Phenotype change in polymorphic plasma proteins following liver transplantation.

In 7 patients who received liver transplants, 12 plasma proteins were subjected to phenotype analysis in donor and recipient before and after transplantation. The plasma proteins analyzed were haptoglobin, transferrin, glycoprotein GC, alpha-1-antitrypsin, complement factor 3 (C3), orosomucoid 1, properdin factor B, complement factor 6, alpha-2-HS-glycoprotein (A2HS), plasminogen, factor B of coagulation factor XIII, and interalpha-trypsin-inhibitor (ITI). Classification was done with isoelectric focusing or agarose gel electrophoresis (C3). A change from recipient to donor type was observed for all systems with the exception of C3. This is the first time such data have been obtained for the A2HS and ITI systems. The time is indicated at which the recipient type disappeared and the donor type appeared. In addition to the expected phenotype changes from recipient to donor type, unexpected results were found in some systems. For instance, in 2 patients a mixed type was synthesized, or new phenotypes appeared. Possible explanations include blood transfusions, immunosuppressive therapy, extrahepatic sites of synthesis and disturbed transplant function. The usefulness of phenotype determination as a diagnostic criterion for transplant function is discussed.