Ak. Trull et al., SERUM ALPHA-GLUTATHIONE S-TRANSFERASE - A SENSITIVE MARKER OF HEPATOCELLULAR DAMAGE ASSOCIATED WITH ACUTE LIVER ALLOGRAFT-REJECTION, Transplantation, 58(12), 1994, pp. 1345-1351
The wide hepatic distribution, high cytosolic concentration, and short
in vivo plasma half-life of serum alpha-glutathione s-transferase are
properties which may make monitoring this enzyme more clinically usef
ul than conventional biochemical liver function tests as a marker of h
epatocellular damage associated with acute liver allograft rejection.
In a prospective longitudinal study of 58 liver transplants in 45 pati
ents, serum alpha-glutathione s-transferase concentrations rose signif
icantly more consistently and more rapidly than conventional liver fun
ction tests in association with acute rejection. However, a rise in a
glutathione s-transferase was less specific for rejection than convent
ional liver function tests although none of the tests had a positive p
redictive value for rejection of greater than 32%. Compatible with the
particularly short in vivo plasma half-life of this enzyme, alpha-glu
tathione s-transferase concentrations fell to or toward normal more ra
pidly than conventional Liver function test measurements following unc
omplicated transplantation as well as during high-dose steroid treatme
nt of rejection. This may be valuable, both in improving the resolutio
n of biochemical changes associated with early rejection episodes and
in determining when treatment of rejection has been successful. Furthe
r studies are warranted, however, to assess whether the fall in GST du
ring rejection treatment does genuinely reflect the histological resol
ution of rejection.