Reconstitution of the actin-scavenger system after orthotopic liver transplantation for end-stage liver disease: A prospective and longitudinal study

Serum levels of the actin scavenger Gc-globulin (group-specific component, vitamin D-binding protein), a member of the albumin multigene family, are d ecreased in severe liver disease but have not been evaluated in relation to liver transplantation. We measured Gc-globulin and globulin-actin complex ratio daily for 2 weeks after transplantation in 17 patients with end-stage liver disease. Before transplantation, Gc-globulin levels were significant ly less in the patients than in healthy controls (235 +/- 106 v 340 +/- 35 mg/L, respectively; P< .001), whereas complex ratio level was in the normal range. Five patients (group N) had pretransplantation Gc-globulin values w ithin the normal range (mean +/- 2 SD), and 12 patients had subnormal value s (group S). In group N, mean Gc-globulin levels posttransplantation remain ed stable at a lower level than before transplantation but still within nor mal range. In this group, cold ischemia time correlated inversely with Gc-g lobulin levels on day 2 (r = -0.88; P < .05). In group S, normal mean level s were reached at a mean of 11 days after transplantation, However, almost half these patients had subnormal Gc-globulin levels at day 14, Complex rat io levels remained normal in the study period in both groups. Prothrombin i ndex levels (plasma coagulation factors II, VII, and X) were identical in b oth groups and returned to normal 7 days posttransplantation, whereas plasm a albumin levels were less than normal in both groups and further decreased after transplantation. In conclusion, the maintenance (group N) or reestab lishment (group S) of serum Gc-globulin to normal levels occurred in the ea rly posttransplantation course in the same time frame as the prothrombin in dex. Gc-globulin synthesis seems unrelated to albumin synthesis. A prolonge d cold ischemia time may cause reduced Gc-globulin levels early after trans plantation. Copyright (C) 1999 by the American Association for the Study of Liver Diseases.