Protein C Activity and Postoperative Metabolic Liver Function after Liver Transplantation

作者：Wagener G^*; Diaz G; Guarrera J V; Minhaz M; Renz J F; Sladen R N

来源：Transplantation Proceedings, 2012, 44(5): 1336-1340.

DOI：10.1016/j.transproceed.2012.01.116

Background. Protein C is a natural thrombin antagonist produced by hepatocytes. Its levels are low in liver failure and predispose patients to increased risk for thrombosis. Little is known about the relationship between protein C activity and hepatic function after orthotopic liver transplantation (OLT).
Methods. We measured protein C activity of 41 patients undergoing liver transplantation by the Staclot method (normal range, 70%-130%) preoperatively and then daily on postoperative days (POD) 0-5.
Results. The mean protein C activity was low before OLT (34.3 +/- 4.3%) and inversely correlated with the preoperative Model for End-Stage Liver Disease score (Spearman's r = 0.643; P < .0001). Mean activity increased significantly on POD 1 (58.9 +/- 4.5%), and remained above preoperative levels through POD 5. Ten patients developed metabolic liver dysfunction defined by a serum total bilirubin >5 mg/dL on POD 7. These patients had significantly lower protein C activity from POD 3 (47.2 +/- 9.6% vs 75.9 +/- 5.8%; P = .01) to POD 5. Preoperative protein C activity correlated inversely with the severity of liver failure as indicated by preoperative MELD score.
Conclusion. Protein C activity recovered rapidly in patients with good allograft function but remained significantly lower in patients who had limited metabolic function as evidenced by increased total bilirubin levels.

• 出版日期2012-6