Assessment of adult living related liver transplantation utilizing serum anti-liver arginase autoantibody assay : a possible novel strategy prospecting its prognosis.

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Background/Aims : Clinical immuno-biochemical blood test for postoperative recipients of living related liver transplantation (LRLT) is still done by combination of assaying serum liver markers as in the past. Our recent study, determining serum anti-liver arginase autoantibody in patients with liver disease, revealed that the autoantibody titre stayed high in continuous liver distraction but easily decreased after the termination of liver damage. This phenomenon prompted us to seek whether this autoantibody can be utilized as a prognostic marker for a postoperative recipient of LRLT.Based on these findings, we tried to clarify whether the serum AAA shows reasonable change even under the state of immunosupression due to postoperative regimen.Methods : Western blot and ELISA were undertaken for the detection and quantification of the anti-liver arginase autoantibody. In the ELISA system, rat liver arginase was used as a target antigen, taking advantage of its high immunological cross reactivity with human liver arginase and the ease of handling it provides.Results : In the cases with short postopcrative hospitalization (<2 months), AAA levels eventually stayed in "critical zone" settled between 5 and 26 U, including normal range (19.7 ± 6.0U), while in those with poor prognosis with prolonged hospitalization (>6months) or with recurrent short term discharge, AAA was never stayed in that level.Conclusions : AAA can be utilized as a prognostic maker that reflect both liver distraction and immunosupression, which are key factors in LRLT.With this in mind, utilization of AAA might ease clinical testing on recipients.