Liver transplantation is an effective intervention for end-stage liver disease, fulminant hepatic failure, and early hepatocellular carcinoma. Yet, there is marked patient-to-patient variation in liver transplantation outcomes. This calls for novel diagnostics to enable rational deployment of donor livers. Metabolomics is a postgenomic high-throughput systems biology approach to diagnostic innovation in clinical medicine. We report here an original systematic review of the metabolomic studies that have identified putative biomarkers in the context of liver transplantation. Eighteen studies met the inclusion criteria that involved sampling of blood (n = 4), dialysate fluid (n = 4), bile (n = 5), and liver tissue (n = 5). Metabolites of amino acid and nitrogen metabolism, anaerobic glycolysis, lipid breakdown products, and bile acid metabolism were significantly different in transplanted livers with and without graft dysfunction. However, criteria for defining the graft dysfunction varied across studies. This systematic review demonstrates that metabolomics can be deployed in identification of metabolic indicators of graft dysfunction with a view to implicated molecular mechanisms. We conclude the article with a horizon scanning of metabolomics technology in liver transplantation and its future prospects and challenges in research and clinical practice.

中文翻译：

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系统评价：预测肝移植手术结果的临床代谢组学。

肝移植是终末期肝病、暴发性肝衰竭和早期肝细胞癌的有效干预措施。然而，肝移植结果的患者与患者之间存在显着差异。这需要新的诊断方法来合理部署供体肝脏。代谢组学是一种用于临床医学诊断创新的后基因组高通量系统生物学方法。我们在此报告了对已在肝移植背景下确定推定生物标志物的代谢组学研究的原始系统评价。18 项研究符合纳入标准，涉及血液取样 (n = 4)、透析液 (n = 4)、胆汁 (n = 5) 和肝组织 (n = 5)。氨基酸和氮代谢的代谢产物、无氧糖酵解、脂质分解产物、在有和没有移植物功能障碍的移植肝脏中，胆汁酸代谢有显着差异。然而，定义移植物功能障碍的标准因研究而异。该系统评价表明，代谢组学可用于鉴定移植物功能障碍的代谢指标，以了解相关的分子机制。我们以对肝移植中代谢组学技术及其在研究和临床实践中的未来前景和挑战的视野扫描来结束这篇文章。该系统评价表明，代谢组学可用于鉴定移植物功能障碍的代谢指标，以了解相关的分子机制。我们以对肝移植中代谢组学技术及其在研究和临床实践中的未来前景和挑战的视野扫描来结束这篇文章。该系统评价表明，代谢组学可用于鉴定移植物功能障碍的代谢指标，以了解相关的分子机制。我们以对肝移植中代谢组学技术及其在研究和临床实践中的未来前景和挑战的视野扫描来结束这篇文章。