Free light chains and pairs of heavy and light chains of immunoglobulins in relation to morbidity of patients before liver transplantation and post-transplantation
Abstract
Objective: To assess the role of free light immunoglobulin chains and pairs of heavy and light immunoglobulin chains in patients before and after liver transplantation (LTx). To compare associations of immunoglobulins and their components with comorbidities as assessed by objective laboratory tests and to evaluate development of laboratory tests during 2-year follow-up.
Design: observational prospective study Settings: Institute for Clinical and Experimental Medicine, Vídeňská 1958/9, 140 21 Prague Material and methods: A group of 174 patients was evaluated before LTx and during a 2-year follow-up. Organ dysfunctions were evaluated by means of ELF score, MELD score, and common laboratory parameters (red blood cells, platelets, liver function, renal function, nutrition, and glucose metabolism).
Reagents and analyzers from The Binding Site (SPA Plus and Optilite analyzer), Abbott (Architect ci 16200), Sysmex (XN), Siemens (Centaur CP), and Stago (STA R Max) were used according to the manufacturer's recommendation. The Spearman correlation, Mann-Whitney, and Friedman tests were used.
Results: Increased IgA, FLC-κ and FLC-λ before LTx were associated with increased ELF and MELD score, creatinine and uric acid and also with decreased concentrations of hemoglobin, platelets, albumin, prealbumin, lipid parameters, and cholinesterase. In patients with increased concentrations of IgA and FLC-κ before LTx, increased IgA and FLC-κ occurred also during the follow-up and worsening of renal function and lipid metabolism was found.
Conclusion: We confirmed prognostic role of serum IgA in patients with serious liver diseases requiring transplantation. Similar prognostic role was found for FLC-κ a FLC-λ.
The measurement of HLC was not associated with organ dysfunctions and comorbidities in these patients.