Serum Factor V Is a Continuous Biomarker of Graft Dysfunction and a Predictor of Graft Loss After Liver Transplantation

Gorgen, Andre; Prediger, Carolina; Prediger, João Edson; Chedid, Marcio; Backes, Ariane Nádia; Araújo, Alexandre de; Grezzana-Filho, T.J.M.; Leipnitz, Ian; Chedid, Aljamir Duarte; Álvares‐da‐Silva, Mário Reis; Kruel, Cléber Dario Pinto

doi:10.1097/tp.0000000000002429

Cited by 15 publications

(23 citation statements)

References 32 publications

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“…Recently, it has been demonstrated than serum factor V was shown to predict early graft loss and patient survival 42,43 . Furthermore, different experimental studies showed that serum concentrations of glycocalyx components or the release of hepatocyte‐derived microRNAs could predict 1‐year graft loss 44–47 …”

Section: Discussionmentioning

confidence: 99%

Combination of arterial lactate levels and Cv‐aCO2/Da‐vO2 ratio to predict early allograft dysfunction after liver transplantation

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Collado

et al. 2021

Clinical Transplantation

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Purpose We examined the ability of the P(v‐a)CO2/Da‐vO2 ratio combined with elevated lactate levels to predict early allograft dysfunction (EAD). Materials and methods Patients were classified into four groups according to lactate levels and P(v‐a)CO2/Da‐vO2 ratio: Group 1; lactate >2.0 mmol/L and P(v‐a)CO2/Da‐vO2 ratio >1.0; Group 2; lactate >2.0 mmol/L and P(v‐a)CO2/Da‐vO2 ratio <1.0; group 3; lactate<2.0 mmol/L and P(v‐a)CO2/Da‐vO2 ratio >1.0; group 4; lactate<2.0 mmol/L and P(v‐a)CO2/Da‐vO2 ratio <1.0. We defined EAD according to Olthoff criteria. Results One‐hundred and fifty patients were included. EAD occurred in 41 patients (27.3%), and was associated with worse graft survival at 1 year (92% vs. 73%; P = ,003) as well as a higher re‐transplantation rate (4,6% vs. 17,1%; P = ,019). The multivariate analysis revealed that P(v‐a)CO2/Da‐vO2 ratio at T6 [OR 7.05(CI95% 2.77–19.01, P<.001)] was an independent predictor for EAD. Belonging to group 1 at 6 h was associated with worse clinical outcomes but no association was found with 1‐year graft survival or 1‐year patient survival. Conclusions In this single center, prospective, observational study in patients who received an OLT, we found that elevated lactate levels combined with a high Cv‐aCO2/Da‐vO2 after 6 h was associated with the development of EAD and worse clinical outcomes in the early postoperative period.

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Section: Discussionmentioning

confidence: 99%

Combination of arterial lactate levels and Cv‐aCO2/Da‐vO2 ratio to predict early allograft dysfunction after liver transplantation

Fuente

Collado

et al. 2021

Clinical Transplantation

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“…Moreover, microRNAs and circular RNAs, such as miRNA-122, circFOXN2, and circNEXTIN3, that are expressed in the liver have been found to be potential early predictors of the onset of EAD ( 6 , 7 ). In addition, serum protein profiles of recipients associated with EAD have been widely studied, and several serum proteins have been identified, such as monocyte chemoattractant protein 1, interleukin 8, factor V, and soluble CD163 ( 8 , 9 , 17 ). However, protein profiles in donor grafts associated with EAD are rarely studied.…”

Section: Discussionmentioning

confidence: 99%

Combination of Early Allograft Dysfunction and Protein Expression Patterns Predicts Outcome of Liver Transplantation From Donation After Cardiac Death

et al. 2021

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Early allograft dysfunction (EAD) after liver transplantation (LT) accompanies poor prognosis. This study aims to explore the relationship between pretransplant intrahepatic proteins and the incidence of EAD, and the value of combined EAD and protein profiles for predicting recipient and graft survival prognosis. Liver biopsy specimens of 105 pretransplant grafts used for LT were collected and used for immunohistochemistry analysis of 5 proteins. And matched clinical data of donor, recipient, transplantation, and prognosis were analyzed. The incidence of EAD was 41.9% (44/105) in this cohort. Macrovesicular steatosis (P = 0.016), donor body mass index (P = 0.013), recipients' pretransplant serum creatinine (P = 0.036), and intrahepatic expression of heme oxygenase 1 (HO1) (P = 0.015) and tumor necrosis factor α (TNF-α) (P = 0.039) were independent predictors of EAD. Inferior graft and recipient prognosis were observed in patients who experienced EAD (P = 0.028 and 0.031) or received grafts with higher expression of sirtuin 1 (P = 0.005 and 0.013). The graft and recipient survival were worst in patients with both EAD and high expression of sirtuin 1 (P = 0.001 and 0.004). In conclusion, pretransplant intrahepatic expression of HO1 and TNF-α are associated with the incidence of EAD. The combination of EAD and EAD-unrelated proteins showed superiority in distinguishing recipients with worse prognosis.

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“…8 Acute kidney injury (AKI) was defined as a >50% rise in the post-LT serum creatinine from the baseline level. 9,10 Patient and graft survival…”

Section: Definitionsmentioning

confidence: 99%

Protein Profiles of Pretransplant Grafts Predict Early Allograft Dysfunction After Liver Transplantation From Donation After Circulatory Death

et al. 2020

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Background. Predicting the development of early allograft dysfunction (EAD) following liver transplantation (LT) remains challenging for transplant clinicians. The objectives of this study are to investigate the potential relationship between the protein profiles of pretransplant grafts and the onset of EAD, and then combine with clinical parameters to construct a mathematically predictive model. Methods. Clinical data of 121 LT procedures from donation after circulatory death at the authors’ center were analyzed. The expression levels of 7 studied proteins were determined by immunohistochemistry. Another independent cohort of 37 subjects was designed for further validation of the predictive model. Results. With an incidence of 43.0% (52/121), EAD was linked to significantly increased risk of acute kidney injury and renal replacement therapy, as well as reduced 6-month patient and liver graft survival. Allograft weight and high intrahepatic vascular endothelial growth factor (VEGF) expression were identified as independent risk factors of EAD and survival outcomes. Liver grafts with high VEGF expression exhibited delayed functional recovery within the first postoperative week. The combination of VEGF overexpression and EAD yielded the highest frequency of renal dysfunction and the worst survival. Based on allograft weight and intrahepatic VEGF expression, an EAD risk assessment model was developed. The incidence of EAD differed significantly between grafts with risk scores ≥−1.72 and <−1.72. The model functioned well in the validation cohort. Conclusions. Pretransplant intrahepatic protein profiling contributes to the estimation of early graft performance and recipient outcomes following LT. The predictive model could allow for an accurate prediction of EAD.

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Serum Factor V Is a Continuous Biomarker of Graft Dysfunction and a Predictor of Graft Loss After Liver Transplantation

Abstract: Factor V is an early marker for EAD and is a continuous predictor of short-term graft loss after LT.

Cited by 15 publications

References 32 publications

Combination of arterial lactate levels and Cv‐aCO2/Da‐vO2 ratio to predict early allograft dysfunction after liver transplantation

Combination of arterial lactate levels and Cv‐aCO2/Da‐vO2 ratio to predict early allograft dysfunction after liver transplantation

Combination of Early Allograft Dysfunction and Protein Expression Patterns Predicts Outcome of Liver Transplantation From Donation After Cardiac Death

Protein Profiles of Pretransplant Grafts Predict Early Allograft Dysfunction After Liver Transplantation From Donation After Circulatory Death

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