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. 1979 Feb 3;1(6159):300–303. doi: 10.1136/bmj.1.6159.300

Urinary excretion of factor VIII after renal transplantation.

Z M Ruggeri, Y B Gordon, N Ardaillou, M J Larrieu, A Tarantino, R Coppola, C Ponticelli, P M Mannucci
PMCID: PMC1597716  PMID: 369659

Abstract

The urinary excretion of factor-VIII-related antigen (VIIIRAg) was measured in 72 patients with kidney transplants and compared with that of two end-products of fibrin-fibrinogen lysis (fragments D and E) to assess their usefulness in monitoring the onset of rejection episodes. Specific and sensitive radioimmunoassays were used to measure the three proteins. Unconcentrated urine samples of 24-hour collections were obtained from 20 healthy subjects, 48 patients with stable transplants, and 24 patients with recent transplants serially followed up from the day of transplantation. Factor VIIIRAg and fragments E and D were not detectable in the urine from healthy subjects but were present in 39%, 60%, and 100% respectively of samples from patients with stable transplants. During 33 acute rejection episodes in 19 patients with recent transplants factor VIIIRAg and fragments E and D were significantly increased above the values observed in patients with stable transplants in 82%, 73%, and 64% of samples respectively; in patients with recent transplants showing no clinical sign of rejection increased excretion of these proteins was observed in 11%, 26%, and 22% of samples respectively. The presence of factor VIIIRAg in urine from patients with kidney allografts suggests that endothelial cell-factor VIII-platelet interactions might pay a key part in the pathogenesis of acute rejection. The results suggest that the assay of factor VIIIRAg in urine is more useful than assays of fragments D and E as a corroborative index of transplant rejection.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Bloom A. L., Giddings J. C., Wilks C. J. Factor 8 on the vascular intima: possible importance in haemostasis and thrombosis. Nat New Biol. 1973 Feb 14;241(111):217–219. doi: 10.1038/newbio241217a0. [DOI] [PubMed] [Google Scholar]
  2. Boneu B., Bierme R., Fournie A., Pontonnier G. Factor-VIII complex fetal growth retardation, and toxaemia. Lancet. 1977 Jan 29;1(8005):263–263. doi: 10.1016/s0140-6736(77)91068-6. [DOI] [PubMed] [Google Scholar]
  3. Busch G. J., Kobayashi K., Hollenberg N. K., Birtch A. G., Colman R. W. Hyperacute renal allograft rejection in the primate. Intrarenal effects of heparin and associated net release of factor VIII activity and kallikrein activation. Am J Pathol. 1975 Jul;80(1):1–20. [PMC free article] [PubMed] [Google Scholar]
  4. Clarkson A. R., Morton J. B., Cash J. D. Urinary fibrin-fibrinogen degradation poducts after renal homotransplantation. Lancet. 1970 Dec 12;2(7685):1220–1223. doi: 10.1016/s0140-6736(70)92181-1. [DOI] [PubMed] [Google Scholar]
  5. Colman R. W., Braun W. E., Busch G. J., Dammin G. J., Merrill J. P. Coagulation studies in the hyperacute and other forms of renal-allograft rejection. N Engl J Med. 1969 Sep 25;281(13):685–691. doi: 10.1056/NEJM196909252811301. [DOI] [PubMed] [Google Scholar]
  6. Donati M. B., Molla A., Michielsen P., Vermylen J. Measurement of urinary fibrinogen-related material: methodologic aspects. J Lab Clin Med. 1974 Jun;83(6):921–936. [PubMed] [Google Scholar]
  7. Ekberg M., Nilsson I. M. Factor VIII and glomerulonephritis. Lancet. 1975 May 17;1(7916):1111–1113. doi: 10.1016/s0140-6736(75)92500-3. [DOI] [PubMed] [Google Scholar]
  8. Gordon Y. B., Martin M. J., Landon J., Chard T. The development of radioimmunoassays for fibrinogen degradation products: fragments D and E. Br J Haematol. 1975 Jan;29(1):109–119. doi: 10.1111/j.1365-2141.1975.tb01804.x. [DOI] [PubMed] [Google Scholar]
  9. Hoq M. S., Anderton J. L., Cunningham M., Cash J. D. Urinary excretion of fibrinogen-related materials, complement, and immunoglobulins in proliferative glomerulonephritis and after renal transplantation. Br Med J. 1974 Jun 8;2(5918):535–538. doi: 10.1136/bmj.2.5918.535. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. Hoq M. S., Clarkson A. R., Anderton J. L., Cash J. D. Urinary excretion of heterophile (sheep) haemagglutinins and fibrin-fibrinogen degradation products after renal transplantation and in proliferative glomerulonephritis. Lancet. 1973 May 12;1(7811):1029–1031. doi: 10.1016/s0140-6736(73)90666-1. [DOI] [PubMed] [Google Scholar]
  11. Hoyer J. R., Bergstein J. M., Michael A. F., Hoyer L. W. Immunofluorescent localization of factor VIII-related antigen and fibrinogen in hyperacute xenograft rejection and in the Shwartzman reaction in the rat. Clin Immunol Immunopathol. 1978 Apr;9(4):454–463. doi: 10.1016/0090-1229(78)90142-3. [DOI] [PubMed] [Google Scholar]
  12. Hoyer J. R., Michael A. F., Hoyer L. W. Immunofluorescent localization of antihemophilic factor antigen and fibrinogen in human renal diseases. J Clin Invest. 1974 May;53(5):1375–1384. doi: 10.1172/JCI107686. [DOI] [PMC free article] [PubMed] [Google Scholar]
  13. Hulme B., Pitcher P. M. Rapid latex-screening test for detection of fibrin-fibrinogen degradation products in urine after renal transplantation. Lancet. 1973 Jan 6;1(7793):6–8. doi: 10.1016/s0140-6736(73)91221-x. [DOI] [PubMed] [Google Scholar]
  14. Jaffe E. A., Hoyer L. W., Nachman R. L. Synthesis of antihemophilic factor antigen by cultured human endothelial cells. J Clin Invest. 1973 Nov;52(11):2757–2764. doi: 10.1172/JCI107471. [DOI] [PMC free article] [PubMed] [Google Scholar]
  15. Naish P., Peters D. K., Shackman R. Increased urinary fibrinogen derivatives after renal allotransplantation. Lancet. 1973 Jun 9;1(7815):1280–1282. doi: 10.1016/s0140-6736(73)91295-6. [DOI] [PubMed] [Google Scholar]
  16. Rosenberg J. C., Broersma R. J., Bullemer G., Mammen E. F., Lenaghan R., Rosenberg B. F. Relationship of platelets, blood coagulation, and fibrinolysis to hyperacute rejection of renal xenografts. Transplantation. 1969 Aug;8(2):152–161. doi: 10.1097/00007890-196908000-00008. [DOI] [PubMed] [Google Scholar]
  17. Ruggeri Z. M., Mannucci P. M., Jeffcoate S. L., Ingram G. I. Immunoradiometric assay of factor VIII related antigen, with observations in 32 patients with von Willebrand's disease. Br J Haematol. 1976 Jun;33(2):221–232. doi: 10.1111/j.1365-2141.1976.tb03533.x. [DOI] [PubMed] [Google Scholar]
  18. Starzl T. E., Boehmig H. J., Amemiya H., Wilson C. B., Dixon F. J., Giles G. R., Simpson K. M., Halgrimson C. G. Clotting changes, including disseminated intravascular coagulation, during rapid renal-homograft rejection. N Engl J Med. 1970 Aug 20;283(8):383–390. doi: 10.1056/NEJM197008202830801. [DOI] [PMC free article] [PubMed] [Google Scholar]

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