SERUM CITRULLINE AND REJECTION IN SMALL BOWEL TRANSPLANTATION: A PRELIMINARY REPORT

瓜氨酸 医学 内科学 胃肠病学 移植 活检 精氨酸 氨基酸 生物 生物化学
作者
Peter G. Pappas,Jean-Marie Saudubray,Andreas G. Tzakis,Daniel Rabier,Manuel Carreno,Orlando Gomez-Marin,Frans Huijing,Barry Gelman,David Levi,Jose Nery,Tomoaki Kato,Naveen K Mittal,Seigo Nishida,John F. Thompson,Phillip Ruiz
出处
期刊:Transplantation [Wolters Kluwer]
卷期号:72 (7): 1212-1216 被引量:64
标识
DOI:10.1097/00007890-200110150-00005
摘要

Background. There is no known serum marker for intestinal rejection. Serum concentrations of the amino acid citrulline arise almost exclusively from the intestinal mucosa. We examined the impact of acute cellular rejection (ACR) of intestinal allografts on serum citrulline levels. Methods. Citrulline concentrations were assayed in serum samples of healthy volunteers (n=6) and seven patients who underwent small bowel transplants (SBTx). Trends in mean citrulline concentrations versus degree of ACR were assessed by matching posttransplantation citrulline concentrations with patients’ grade of ACR at time of serum collection. Rejection was confirmed by biopsy and graded by following standardized criteria. An additional patient had citrulline concentrations determined for 31 sequential specimens 3–60 days posttransplant. Results. Mean citrulline concentrations in controls were significantly higher than posttransplantation samples at any rejection grade. Mean concentrations declined significantly as rejection severity increased. The overall downward trend was statistically significant (P <0.05). In sequential measurements, citrulline levels increased significantly over time with declining severity of rejection. The increase in mean citrulline concentration between posttransplant days 3–16 and 52–60 was significant (P <0.01). Conclusions. Serum citrulline levels decline with increasing grade of ACR and may be a useful serum marker for intestinal rejection.

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