Prediction of late allograft dysfunction following liver transplantation by immunological blood biomarkers.


Journal

Transplant immunology
ISSN: 1878-5492
Titre abrégé: Transpl Immunol
Pays: Netherlands
ID NLM: 9309923

Informations de publication

Date de publication:
12 2021
Historique:
received: 10 04 2021
revised: 09 08 2021
accepted: 10 08 2021
pubmed: 16 8 2021
medline: 19 2 2022
entrez: 15 8 2021
Statut: ppublish

Résumé

An accelerated course of hepatic fibrosis may occur in liver transplantation (LT) patients despite normal or slightly abnormal liver blood tests. To identify screening tools based on blood biomarkers to predict late allograft dysfunction in LT recipients. 174 LT recipients were enrolled. Liver biopsy, liver functional tests, cytokine quantitation in serum, as well as soluble MHC class I polypeptide-related sequence A and B (sMICA/sMICB) and soluble UL16 binding protein 2 (sULBP2) were performed. Patients with late graft dysfunction had a significantly higher donor age, lower albumin level, higher alanine (ALT) and aspartate aminotransferase (AST), gamma-glutamyl transpeptidase (GGT), total bilirubin and alkaline phosphatase (ALP), higher sMICA, sULBP2, higher interleukin (IL) 6, interferon γ and lower IL10 in serum as compared to recipients without allograft dysfunction. In order to provide a better statistical accuracy for discriminating 5-year allograft dysfunction from other less progressive subtype of allograft injury, we established a predictive model, based on 7 parameters (serum ALP, ALT, AST, GGT, sMICA, IL6 and albumin) which provided an Area Under the Receiver Operating Characteristics (AUROC) curve of 0.905. Blood-based biomarkers can significantly improve prediction of late liver allograft outcome in LT patients. The new developed score comprising serum parameters, with an excellent AUROC, can be reliably used for diagnosing late allograft dysfunction in transplanted patients.

Sections du résumé

BACKGROUND
An accelerated course of hepatic fibrosis may occur in liver transplantation (LT) patients despite normal or slightly abnormal liver blood tests.
AIM
To identify screening tools based on blood biomarkers to predict late allograft dysfunction in LT recipients.
METHODS
174 LT recipients were enrolled. Liver biopsy, liver functional tests, cytokine quantitation in serum, as well as soluble MHC class I polypeptide-related sequence A and B (sMICA/sMICB) and soluble UL16 binding protein 2 (sULBP2) were performed.
RESULTS
Patients with late graft dysfunction had a significantly higher donor age, lower albumin level, higher alanine (ALT) and aspartate aminotransferase (AST), gamma-glutamyl transpeptidase (GGT), total bilirubin and alkaline phosphatase (ALP), higher sMICA, sULBP2, higher interleukin (IL) 6, interferon γ and lower IL10 in serum as compared to recipients without allograft dysfunction. In order to provide a better statistical accuracy for discriminating 5-year allograft dysfunction from other less progressive subtype of allograft injury, we established a predictive model, based on 7 parameters (serum ALP, ALT, AST, GGT, sMICA, IL6 and albumin) which provided an Area Under the Receiver Operating Characteristics (AUROC) curve of 0.905.
CONCLUSIONS
Blood-based biomarkers can significantly improve prediction of late liver allograft outcome in LT patients. The new developed score comprising serum parameters, with an excellent AUROC, can be reliably used for diagnosing late allograft dysfunction in transplanted patients.

Identifiants

pubmed: 34391882
pii: S0966-3274(21)00088-5
doi: 10.1016/j.trim.2021.101448
pii:
doi:

Substances chimiques

Biomarkers 0
gamma-Glutamyltransferase EC 2.3.2.2
Aspartate Aminotransferases EC 2.6.1.1

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

101448

Informations de copyright

Copyright © 2021 Elsevier B.V. All rights reserved.

Auteurs

Speranta Iacob (S)

Center for Digestive Diseases and Liver Transplantation, Fundeni Clinical Institute, Bucharest, Romania; Carol Davila University of Medicine and Pharmacy, Bucharest, Romania. Electronic address: msiacob@gmail.com.

Vito Cicinnati (V)

Department of Medicine B for Gastroenterology and Hepatology, University Hospital Muenster, 48149 Muenster, Germany.

Iyad Kabar (I)

Department of Medicine B for Gastroenterology and Hepatology, University Hospital Muenster, 48149 Muenster, Germany.

Anna Hüsing-Kabar (A)

Department of Medicine B for Gastroenterology and Hepatology, University Hospital Muenster, 48149 Muenster, Germany.

Arnold Radtke (A)

Department of General, Visceral and Transplant Surgery, Comprehensive Cancer Center, University of Tübingen, 72076 Tübingen, Germany.

Razvan Iacob (R)

Center for Digestive Diseases and Liver Transplantation, Fundeni Clinical Institute, Bucharest, Romania; Carol Davila University of Medicine and Pharmacy, Bucharest, Romania.

Hideo Baba (H)

Institute for Pathology, University Hospital Essen, 45147 Essen, Germany.

Hartmut H Schmidt (HH)

Department of Medicine B for Gastroenterology and Hepatology, University Hospital Muenster, 48149 Muenster, Germany.

Andreas Paul (A)

Department of General, Visceral and Transplantation Surgery, University Hospital Essen, 45147 Essen, Germany.

Susanne Beckebaum (S)

Department of Medicine B for Gastroenterology and Hepatology, University Hospital Muenster, 48149 Muenster, Germany.

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Classifications MeSH