Trends in serum citrulline and acute rejection among recipients of small bowel transplants

P. A. Pappas; A. G. Tzakis; J. M. Saudubray; J. J. Gaynor; M. R. Carreno; F. Huijing; G. Kleiner; D. Rabier; T. Kato; D. M. Levi; S. Nishida; B. Gelman; J. F. Thompson; N. Mittal; P. Ruiz

doi:10.1016/j.transproceed.2003.12.007

Trends in serum citrulline and acute rejection among recipients of small bowel transplants

P. A. Pappas, A. G. Tzakis, J. M. Saudubray, J. J. Gaynor, M. R. Carreno, F. Huijing, G. Kleiner, D. Rabier, T. Kato, D. M. Levi, S. Nishida, B. Gelman, J. F. Thompson, N. Mittal, P. Ruiz

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Abstract

A test for detecting acute cellular rejection (ACR) of small intestinal transplants (ITx) would be a major advance. Small preliminary studies suggest that serum citrulline levels correlate with ACR. The results for a group of 26 isolated intestinal and multivisceral transplant recipients are summarized here. Serum citrulline concentrations were determined by ion exchange chromatography and compared to biopsy-based grade of ACR. Other factors considered included patient and donor age and sex, ischemia time, and serum creatinine. Straight-line fits were employed to describe how each patient's citrulline levels changed over time. Estimated times to achieve normal citrulline (≥30 μmol/L) ranged from 1 to 730 days posttransplant for 21 patients demonstrating increasing citrulline levels over time. Using stepwise linear regression, patients' ranks for time required to achieve normal citrulline levels were the only independent predictors of both maximum ACR (P < .0001) and average ACR (P = .0059) after 14 days posttransplant. The rate and direction of change in citrulline over time may be an indicator of the risk of acute rejection. We plan to further examine the use of citrulline as a marker for rejection in larger prospective studies.

Original language	English (US)
Pages (from-to)	345-347
Number of pages	3
Journal	Transplantation proceedings
Volume	36
Issue number	2
DOIs	https://doi.org/10.1016/j.transproceed.2003.12.007
State	Published - Mar 2004
Externally published	Yes

ASJC Scopus subject areas

Surgery
Transplantation

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Pappas, P. A., Tzakis, A. G., Saudubray, J. M., Gaynor, J. J., Carreno, M. R., Huijing, F., Kleiner, G., Rabier, D., Kato, T., Levi, D. M., Nishida, S., Gelman, B., Thompson, J. F., Mittal, N., & Ruiz, P. (2004). Trends in serum citrulline and acute rejection among recipients of small bowel transplants. Transplantation proceedings, 36(2), 345-347. https://doi.org/10.1016/j.transproceed.2003.12.007

Pappas, PA, Tzakis, AG, Saudubray, JM, Gaynor, JJ, Carreno, MR, Huijing, F, Kleiner, G, Rabier, D, Kato, T, Levi, DM, Nishida, S, Gelman, B, Thompson, JF, Mittal, N & Ruiz, P 2004, 'Trends in serum citrulline and acute rejection among recipients of small bowel transplants', Transplantation proceedings, vol. 36, no. 2, pp. 345-347. https://doi.org/10.1016/j.transproceed.2003.12.007

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abstract = "A test for detecting acute cellular rejection (ACR) of small intestinal transplants (ITx) would be a major advance. Small preliminary studies suggest that serum citrulline levels correlate with ACR. The results for a group of 26 isolated intestinal and multivisceral transplant recipients are summarized here. Serum citrulline concentrations were determined by ion exchange chromatography and compared to biopsy-based grade of ACR. Other factors considered included patient and donor age and sex, ischemia time, and serum creatinine. Straight-line fits were employed to describe how each patient's citrulline levels changed over time. Estimated times to achieve normal citrulline (≥30 μmol/L) ranged from 1 to 730 days posttransplant for 21 patients demonstrating increasing citrulline levels over time. Using stepwise linear regression, patients' ranks for time required to achieve normal citrulline levels were the only independent predictors of both maximum ACR (P < .0001) and average ACR (P = .0059) after 14 days posttransplant. The rate and direction of change in citrulline over time may be an indicator of the risk of acute rejection. We plan to further examine the use of citrulline as a marker for rejection in larger prospective studies.",

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AU - Tzakis, A. G.

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AU - Gaynor, J. J.

AU - Carreno, M. R.

AU - Huijing, F.

AU - Kleiner, G.

AU - Rabier, D.

AU - Kato, T.

AU - Levi, D. M.

AU - Nishida, S.

AU - Gelman, B.

AU - Thompson, J. F.

AU - Mittal, N.

AU - Ruiz, P.

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Trends in serum citrulline and acute rejection among recipients of small bowel transplants

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