CHANGES IN BILIARY (HIGH-MOLECULAR-MASS) AND LIVER ISOFORMS OF ALKALINE-PHOSPHATASE AFTER BABOON-TO-HUMAN LIVER-TRANSPLANTATION

We report a case of hyperphosphatasemia in a 35-year-old patient with hepatitis B who underwent an orthotopic xenogeneic liver transplant. M arked increases in total alkaline phosphatase (ALP; EC 3.1.3.1) activi ty began 5 days posttransplantation (six times human normal) and incre ased to similar to 17 times normal at day 11. Increased ALP persisted for >40 days and steadily increased to 75 times normal in the patient' s last 30 days. Gel electrophoresis detected both liver (LALP) and bil iary (high-molecular-mass, BALP) isoforms. LALP measured with ion-exch ange columns revealed an activity time course pattern similar to that of total ALP. Results for BALP activity also obtained with ion-exchang e columns exhibited broad variability, ranging from 2 to 428 times nor mal.