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Hyaluronic Acid Is a Biomarker for Allograft Dysfunction and Predicts 1-Year Graft Loss After Liver Transplantation.
Rostved, A A; Ostrowski, S R; Peters, L; Lundgren, J D; Hillingsø, J; Johansson, P I; Rasmussen, A.
Afiliación
  • Rostved AA; Department of Surgical Gastroenterology and Transplantation, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark. Electronic address: andreas.arendtsen.rostved@regionh.dk.
  • Ostrowski SR; Department of Clinical Immunology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.
  • Peters L; Section 2100, CHIP, Department of Infectious Diseases, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.
  • Lundgren JD; Section 2100, CHIP, Department of Infectious Diseases, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.
  • Hillingsø J; Department of Surgical Gastroenterology and Transplantation, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.
  • Johansson PI; Department of Clinical Immunology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.
  • Rasmussen A; Department of Surgical Gastroenterology and Transplantation, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.
Transplant Proc ; 50(10): 3635-3643, 2018 Dec.
Article en En | MEDLINE | ID: mdl-30577249
BACKGROUND: Allograft dysfunction after liver transplantation has a profound impact on the risks of death and retransplantation within the first year. We tested whether elevated hyaluronic acid (HA; a glycosaminoglycan cleared by hepatic sinusoidal endothelium) levels may predict excess risk of graft loss. METHODS: This was a retrospective single-center prognostic cohort study. Patients with either a plasma sample before transplantation, an early post-transplantation sample nearest day 30 (range 10-89 d, 80% within days 15-60), or both were included. Plasma HA was measured with the use of enzyme-linked immunosorbent assays. The primary end point was 1-year graft loss (all-cause mortality and retransplantation). A secondary end point was biliary stricture. RESULTS: In this study, 169 of 196 patients who received a liver transplant in the study period were included. Pre-transplantation HA (n = 152) did not predict graft loss. Post-transplantation HA (n = 124) was higher among patients with graft loss (median, 177 µg/L [interquartile range (IQR), 89-465] vs 54 µg/L [IQR 37-93]) and was a strong predictor of this outcome (hazard ratio per 50 µg/L, 1.24 [95% confidence interval [CI], 1.14-1.34]). The discriminatory ability of HA was high (area under the receiver operating characteristic curve, 0.86 [95% CI, 0.77-0.94]) and noninferior to other liver function tests. When adjusted for known risk factors of graft loss, HA remained an independent predictor of graft loss. CONCLUSIONS: High post-transplantation plasma HA level was a strong predictor of 1-year all-cause mortality and retransplantation, whereas pre-transplantation levels were not, despite variety in the time span of blood sampling. Prospective studies are warranted to assess the utility of HA in liver transplantation.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Trasplante de Hígado / Supervivencia de Injerto / Ácido Hialurónico Tipo de estudio: Etiology_studies / Incidence_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Adult / Female / Humans / Male / Middle aged Idioma: En Revista: Transplant Proc Año: 2018 Tipo del documento: Article Pais de publicación: Estados Unidos
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Trasplante de Hígado / Supervivencia de Injerto / Ácido Hialurónico Tipo de estudio: Etiology_studies / Incidence_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Adult / Female / Humans / Male / Middle aged Idioma: En Revista: Transplant Proc Año: 2018 Tipo del documento: Article Pais de publicación: Estados Unidos