Adrenomedullin in liver transplantation and its relationship with vascularcomplications

Adrenomedullin (AM) is a potent vasodilating peptide that increases rat pla telet cyclic adenosine monophosphate levels and acts on endothelial cells t o stimulate nitric oxide release, Both mechanisms inhibit platelet function , Considering these effects, AM may have a role in cardiovascular regulatio n after orthotopic liver transplantation (OLT) and could have an antithromb otic effect. The aim of the present study is to investigate plasma AM level s in the early postoperative period after OLT and their relationship with v ascular complications in OLT, We measured plasma AM levels in 35 patients w ith cirrhosis who underwent OLT at baseline and 1, 7, and 15 days postopera tively, We found that AM levels were significantly greater in patients with cirrhosis compared with healthy subjects. Of the 35 patients, 10 had vascu lar complications, In these 10 patients, AM concentrations were significant ly greater than those observed in the nonthrombotic group in the early post operative period. In addition, we also noticed in the nonthrombotic group a significant increase in AM levels from baseline to day 1, then a decrease to baseline levels in the early postoperative period, Our study shows that AM might act as a new humoral factor involved in the response to surgery in OLT and is significantly associated with vascular thrombosis in OLT. Copyr ight (C) 1999 by the American Association for the Study of Liver Diseases.