查了肝移植患者外周循环中内皮细胞相关止血蛋白的变化，并将止血参数检测结果与常规血液学和生化检查数据以及临床信息进行了比较。12例患者中，8例发生急性排斥反应。除血小板计数在排斥反应治疗后升高外，排斥反应组和非排斥反应组在任何测量的止血参数上均无显著差异。12例患者中有2例在研究期间发生致命性肝血管血栓形成。在这些患者与无血栓形成并发症的患者之间发现了许多显著差异，最明显的是血管性血友病因子抗原与瑞斯托霉素辅因子比值以及凝血酶 - 抗凝血酶复合物生成增加。这些变化在血栓形成临床检测之前就已出现。因此，这些参数的测量可能对移植后血栓形成的诊断和监测具有预测价值。
