Başkent Üniversitesi Yayınları

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Author: search.filters.author.Blancher, AntoineSubject: search.filters.subject.Alanine aminotransferase

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    Prevalence of Cryoglobulinemia and Autoimmune Markers in Liver Transplant Patients
    (Başkent Üniversitesi, 2008-09) Garrouste, Cyril; Rostaing, Lionel; Blancher, Antoine; Durand, Dominique; Lavayssière, Laurence; Esposito, Laure; Boulestin, Anne; Kamar, Nassim
    Objectives: To examine the prevalence of cryoglobulinemia and autoimmune markers in stable liver transplant recipients and to determine risk factors and clinical impact. Materials and Methods: Ninety-two liver transplant recipients were tested for cryoglobulinemia, hepatitis B and C, complement C3, complement C4, CH50, antinuclear antibodies, anticytoplasmic neutrophil antibodies, anticardiolipid antibodies, rheumatoid factors, and lymphocyte subpopulations. Liver, renal, and hematology tests were done. Immuno­suppressive regimens were based on calcineurin inhibitors in 94.6% of the patients. Results: Cryoglobulinemia was present in 18 patients (19.5%) with characteristics of type II in 27.7%, type III in 61.3%, and indeterminate in 11%. Cryoglobulinemia was present in 55.5% of patients with positive hepatitis C virus serology compared with 35.86% of patients with negative hepatitis C virus serology (P = .06). Among those with hepatitis C virus markers, cryoglobulinemia was present in 30%. Anticytoplasmic neutrophil antibodies were positive in 23% of the patients with cryoglobulinemia, but in only 5.4% of the patients without cryoglobulinemia (P = .006). Albuminemia was significantly lower in patients with cryoglobulinemia (38 ± 4.2 g/L) than it was in patients without cryoglobulinemia (40.2 ± 3.4; P = .05). Cryoglobulinemia was symptomatic in 4 patients (22.2% of all patients). Independent factors associated with cryo­globulinemia were presence of anticytoplasmic neutrophil antibodies, more than 4 HLA incompatibilities, alanine aminotransferase level of 0.68 µkat/L or more, and an albuminemia level greater than 38 g/L. Conclusions: Cryoglobulinemia is frequent after liver transplant and is symptomatic in ap­proximately 20% of all patients.