Journal of Hepato-Biliary-Pancreatic Surgery

, Volume 16, Issue 4, pp 513–520

Tissue factor expression demonstrates severe sinusoidal endothelial cell damage during rejection after living-donor liver transplantation

  • Masanobu Usui
  • Naohisa Kuriyama
  • Masashi Kisawada
  • Takashi Hamada
  • Shugo Mizuno
  • Hiroyuki Sakurai
  • Masami Tabata
  • Hiroshi Imai
  • Kohji Okamoto
  • Shinji Uemoto
  • Shuji Isaji
Original article



Since it is well known that endothelial cells may be important targets during rejection after living-donor liver transplantation, in this study we investigated liver sinusoidal endothelial cell (SEC) damage during rejection by focusing on thrombomodulin (TM) and hyaluronic acid (HA) as plasma markers of SEC damage. We also examined tissue factor (TF) expression in SECs, because damage to endothelial cells leads to immediate activation of the coagulation system, with the damage being triggered mainly by TF.


Living-donor liver transplantation was performed at Mie University Hospital between March 2002 and December 2007; there were 8 patients with rejection (4 with acute cellular rejection and 4 with chronic rejection) and 32 patients without rejection. Liver biopsy tissue was immunostained with an anti-TF antibody, and assessed for SEC damage. In addition, total RNA was extracted from liver biopsy tissue and tested for TF mRNA expression by reverse-transcription polymerase chain reaction (RT-PCR).


The plasma TM level was significantly higher in the rejection group than in the non-rejection group. TF expression was observed in SECs, in infiltrating inflammatory cells, and in the vascular endothelium in the rejection group. TF mRNA expression was significantly higher in the rejection group than in the non-rejection group.


We demonstrated that TF expression revealed severe SEC damage in grafted liver during both acute cellular rejection and chronic rejection.


Tissue factor Sinusoidal endothelial cell Living-donor liver transplantation Thrombomodulin Hyaluronic acid 


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Copyright information

© Springer 2009

Authors and Affiliations

  • Masanobu Usui
    • 1
  • Naohisa Kuriyama
    • 1
  • Masashi Kisawada
    • 1
  • Takashi Hamada
    • 1
  • Shugo Mizuno
    • 1
  • Hiroyuki Sakurai
    • 1
  • Masami Tabata
    • 1
  • Hiroshi Imai
    • 2
  • Kohji Okamoto
    • 3
  • Shinji Uemoto
    • 4
  • Shuji Isaji
    • 1
  1. 1.Department of Hepatobiliary Pancreatic and Transplant Surgery, Graduate School of MedicineMie UniversityTsu, MieJapan
  2. 2.Department of Pathology, Graduate School of MedicineMie UniversityTsu, MieJapan
  3. 3.First Department of SurgeryUniversity of Occupational and Environmental HealthKitakyushu, FukuokaJapan
  4. 4.Department of Hepatobiliary Pancreatic and Transplantation Surgery, Graduate School of MedicineKyoto UniversityKyotoJapan

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