The clinical investigator

, Volume 72, Issue 12, pp 1007–1011 | Cite as

Serum amyloid A protein (SAA): a marker for liver allograft rejection in humans

  • G. Feussner
  • C. Stech
  • J. Dobmeyer
  • H. Schaefer
  • G. Otto
  • R. Ziegler
Original Articles


Serum amyloid A protein (SAA) concentrations were monitored in 12 consecutive liver transplant recipients until the 70th postoperative day. Fourteen rejection episodes were identified histologically in 42 liver biopsies of the grafts. Of 12 rejections 8 (66.7%) were characterized by pronounced simultaneous increases in SAA concentrations in plasma, the mean peak value being 16.94 ± 8.82 mg/dl (range 4.58–28.55 mg/dl) compared with a mean normal value of 0.98 ±0.42 mg/dl in healthy controls. Of 42 biopsies 28 did not show histological evidence of graft rejection. Of 25 negative biopsies 24 (96.0%) were not accompanied by a parallel SAA increase in plasma. These findings demonstrate that measurements of SAA concentrations may provide a valuable non-invasive aid in identifying acute liver allograft rejection in humans.

Key words

Acute phase reaction Allograft rejection Liver transplantation Serum amyloid A protein 



C-reactive protein


receiveroperating characteristic


serum amyloid A protein


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  1. 1.
    Clopper CJ, Pearson S (1934) The use of confidence or fiducial limits illustrated in the case of the binomial. Biometrika 26:404–413Google Scholar
  2. 2.
    Demetris AJ, Qian S, Sun H, Fung JJ (1990) Liver allograft rejection: an overview of morphologic findings. Am J Surg Pathol 14 [Suppl 1]: 49–63Google Scholar
  3. 3.
    Feinstein AR (1985) Clinical epidemiology. The architecture of clinical research. Saunders, Philadelphia, pp 601–604Google Scholar
  4. 4.
    Feussner G, Schuster M, Ziegler R (1991) Serum amyloid A protein in very low density- and high density lipoproteins during the course of acute myocardial infarction. Electrophoresis 12:283–286Google Scholar
  5. 5.
    Hocke G, Ebel H, Bittner K, Müller T, Kaffarnik H, Steinmetz A (1989) A rapid laser immunonephelometric assay for serum amyloid A (SAA) and its application to the diagnosis of kidney allograft rejection. Klin Wochenschr 67:447–451Google Scholar
  6. 6.
    Klintmalm GBG, Nery JR, Husberg BS, Gonwa TA, Tillery GW (1989) Rejection in liver transplantation. Hepatology 10:978–985Google Scholar
  7. 7.
    Maury CPJ, Teppo AM, Eklund B, Ahonen J (1983) Serum amyloid A protein: a sensitive indicator of renal allograft rejection in humans. Transplantation 36:501–504Google Scholar
  8. 8.
    Maury CPJ, Teppo AM, Raunio P (1983) The acute phase response and its relation to amyloid degrading activity in serum of patients with rheumatoid arthritis undergoing arthroplasty. Eur J Clin Invest 13:73–78Google Scholar
  9. 9.
    Maury CPJ, Höckerstedt K, Teppo AM, Lautenschlager I, Scheinin TM (1984) Changes in serum amyloid A protein and beta-2-microglobulin in association with liver allograft rejection. Transplantation 38:551–553Google Scholar
  10. 10.
    Maury CPJ, Teppo AM, Ahonen J, von Willebrand E (1984) Measurement of serum amyloid A protein concentrations as test of renal allograft rejection in patients with initially nonfunctioning grafts. Br Med J 288:360–361Google Scholar
  11. 11.
    Maury CPJ, Teppo AM, Ahonen J, von Willebrand E (1986) Evaluation of serum amyloid A protein as a marker of allograft rejection in patients with initially nonfunctioning renal transplants. Transplant Proc 18:86–87Google Scholar
  12. 12.
    Shaw BM jr, Gordon RD, Iwatsuki S, Starzl TE (1985) Hepatic retransplantation. Transplant Proc 17:264–271Google Scholar
  13. 13.
    Starzl TE, Demetris AJ, van Thiel D (1989) Liver transplantation. N Engl J Med 321:1014–1022, 1092–1099Google Scholar
  14. 14.
    Whither JT, Chambers RE, Higginson J, Nashef L, Higgins PG (1985) Acute phase response of serum amyloid A protein and C-reactive protein to the common cold and influenca. J Clin Pathol 38:312–316Google Scholar

Copyright information

© Springer-Verlag 1994

Authors and Affiliations

  • G. Feussner
    • 1
  • C. Stech
    • 1
  • J. Dobmeyer
    • 1
  • H. Schaefer
    • 2
  • G. Otto
    • 3
  • R. Ziegler
    • 1
  1. 1.Medizinische KlinikUniversität HeidelbergHeidelbergGermany
  2. 2.Institut für Medizinische Biometrie und InformatikUniversität HeidelbergHeidelbergGermany
  3. 3.Chirurgische KlinikUniversität HeidelbergHeidelbergGermany

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