A solid-phase, noncompetitive radioimmunoassay has been developed for aldolase B in human serum and tissues. Aldolase B was purified from human liver, and specific antisera to purified aldolase B were obtained from chickens. Specific antihuman aldolase B IgG was purified by affinity chromatography. Disposable polypropylene plates were coated with affinity purified specific IgG antibody and used for radioimmunoassay with 125I-specific IgG antibody to aldolase B. The nonspecific binding was minimized by saturating the binding sites of the plates with 2% ovalbumin in 0.1% Tween 20. This radioimmunoassay is specific for the aldolase B subunit, with no cross-reactivity with human aldolase A or aldolase C subunits. Aldolase B is predominantly found in normal liver. Relatively high aldolase B levels are also observed in kidney. Serum levels of aldolase B in 21 normal subjects ranged from 21 to 39 ng per ml, with a mean of 28.7 +/- 8.6 (2 S.D.) ng per ml. Forty of 42 (95%) patients with acute and chronic hepatitis without cirrhosis had serum aldolase B levels greater than 40 ng per ml. Serum aldolase B levels correlated well with total serum aldolase enzyme activities (r = 0.967) and SGPT (r = 0.951) in patients with liver diseases. In cancer patients, serum aldolase B was slightly elevated in 15 of 26 (58%) patients with cancer metastatic to the liver or primary liver cell carcinoma, whereas no elevation of serum aldolase B was observed in 16 cancer patients without liver metastasis. Measurements of aldolase B serum levels by radioimmunoassay appear to be a useful measure of liver cell necrosis from benign or malignant liver diseases.

Alanine Transaminase↗

PubMedDate not supplied

Leukoreduction and acute rejection in liver transplantation: an interim analysis.

BACKGROUND: Little is known about the effect of blood transfusions and leukoreduction on acute rejection in liver transplantation. The purpose of this study was to assess the impact of leukoreduction on the occurrence of early rejection episodes in liver transplantation. METHODS: In 1999, mandatory leukoreduction was implemented in our program. Data from 339 consecutive liver transplant recipients were analyzed with attention to the time period as a proxy for leukoreduction, the number of transfusions, the wait list status, the hepatitis B or C status, the recipient age, and the type of immunosuppression. RESULTS: Using an early (6-month) rejection-free graft survival model, we observed that introduction of leukoreduction was independently associated with fewer rejection episodes (P =.001). Despite the lower rejection rate, due to a regimen of tacrolimus and antithymocyte globulin, the effect of implementation of leukoreduction remained significant (P =.021). CONCLUSION: The use of leukoreduction is associated with fewer early rejections, irrespective of the type of immunosuppression. These data support an exploration of the immunomodulatory effect of leukoreduction.

Disease-Free Survival↗

PubMedDate not supplied

Decreasing viral load pretransplant and passive immunoprophylaxis with hepatitis B immunoglobulin posttransplant prevents hepatitis B virus recurrence after liver transplantation: an 8-year single-center experience.

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Adult↗

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Besides the liver, what does the virus of hepatitis attack?

I have reviewed some of the clinical and pathogenetic features of the extrahepatic syndromes of viral hepatitis B. They are important for three reasons: First, it is important to be able to reassure the patient with acute viral hepatitis that the troubling symptoms which he frequently fears are due to rheumatoid arthritis, are self-limited, are benign, and will disappear. Second, these syndromes will occur with occult liver disease or with no active liver disease. Frequently, patients will consult a dermatologist for a rash or a rheumatologist for arthritis. They will see a clinical immunologist for a severe vasculitis or a nephrologist for nephritis. They will have no apparent evidence of liver disease, and the etiologic agent will not be discovered unless it is searched for, that is, unless one is aware that an occult infection with the hepatitis B virus can cause these syndromes. The third important reason is that all of these syndromes previously have been thought to be idiopathic; several of them have been rather severe and even fatal. Now, with the advent of potential antiviral therapy for viral hepatitis, it becomes important to make a correct diagnosis because now, for the first time, one can think about antiviral therapy for some of these serious syndromes.

Adult↗