Increased Retinol Binding Protein in the Sera of Patients with Severe Ischemic Damage of the Liver after Transplantation

Objectives: To study retinol binding protein variation in the serum of patients who have undergone liver transplantation. Methods: Retinol binding protein was retrospectively determined by the immunonephelometric method on serum from 14 patients who had undergone orthotopic liver transplantation 2 weeks after the surgery and then once a month during the first year posttransplantation. The patients were divided into two groups on the basis of early (first 10 days) postoperative graft function: group I, 6 patients with severe ischemic damage; and group II, 8 patients with moderate-severe liver dysfunction. Results: The mean retinol binding protein level at one year of follow-up was persistently higher in group I than in group II (83.1 ± 33.4 vs. 44.6 ± 20.7 mg/L, p < 0.001). Interestingly, retinol binding protein levels remained higher in patients of group I even when the other biochemical parameters of liver function returned to normal. The increase in retinol binding protein serum levels was independent of variation in other parameters of liver and kidney function, but was correlated with an increase in transthyretin and retinol levels. Conclusion: Our results show a close relationship between a permanent high retinol binding protein level and severe graft injury after liver transplantation. However, the mechanism underlying the increase remains to be defined