Uric Acid as a Predictor for Early Allograft Dysfunction after Living Donor Liver Transplantation: A Prospective Observational Study

Hu, Limin; Tsai, Hsin‐I; Lee, Chao‐Wei; Chen, Huiming; Lee, Wei‐Chen; Yu, Huang-Ping

doi:10.3390/jcm10122729

Cited by 5 publications

(13 citation statements)

References 30 publications

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“…Other biomarkers such as inflammatory cytokines, chemokines, metabolites, lipid profile, and factor V had also proved to be associated with EAD. 8,17,18,[20][21][22][23]25 However, the QOE supporting their utility is relatively low due to single study and small sample size.…”

Section: Discussionmentioning

confidence: 99%

Biomarkers and predictive models of early allograft dysfunction in liver transplantation – A systematic review of the literature, meta‐analysis, and expert panel recommendations

Liu

Martins

Bhat

et al. 2022

Clinical Transplantation

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Background: Prompt identification of early allograft dysfunction (EAD) is critical to reduce morbidity and mortality in liver transplant (LT) recipients.Objectives: Evaluate the evidence supporting biomarkers that can provide diagnostic and predictive value for EAD.Data sources: Ovid MEDLINE, Embase, Scopus, Google Scholar, and Cochrane Central.Methods: Systematic review following PRISMA guidelines and recommendations using the GRADE approach was derived from an international expert panel. Studies that investigated biomarkers or models for predicting EAD in adult LT recipients were included for in-depth evaluation and meta-analysis. Olthoff's criteria were used as the standard reference for the diagnostic accuracy evaluation. PROSPERO ID: CRD42021293838Results: Ten studies were included for the systematic review. Lactate, lactate clearance, uric acid, Factor V, HMGB-1, CRP to ALB ratio, phosphocholine, total cholesterol, and metabolomic predictive model were identified as potential early EAD predictive biomarkers. The sensitivity ranged between .39 and .92, while the specificity ranged from .63 to .90. Elevated lactate level was most indicative of EAD after adult LT (pooled diagnostic odds ratio of 7.15 (95%CI: 2.38-21.46)). The quality of evidence (QOE) for lactate as indicator was moderate according to the GRADE approach, whereas the QOE for other biomarkers was very low to low likely as consequence of study design characteristics such as single study, small sample size, and large ranges of sensitivity or specificity. Conclusions:Lactate is an early indicator to predict EAD after LT (Quality of Evidence: Moderate | Grade of Recommendation: Strong). Further multicenter studies and the use of machine perfusion setting should be implemented for validation.

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Section: Discussionmentioning

confidence: 99%

Biomarkers and predictive models of early allograft dysfunction in liver transplantation – A systematic review of the literature, meta‐analysis, and expert panel recommendations

Liu

Martins

Bhat

et al. 2022

Clinical Transplantation

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“…A number of risk factors for the incidence of EAD have been identified by previous studies including recipient-related, donor-related, and surgical factors ( 7 , 9 , 23 ). Golse et al reported the potentially predictive utility of lactate for EAD.…”

Section: Discussionmentioning

confidence: 99%

“…There are many mechanisms of EAD, among which ischemia-reperfusion injury (IRI) remains the most likely ( 6 ). There are also many risk factors for the incidence of EAD, such as donor body mass index (BMI), uric acid, postoperative hepatic artery resistance index, and the C-reactive protein-to-albumin ratio, which have been reported in previous studies ( 5 , 7 – 9 ).…”

Section: Introductionmentioning

confidence: 97%

Postoperative serum myoglobin as a predictor of early allograft dysfunction after liver transplantation

Zhang

Han

et al. 2022

Front. Surg.

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BackgroundEarly allograft dysfunction (EAD) is a common postliver transplant complication that has been associated with graft failure and risk for poor prognosis. There are many risk factors for the incidence of EAD after liver transplantation (LT). This study investigated whether elevated postoperative myoglobin (Mb) increases the incidence of EAD in liver transplanted recipients.MethodsA total of 150 adult recipients who measured Mb within 3 days after liver transplantation between June 2019 and June 2021 were evaluated. Then, all patients were divided into two groups: the EAD group and the non-EAD group. Univariate and multivariate logistic regression analyses were performed, and receiver operating characteristic curves (ROCs) were constructed.ResultsThe incidence of EAD was 53 out of 150 patients (35.3%) in our study. Based on the multivariate logistic analysis, the risk of EAD increased with elevated postoperative Mb (OR = 1.001, 95% CI 1.000–1.001, P = 0.002). The Mb AUC was 0.657, and it was 0.695 when combined with PCT. When the subgroup analysis was conducted, the AUC of serum Mb prediction was better in patients whose preoperative model for end-stage liver disease score ≤ 15 or operative time ≥ 10 h (AUC = 0.751, 0.758, respectively, or 0.760, 0.800 when combined with PCT).ConclusionElevated Mb significantly increased the risk of postoperative EAD, suggesting that postoperative Mb may be a novel predictor of EAD after liver transplantation.The study was registered in the Chinese Clinical Trial Registry (Registration number: ChiCTR2100044257, URL: http://www.chictr.org.cn).

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“…Moreover, NLR, when combined with AFP, CEA and uric acid, gave an AUROC as high as 0.933. Uric acid has recently been identified as a predictor for liver function after living donor liver transplantation [36]. Uric acid has been known for its antioxidant activity in various diseases and the liver is the major site of uric acid production.…”

Section: Discussionmentioning

confidence: 99%

Does Neutrophil to Lymphocyte Ratio Have a Role in Identifying Cytokeratin 19-Expressing Hepatocellular Carcinoma?

Lee

Lin

et al. 2021

JPM

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Background: Cytokeratin 19-positive (CK19(+)) hepatocellular carcinomas (HCC) are generally associated with poor prognosis after hepatectomy. It is typically detected from postoperative immunochemistry. We have analyzed several clinically available biomarkers, in particular, neutrophil to lymphocyte ratio (NLR) and aim to develop a panel of biomarkers in identifying CK19 expression in (HCC) preoperatively. Methods: We retrospectively reviewed 36 HCC patients who underwent liver resections during January 2017 to March 2018 in Chang Gung Memorial Hospital. Patients were grouped based on the status of CK19 expression and their baseline characteristics, perioperative and oncologic outcomes were compared. Novel biomarkers including NLR, alpha-fetoprotein (AFP), carcinoembryonic antigen (CEA) and uric acid were analyzed and correlated with CK19 expression. Results: NLR is highly associated with CK19 expression. NLR alone gave an AUROC of 0.728 (p-value = 0.043), higher than AFP, CEA or tumor size alone. NLR when combined with AFP, CEA and uric acid, gave an AUROC as high as 0.933 (p-value = 0.004). Conclusion: The current study demonstrated the predictive capability of NLR in combination with AFP, CEA and uric acid for CK19 expression in HCC patients preoperatively. Further prospective, large-scale studies are warranted to validate our findings.

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Uric Acid as a Predictor for Early Allograft Dysfunction after Living Donor Liver Transplantation: A Prospective Observational Study

Cited by 5 publications

References 30 publications

Biomarkers and predictive models of early allograft dysfunction in liver transplantation – A systematic review of the literature, meta‐analysis, and expert panel recommendations

Biomarkers and predictive models of early allograft dysfunction in liver transplantation – A systematic review of the literature, meta‐analysis, and expert panel recommendations

Postoperative serum myoglobin as a predictor of early allograft dysfunction after liver transplantation

Does Neutrophil to Lymphocyte Ratio Have a Role in Identifying Cytokeratin 19-Expressing Hepatocellular Carcinoma?

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