Soluble endothelial cell protein C receptor and thrombomodulin levels after renal transplantation

Both thrombomodulin (TM) and endothelial protein C receptor (EPCR) are candidate biomarkers of endothelial damage and have a role of anti-thrombotic defense mechanism in vascular structure. In this study, we aimed to investigate soluble EPCR (sEPCR), soluble TM (sTM) and tumor necrosis factor-alpha (TNF-alpha) levels in hemodialysis (HD) and renal transplant (RTx) recipients. Twenty-seven RTx recipients and 15 HD patients were recruited to the study. RTx recipients were evaluated before and 3 months after transplantation. Plasma sEPCR, sTM and TNF-alpha levels were measured at baseline and 3 months later in both groups. Moreover, 27 healthy subjects were evaluated regarding sEPCR. At baseline, there was no difference in sTM, sEPCR, TNF-alpha and C-reactive protein (CRP) between the groups. In paired analysis, sEPCR (266 +/- A 132 to 117 +/- A 72 ng/ml), sTM (635 +/- A 165 to 100 +/- A 41 ng/ml) and TNF-alpha (11.2 +/- A 4.3 to 6.0 +/- A 3.5 pg/ml) were significantly decreased in RTx patients (P < 0.0001) at 3 months, while there was no change in the HD group. In the healthy subjects, sEPCR was found to be 79 +/- A 26 ng/ml at baseline, which was lower than in both groups. We showed that the recently proposed endothelial damage biomarkers, sTM and sEPCR, are elevated in HD patients and significantly decrease after kidney transplantation.