URINARY THROMBOXANE B-2 AS AN INDICATOR OF ACUTE REJECTION IN HUMAN LIVER-TRANSPLANTATION

Urinary thromboxane B-2 (u-TXB(2)) was measured and analyzed after a h uman liver transplantation in 28 patients (30 transplantations) who un derwent an orthotopic liver transplantation. Our results showed that t he u-TXB(2) levels exceeded 3.0 mu g/mmol creatinine in only 2 of the 13 cases that had a favorable postoperative course, In 10 of the 11 ep isodes of acute rejection, the u-TXB(2) levels exceeded 3.0 mu g/mmol creatinine. In 6 episodes of acute rejection, the TXB(2) levels were m ore than 5.0. In 4 out of 6 episodes of infection unassociated with re jection, the u-TXB(2) values were between 3.0 and 4.9 mu g/mmol creati nine. In 2 episodes of liver necrosis the TXB(2) value reached 5.3 in one and 0.9 in the other, In conclusion, the u-TXB(2) level was observ ed to be elevated in cases of acute rejection, infection, or necrosis. The diagnosis of acute rejection on the basis of u-TXB(2) showed a se nsitivity of 58.8%, a specificity of 93.3%, and an accuracy of 75.0% f or a threshold level of 3.0 mu g/mmol creatinine, and a sensitivity of 85.7%, a specificity of 79.2%, and an accuracy of 80.6% for a thresho ld level of TXB(2) of 5.0 mu g/mmol creatinine, These results indicate that the serial determination of u-TXB(2) is a useful diagnostic mean s for predicting acute rejection after liver transplantation.