Prevalence of cryoglobulinemia and autoimmune markers in liver transplant patients

To examine the prevalence of cryoglobulinemia and autoimmune markers in stable liver transplant recipients and to determine risk factors and clinical impact. Ninety-two liver transplant recipients were tested for cryoglobulinemia, hepatitis B and C, complement C3, complement C4, CH50, antinuclear an...

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Bibliographic Details
Published in:Experimental and clinical transplantation 2008-09, Vol.6 (3), p.184-189
Main Authors: Garrouste, Cyril, Kamar, Nassim, Boulestin, Anne, Esposito, Laure, Lavayssiere, Laurence, Durand, Dominique, Blancher, Antoine, Rostaing, Lionel
Format: Article
Language:English
Subjects:
Adult
Aged
Autoimmunity - immunology
Creatinine - metabolism
Cryoglobulinemia - classification
Cryoglobulinemia - epidemiology
Cryoglobulinemia - etiology
Female
Humans
Incidence
Liver Transplantation - adverse effects
Liver Transplantation - immunology
Male
Middle Aged
Patient Selection
Postoperative Complications - epidemiology
Postoperative Complications - immunology
Surveys and Questionnaires
Young Adult
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Summary:To examine the prevalence of cryoglobulinemia and autoimmune markers in stable liver transplant recipients and to determine risk factors and clinical impact. 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. 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 microkat/L or more, and an albuminemia level greater than 38 g/L. Cryoglobulinemia is frequent after liver transplant and is symptomatic in approximately 20% of all patients.
ISSN:1304-0855