SERUM LEVELS OF ENDOTHELIAL INJURY MARKERS CREATINE KINASE-BB AND SOLUBLE THROMBOMODULIN DURING HUMAN LIVER-TRANSPLANTATION

Endothelial damage within the sinusoids of the liver probably plays a key role in primary liver dysfunction following transplantation. The a im of this work was to study the serum levels of two potential markers of endothelial damage, creatine kinase-BB and soluble thrombomodulin, during human graft revascularization. Thirteen human liver grafts wer e preserved in UW solution (mean time: 13.8 h). Creatine kinase-BB and transaminase activities and soluble thrombomodulin levels were measur ed: 1) in effluent and 2) in serum samples sequentially collected befo re revascularization, then during the first 120 min of revascularizati on and first post-operative week. No correlation was observed between serum values (peak) and effluent values. In serum, pre-operative creat ine kinase-BB activities were correlated with soluble thrombomodulin l evels (p=0.01). Both increased significantly during the first minutes of the revascularization, then decreased markedly. In contrast, AST ac tivity was maximal at day 1. This detectable and early release of crea tine kinase-BB and soluble thrombomodulin in blood is in keeping with the early occurence of endothelial damage. Together with previous data , these findings suggest that serum determination of these two markers may be a useful tool in the assessment of endothelial injury in liver transplantation. (C) Munksgaard, 1996.