Different time course of circulating adhesion molecules and hyaluran during hepatic allograft rejection

Background. Inducible adhesion molecules are involved in cell-mediated allo graft rejection. In addition, the endothelium is the main target of this pr ocess. This study investigated, whether soluble (s) forms of vascular cell adhesion molecule-1 (VCAM-1) and intercellular adhesion molecule-1 (ICAM-1) are elevated during cellular rejection and whether hyaluran is a useful ma rker of endothelial function in liver transplantation. Methods. Serum levels of sICAM-1, sVCAM-1, and hyaluran were determined in 24 controls and 27 hepatic transplant recipients, These patients were divid ed in two groups: group I, 14 patients without rejection; and group II, 13 patients with rejection. Samples were collected on day 1 and 7 after transp lantation, on the day of liver biopsy, and after treatment of the rejection . Results. We found a significant increase in sICAM-1 levels in the postopera tive period in the rejection group compared with the non rejection group. I t persisted significantly elevated until the diagnosis of rejection was mad e. In contrast, sVCAM-1 was only significantly elevated in the rejection gr oup when diagnosis of rejection was evident. Hyaluran levels were also sign ificantly elevated in the rejection group at diagnosis of rejection, We not iced a significant decline in sICAM-1, sVCAM-1, and hyaluran levels after s uccessful treatment of rejection. In addition, we observed in the non-rejec tion group a stable lower levels of hyaluran during the entire postoperativ e period. Conclusions. The release of circulating adhesion molecules is a prominent f eature coinciding with the first episode of hepatic rejection. Differential patterns of sICAM-1 and sVCAM-1 exist during rejection. In addition, hyalu ran levels may be a sensitive marker of liver endothelial cell function in the postoperative period of liver transplantation.