Circulating adhesion molecules in orthotopic liver transplantation: relation to clinical course

ABSTRACT

Intercellular adhesion molecules [ICAMs] constitute an integral part of the immune reactions in various clinical conditions. Soluble forms shed or released from effector cells retain ligand-binding activity and their measurement in body fluids has proved as useful markers of cellular and endothelial reactivity. In this work, circulating soluble intercellular adhesion molecule-1 [sICAM-1], soluble vascular cell adhesion molecule [sVCAM-1], soluble E and P-selectins [sE- and sP-selectins] were measured by enzyme immuno-assay [EIA] in the serum of 27 liver transplant recipients who received cadaveric grafts within the previous 13 years and who were showing different clinical courses. 13 patients were having stable graft function [Stable group] and 14 showing evidence of chronic rejection +/- viral pathology [Unstable group]. 12 patients with hepatitis C virus [HCV] cirrhosis still on the waiting list for liver transplantation were also included [Pre-transplant group], in addition to 15 healthy subjects matched for age and sex [Control group]. A significant increase in sICAMs was noted in all patient groups as compared to controls except those stable non-viral cases who showed sICAM levels comparable to the control subjects. Patients transplanted for non-viral aetiology had their levels markedly lower than viral cases, whether stable or unstable. Stable cases showing viral recurrence had their sICAM levels comparable to the pre-transplanted cases with an insignificant increase in the unstable group. We could conclude that sICAM levels can be used to monitor graft integrity in the non-viral cases but their use in patients transplanted for viral causes would not be justified