A PILOT-STUDY OF SOLUBLE ADHESION MOLECULES AS SURROGATE MARKERS FOR ACUTE LIVER ALLOGRAFT-REJECTION

Background Tissue endothelial adhesion molecule expression is increase d during acute liver allograft rejection. Soluble forms exist, but the ir correlation to rejection and their clinical value have not been det ermined. Methods. We studied endothelial adhesion molecule tissue expr ession and soluble levels in blood and bile and correlated these to th e clinical course of 11 adult patients followed for 30 consecutive day s after liver transplantation. Results. Three biopsies showing acute r ejection demonstrated increased intercellular adhesion molecule (ICAM) -1 but not endothelial leukocyte adhesion molecule-1 expression on hep atic endothelial cells during rejection. Vascular cell adhesion molecu le (VCAM)-1 staining was focally increased in two of three specimens. Levels of soluble ICAM-1 or soluble VCAM-1 by ELISA did not distinguis h acute rejection from nonrejection conditions. Conclusion. We confirm ed that endothelial ICAM-1 expression is more intense in rejecting all ografts and is more sensitive than changes in VCAM-1 or endothelial le ukocyte adhesion molecule-1. However, soluble adhesion molecule determ ination was not useful in the accurate detection of acute rejection.