Research Article
Kentaro Yamagiwa, Yusuke Ii
Abstract
Introduction: The importance of measuring Secretory Immunoglobulin A (sIg-A) levels in clinical samples from the recipients of liver transplantation is still unclear. An observational study was conducted to investigate the importance of biliary sIg-A in the early period after Living-Donor Liver Transplantation (LDLT). Methods: The biliary sIg-A level (μg/ml) of 18 patients who underwent LDLT, and a control group of 5 patients who underwent Choledochotomy (CDT) in the Department of Hepatobiliary-Pancreatic Transplant Surgery of Mie University Hospital between 2003 and 2005 was measured on Postoperative Day 7 (POD 7). The biliary sIg-A levels were compared with 11 clinical variables including portal venous Interleukin (IL)-6 levels and Portal Venous Pressure (PVP), on POD 7 in the LDLT group. Results: The biliary sIg-A levels in the LDLT group (102.8 ± 74.8) were significantly higher (p=0.014) than in the CDT group (11.7 ± 5.6). Postoperative complications developed in 6 patients (33%) in the LDLT group, but there were no significant differences between the biliary sIg-A levels according to whether the patients had developed postoperative complications. There were significant positive correlations between the biliary sIg-A levels and portal venous IL-6 (p<0.006) levels, PVP values (p<0.015), and serum T-Bil (p<0.023) values in the LDLT group. Conclusions: The measurement of biliary sIg-A in the early period after LDLT is thought to be useful for analyzing postoperative complications with high PVP and hyperbilirubinemia.