Mediators of leukocyte yctivation play a role in disseminated intravascular coagulation during orthotopic liver transplantation

Leukocytes play an important role in the development of
disseminated intravascular coagulation (DIC). In the reperfusion
phase of OLT a DIC-like situation has been described and has been
held responsible for the high blood loss during this phase. We
investigated the role of leukocytes in the pathogenesis of DIC in
OLT by measuring the leukocytic mediators released upon activation
(cathepsin B, elastase, TNF, neopterin) and the levels of
thrombin-antithrombin III (TAT) complexes, seen as markers of
prothrombin activation. Arterial blood samples were taken at 10
different time points during and after OLT. Samples were also taken
of the perfusate released from the liver graft vein during the
flushing procedure before the reperfusion phase. Aprotinin was
given as a continuous infusion (0.2-0.4 Mill. KlU/hr) and its
plasma levels were determined. Significantly elevated levels of
neopterin (15-fold; P