Parameters of the Kallikrein-Kinin, Coagulation and Fibrinolytic Systems as Early Indicators of Kidney Transplant Rejection

Abstract

In order to find early indicators of kidney transplant rejection before clinical symptoms were noticed, parameters of the coagulation, fibrinolytic and kallikrein-kinin systems were measured. Nineteen patients were followed before and daily after kidney transplantation during the first week and every second day in the following weeks. All patients received immunosuppressive therapy with ciclosporin and corticoids. Ten patients suffered from transplant rejection. The first rejection occurred on the 7th day after transplantation. Of all the parameters measured, kallikrein inhibition, β-FXIIa inhibition, plasminogen and antithrombin III were early indicators of kidney transplant rejections. A rise in these parameters could be demonstrated 2–3 days before clinical signs were noticed. In the other 9 patients no significant rises in antithrombin III, plasminogen, kallikrein inhibition and β-FXIIa inhibition could be found.

Activation of Coagulation and Fibrinolysis Following OKT3 Administration to Renal Transplant Recipients: Association with Distinct Mediators

“…No significant changes in plasma kallikrein-Cl-inhibitor complex levels were observed, suggesting that activation of coagulation did not occur via the intrinsic pathway and thus probably was mediated via the extrinsic pathway of coagulation. Pre-treatment values of plasma TATc, t-PA and PAPc levels in all patients were slightly elevated as compared to healthy controls, which is probably due to the acute rejection process of the renal allograft, as was described by Schrader et al (25). In clinical trials performed on side effects (1,26) and in our own experience, treatment with OKT3 at a dose of 5 mg/day is not associated with thromboembolic complications, which may be explained by the relatively short duration of coagulation activation and simulta neous activation of fibrinolysis.…”

Plasma proteolytic activity in liver transplant rejection

“…Furthermore, the important role of the liver in hemostasis has been illustrated by the correction of inherited coagulation defects by OLT [lo, 191. Previous studies have also indicated that parameters of the coagulation system are of importance as predictive indicators of kidney transplant rejection [29]. Our studies have revealed the following variations in levels of some components of the kallikrein-kinin, coagulation, and fibrinolytic systems, which lead us to believe that activation of these systems occurs not only during OLT but also during the period following OLT 1.…”

Pelvic Adhesion and Gonadotropin-Releasing Hormone Analogue: Effects of Triptorelin Acetate Depot on Coagulation and Fibrinolytic Activities

“…35 Elevated levels have been reported in conjunction with pregnancy, 36 hormonal contraceptives, 37 obesity, 38 anabolic steroids, 39 hypothyroidism, 40 and in liver or kidney transplant patients. 41 In this study, no significant change in plasminogen activity was noted for either GnRH-a treated or control groups. α2-Antiplasmin is the fast SERPIN inhibitor of plasmin.…”