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.

中文翻译：

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通过免疫血液生物标志物预测肝移植后的晚期同种异体移植物功能障碍

背景

尽管肝脏血液检查正常或轻微异常，肝移植 (LT) 患者仍可能出现肝纤维化加速进程。

目的

确定基于血液生物标志物的筛查工具，以预测 LT 受者的晚期同种异体移植物功能障碍。

方法

招募了 174 名 LT 接受者。进行了肝活检、肝功能测试、血清中细胞因子的定量以及可溶性 MHC I 类多肽相关序列 A 和 B (sMICA/sMICB) 和可溶性 UL16 结合蛋白 2 (sULBP2)。

结果

晚期移植物功能障碍患者的供体年龄显着增加，白蛋白水平较低，丙氨酸（ALT）和天冬氨酸氨基转移酶（AST）、γ-谷氨酰转肽酶（GGT）、总胆红素和碱性磷酸酶（ALP）、sMICA、sULBP2、与没有同种异体移植物功能障碍的受者相比，血清中较高的白细胞介素 (IL) 6、干扰素 γ 和较低的 IL10。为了提供更好的统计准确性，以区分 5 年同种异体移植物功能障碍与其他进展较慢的同种异体移植物损伤亚型，我们建立了一个基于 7 个参数（血清 ALP、ALT、AST、GGT、sMICA、IL6 和白蛋白）的预测模型它提供了 0.905 的接收器操作特性 (AUROC) 曲线下面积。

结论

基于血液的生物标志物可以显着提高对 LT 患者晚期肝移植结果的预测。新开发的评分包括血清参数，具有出色的 AUROC，可可靠地用于诊断移植患者的晚期同种异体移植物功能障碍。