Zebin Zhu1,2,3, Yunhua Tang1,2,3, Shanzhou Huang1,2,3, Qiang Zhao1,2,3, Paul M Schroder4, Zhiheng Zhang1,2,3, Yixi Zhang1,2,3, Chengjun Sun1,2,3, Linhe Wang1,2,3, Weiqiang Ju1,2,3, Dongping Wang1,2,3, Zhiyong Guo1,2,3, Xiaoshun He1,2,3. 1. Organ Transplant Center, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China. 2. Guangdong Provincial Key Laboratory of Organ Donation and Transplant Immunology, Guangzhou, China. 3. Guangdong Provincial International Cooperation Base of Science and Technology, Guangzhou, China. 4. Department of Surgery, Duke University Medical Center, Durham, North Carolina.
Abstract
BACKGROUND: The clinical significance of apoptosis in assessing the quality of donor liver grafts remains unknown. AIMS: This study aimed to determine whether apoptosis in a donor liver is predictive of early allograft dysfunction (EAD) and graft survival after liver transplantation (LT). METHODS: Donor liver specimens were analyzed for apoptosis using TUNEL assays. The prognostic factors for EAD were identified through logistic regression analyses, and a nomogram was developed. RESULTS: The apoptosis index of donor livers in EAD patients was significantly higher than that of donors livers in non-EAD patients (median 5.3; interquartile range [IQR] 3.4 vs 3.5; 3.6, P < 0.001). Multivariate analyses identified the apoptosis index of the donor liver (HR = 6.927, P < 0.001) and five other characteristics as independent predictors of EAD. A nomogram built on these predictive variables showed good calibration and discriminatory abilities, with a c-index value of 0.847. The 30-day graft survival rates in the high apoptosis index (apoptosis index >4.4%) group were significantly lower than those in the low apoptosis index (apoptosis index ≤4.4%) group (84.4% vs 97.6%, P = 0.004). CONCLUSIONS: Donor liver apoptosis plays a significant role in predicting EAD after LT. Furthermore, a high apoptosis index in the donor liver was associated with inferior graft survival in the short-term.
BACKGROUND: The clinical significance of apoptosis in assessing the quality of donor liver grafts remains unknown. AIMS: This study aimed to determine whether apoptosis in a donor liver is predictive of early allograft dysfunction (EAD) and graft survival after liver transplantation (LT). METHODS:Donor liver specimens were analyzed for apoptosis using TUNEL assays. The prognostic factors for EAD were identified through logistic regression analyses, and a nomogram was developed. RESULTS: The apoptosis index of donor livers in EADpatients was significantly higher than that of donors livers in non-EADpatients (median 5.3; interquartile range [IQR] 3.4 vs 3.5; 3.6, P < 0.001). Multivariate analyses identified the apoptosis index of the donor liver (HR = 6.927, P < 0.001) and five other characteristics as independent predictors of EAD. A nomogram built on these predictive variables showed good calibration and discriminatory abilities, with a c-index value of 0.847. The 30-day graft survival rates in the high apoptosis index (apoptosis index >4.4%) group were significantly lower than those in the low apoptosis index (apoptosis index ≤4.4%) group (84.4% vs 97.6%, P = 0.004). CONCLUSIONS:Donor liver apoptosis plays a significant role in predicting EAD after LT. Furthermore, a high apoptosis index in the donor liver was associated with inferior graft survival in the short-term.
Authors: Shaojun Shi; Eliano Bonaccorsi-Riani; Ivo Schurink; Thierry van den Bosch; Michael Doukas; Karishma A Lila; Henk P Roest; Daela Xhema; Pierre Gianello; Jeroen de Jonge; Monique M A Verstegen; Luc J W van der Laan Journal: Front Immunol Date: 2022-05-17 Impact factor: 8.786