Fecal calprotectin level measurements in small bowel allograft monitoring

A pilot study

Edip Akpinar, Jacinto Vargas, Tomaoki Kato, Lesley J Smith, Erick Hernandez, Gennaro Selvaggi, Seigo Nishida, Jang Moon, Eddie Island, David Levi, Phillip Ruiz, Andreas G. Tzakis

Research output: Contribution to journalArticle

28 Citations (Scopus)

Abstract

BACKGROUND. Protocol endoscopy with biopsy is currently the gold standard of small bowel transplantion (SBTx) monitoring, however it is invasive, costly, needs skilled operator, may require anesthesia and may cause complications. We investigated fecal calprotectin level (FCL) as a candidate noninvasive marker for monitoring patients after SBTx. METHODS. A pilot study was performed to test the use of FCL measurement in following up SBTx patients. Ileostomy effluents were collected at various postoperative days before endoscopy and biopsy. FCLs were measured by enzyme-linked immunosorbent assay and a cut-off level of 100 ng/mg was considered positive. The results were retrospectively evaluated in combination with clinical, endoscopic, and histopathological findings. FCLs are presented as median nanogram per milligram. RESULTS. FCLs were measured in 122 samples that were obtained from 29 patients after SBTx. Only 1 of 69 positive FCL did not accompany abnormal findings. Retrospective evaluation showed that 11 samples from six patients (FCL: 217) coincided with rejection episodes, six samples from three patients (FCL: 125) coincided with viral enteritis, 51 samples from 21 patients (FCL: 207) coincided with nonspecific inflammation, 11 samples from two patients (FCL: 998) coincided with chronic intestinal ulceration, and finally 50 samples from 19 patients (FCL: 43) coincided with normal findings. No significant FCL difference was found between rejection, infection, and inflammation. FCL evolution in individuals showed that FCL can predict rejection days before histopathological diagnosis. CONCLUSION. FCL is a sensitive test for ongoing organic intestinal allograft pathologies. It might be useful as prescreening marker to avoid unnecessary endoscopies.

Original languageEnglish
Pages (from-to)1281-1286
Number of pages6
JournalTransplantation
Volume85
Issue number9
DOIs
StatePublished - May 1 2008

Fingerprint

Leukocyte L1 Antigen Complex
Allografts
Endoscopy
Inflammation
Biopsy
Ileostomy
Enteritis
Physiologic Monitoring

Keywords

  • Allograft monitoring
  • Calprotectin
  • Small bowel transplantation

ASJC Scopus subject areas

  • Transplantation
  • Immunology

Cite this

Akpinar, E., Vargas, J., Kato, T., Smith, L. J., Hernandez, E., Selvaggi, G., ... Tzakis, A. G. (2008). Fecal calprotectin level measurements in small bowel allograft monitoring: A pilot study. Transplantation, 85(9), 1281-1286. https://doi.org/10.1097/TP.0b013e31816dcea2

Fecal calprotectin level measurements in small bowel allograft monitoring : A pilot study. / Akpinar, Edip; Vargas, Jacinto; Kato, Tomaoki; Smith, Lesley J; Hernandez, Erick; Selvaggi, Gennaro; Nishida, Seigo; Moon, Jang; Island, Eddie; Levi, David; Ruiz, Phillip; Tzakis, Andreas G.

In: Transplantation, Vol. 85, No. 9, 01.05.2008, p. 1281-1286.

Research output: Contribution to journalArticle

Akpinar, E, Vargas, J, Kato, T, Smith, LJ, Hernandez, E, Selvaggi, G, Nishida, S, Moon, J, Island, E, Levi, D, Ruiz, P & Tzakis, AG 2008, 'Fecal calprotectin level measurements in small bowel allograft monitoring: A pilot study', Transplantation, vol. 85, no. 9, pp. 1281-1286. https://doi.org/10.1097/TP.0b013e31816dcea2
Akpinar, Edip ; Vargas, Jacinto ; Kato, Tomaoki ; Smith, Lesley J ; Hernandez, Erick ; Selvaggi, Gennaro ; Nishida, Seigo ; Moon, Jang ; Island, Eddie ; Levi, David ; Ruiz, Phillip ; Tzakis, Andreas G. / Fecal calprotectin level measurements in small bowel allograft monitoring : A pilot study. In: Transplantation. 2008 ; Vol. 85, No. 9. pp. 1281-1286.
@article{2b7c51d18d854e86bc0c39db676f81a5,
title = "Fecal calprotectin level measurements in small bowel allograft monitoring: A pilot study",
abstract = "BACKGROUND. Protocol endoscopy with biopsy is currently the gold standard of small bowel transplantion (SBTx) monitoring, however it is invasive, costly, needs skilled operator, may require anesthesia and may cause complications. We investigated fecal calprotectin level (FCL) as a candidate noninvasive marker for monitoring patients after SBTx. METHODS. A pilot study was performed to test the use of FCL measurement in following up SBTx patients. Ileostomy effluents were collected at various postoperative days before endoscopy and biopsy. FCLs were measured by enzyme-linked immunosorbent assay and a cut-off level of 100 ng/mg was considered positive. The results were retrospectively evaluated in combination with clinical, endoscopic, and histopathological findings. FCLs are presented as median nanogram per milligram. RESULTS. FCLs were measured in 122 samples that were obtained from 29 patients after SBTx. Only 1 of 69 positive FCL did not accompany abnormal findings. Retrospective evaluation showed that 11 samples from six patients (FCL: 217) coincided with rejection episodes, six samples from three patients (FCL: 125) coincided with viral enteritis, 51 samples from 21 patients (FCL: 207) coincided with nonspecific inflammation, 11 samples from two patients (FCL: 998) coincided with chronic intestinal ulceration, and finally 50 samples from 19 patients (FCL: 43) coincided with normal findings. No significant FCL difference was found between rejection, infection, and inflammation. FCL evolution in individuals showed that FCL can predict rejection days before histopathological diagnosis. CONCLUSION. FCL is a sensitive test for ongoing organic intestinal allograft pathologies. It might be useful as prescreening marker to avoid unnecessary endoscopies.",
keywords = "Allograft monitoring, Calprotectin, Small bowel transplantation",
author = "Edip Akpinar and Jacinto Vargas and Tomaoki Kato and Smith, {Lesley J} and Erick Hernandez and Gennaro Selvaggi and Seigo Nishida and Jang Moon and Eddie Island and David Levi and Phillip Ruiz and Tzakis, {Andreas G.}",
year = "2008",
month = "5",
day = "1",
doi = "10.1097/TP.0b013e31816dcea2",
language = "English",
volume = "85",
pages = "1281--1286",
journal = "Transplantation",
issn = "0041-1337",
publisher = "Lippincott Williams and Wilkins",
number = "9",

}

TY - JOUR

T1 - Fecal calprotectin level measurements in small bowel allograft monitoring

T2 - A pilot study

AU - Akpinar, Edip

AU - Vargas, Jacinto

AU - Kato, Tomaoki

AU - Smith, Lesley J

AU - Hernandez, Erick

AU - Selvaggi, Gennaro

AU - Nishida, Seigo

AU - Moon, Jang

AU - Island, Eddie

AU - Levi, David

AU - Ruiz, Phillip

AU - Tzakis, Andreas G.

PY - 2008/5/1

Y1 - 2008/5/1

N2 - BACKGROUND. Protocol endoscopy with biopsy is currently the gold standard of small bowel transplantion (SBTx) monitoring, however it is invasive, costly, needs skilled operator, may require anesthesia and may cause complications. We investigated fecal calprotectin level (FCL) as a candidate noninvasive marker for monitoring patients after SBTx. METHODS. A pilot study was performed to test the use of FCL measurement in following up SBTx patients. Ileostomy effluents were collected at various postoperative days before endoscopy and biopsy. FCLs were measured by enzyme-linked immunosorbent assay and a cut-off level of 100 ng/mg was considered positive. The results were retrospectively evaluated in combination with clinical, endoscopic, and histopathological findings. FCLs are presented as median nanogram per milligram. RESULTS. FCLs were measured in 122 samples that were obtained from 29 patients after SBTx. Only 1 of 69 positive FCL did not accompany abnormal findings. Retrospective evaluation showed that 11 samples from six patients (FCL: 217) coincided with rejection episodes, six samples from three patients (FCL: 125) coincided with viral enteritis, 51 samples from 21 patients (FCL: 207) coincided with nonspecific inflammation, 11 samples from two patients (FCL: 998) coincided with chronic intestinal ulceration, and finally 50 samples from 19 patients (FCL: 43) coincided with normal findings. No significant FCL difference was found between rejection, infection, and inflammation. FCL evolution in individuals showed that FCL can predict rejection days before histopathological diagnosis. CONCLUSION. FCL is a sensitive test for ongoing organic intestinal allograft pathologies. It might be useful as prescreening marker to avoid unnecessary endoscopies.

AB - BACKGROUND. Protocol endoscopy with biopsy is currently the gold standard of small bowel transplantion (SBTx) monitoring, however it is invasive, costly, needs skilled operator, may require anesthesia and may cause complications. We investigated fecal calprotectin level (FCL) as a candidate noninvasive marker for monitoring patients after SBTx. METHODS. A pilot study was performed to test the use of FCL measurement in following up SBTx patients. Ileostomy effluents were collected at various postoperative days before endoscopy and biopsy. FCLs were measured by enzyme-linked immunosorbent assay and a cut-off level of 100 ng/mg was considered positive. The results were retrospectively evaluated in combination with clinical, endoscopic, and histopathological findings. FCLs are presented as median nanogram per milligram. RESULTS. FCLs were measured in 122 samples that were obtained from 29 patients after SBTx. Only 1 of 69 positive FCL did not accompany abnormal findings. Retrospective evaluation showed that 11 samples from six patients (FCL: 217) coincided with rejection episodes, six samples from three patients (FCL: 125) coincided with viral enteritis, 51 samples from 21 patients (FCL: 207) coincided with nonspecific inflammation, 11 samples from two patients (FCL: 998) coincided with chronic intestinal ulceration, and finally 50 samples from 19 patients (FCL: 43) coincided with normal findings. No significant FCL difference was found between rejection, infection, and inflammation. FCL evolution in individuals showed that FCL can predict rejection days before histopathological diagnosis. CONCLUSION. FCL is a sensitive test for ongoing organic intestinal allograft pathologies. It might be useful as prescreening marker to avoid unnecessary endoscopies.

KW - Allograft monitoring

KW - Calprotectin

KW - Small bowel transplantation

UR - http://www.scopus.com/inward/record.url?scp=43449136778&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=43449136778&partnerID=8YFLogxK

U2 - 10.1097/TP.0b013e31816dcea2

DO - 10.1097/TP.0b013e31816dcea2

M3 - Article

VL - 85

SP - 1281

EP - 1286

JO - Transplantation

JF - Transplantation

SN - 0041-1337

IS - 9

ER -