The incidence of acute and chronic rejection has declined with improvement of immunosuppression regimens in liver transplant recipients. The CD44 protein belongs to a large family of type I Trans membrane glycoproteins and expressed on the surface of most vertebrate cells and is an important receptor for the components of extracellular matrix.The study evaluated if the serum level of CD44 had a value in diagnosis of acute rejection depending on proved rejection by liver biopsy. The patients were recruited from ASCOT from May 2017 to December 2018. They were 20 adults with Post LDLT with elevated liver function tests and were reviewed.The results showed that serum level of CD44 was significantly lower in the rejection group in our study in patient with post liver transplantation. There was highly significant difference between controls & patients \as regards serum level of CD44. Negative correlation between serum levels of CD44, WBCs & AST. There was highly significant difference between patients with different pathological findings as regards serum level of CD44. The best cut off point for serum level of CD44 as a marker of rejection was found ≤ 44ng/ml with sensitivity of 85% and specificity of 95% in diagnosis of acute cellular rejection.

Background The first human orthotopic liver transplantation (LT) in Europe was performed by Sir Roy Calne in Cambridge in 1968, only one year after the first successful human liver transplantation reported by Thomas Starzl in the United States. Since then LT has evolved rapidly, becoming the standard therapy for acute and chronic liver failure of all aetiologies, with more than 80,000 procedures performed to date. Survival rates have improved significantly in the last 25 years, achieving rates of 96% and 71% at 1 and 10 years after LT respectively. Objective To assessment of value of serum level of CD44 as a marker of rejection in patients with post liver transplantation. Patients and Methods The study was conducted on patient all were recruited from ASCOT from May 2017 till December 2018. It included 20 adult patients with Post LDLT with elevated liver function tests and they were reviewed to determine if the serum level of CD44 had a value in diagnosis of acute rejection depending on proving the rejection by liver biopsy. They were distributed as 14 males and 6 females with age ranging 16 - 59 years. After obtaining the results of liver biopsy we had 14 patients with rejection, 4 patients with cholangitis with biliary obstruction and 2 patient with rejection with vascular insult. Results The control group was with irrelevant past medical history and normal liver functions, normal liver biopsy and underwent measurement of CD44 serum level. They were distributed as 14 males and 6 females with age ranging 26 – 41 years. Conclusion There was correlation between different pathological findings in liver biopsy and Serum level of CD44 that the low levels being with rejection and higher levels being with control group, that the CD44 may be used as a marker for rejection.