Serum Amyloid a and C-Reactive Protein in the First 4 Weeks after Liver Transplantation

Abstract

SAA and CRP serum levels were monitored for 4 weeks after liver transplantation (Tx) in 10 patients. Median age of these 6 women and 4 men was 41 years (range 17-55). Therapy consisted of high dose glucocorticoids with azathioprine. One week after Tx a biopsy was taken to detect acute rejection. SAA and CRP were measured by ELISA. Median SAA level before Tx was 2.5 mg/1 and median CRP 9.4 mg/1. Top SAA and CRP levels were seen after 1 to 3 days. The severity of acute rejection did not correlate with SAA and CRP levels 2,3,7 and 14 days after Tx. Basal reference values for “healthy” (N=19) patients 1-3 years after Tx were calculated: Median SAA 2.1 mg/1, 95% upper limit 6.2 mg/1. Median CRP 0.35 mg/1, 95% upper limit 3.7 mg/1. SAA values were higher than basal values of 50 healthy controls (p>0.0001), while CRP values did not differ. In conclusion, the diseased liver was deficient in the production of CRP and especially SAA. CRP and SAA levels did not correlate with the acute rejection found one week after Tx. Basal reference values of “healthy” patients years after Tx showed a modest elevation of SAA levels compared to healthy controls. This elevation of SAA in combination with normal CRP might be caused by maintenance therapy with glucocorticoids, although subclinical rejection cannot be excluded.