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Serum lipids may predict graft dysfunction post-transplant in LDLT recipients

Measuring serum lipids post-transplantation may help predict regeneration and segmental graft dysfunction among living donor liver transplant recipients, according to data published in Liver Transplantation.

“Hepatic regeneration requires substantial de novo lipid synthesis, and we previously reported that expression of lipid-related genes is dysregulated in [living donor liver transplantation],” Kim M. Olthoff, MD, of the department of surgery, University of Pennsylvania, and colleagues wrote. “Here, we compare serum lipid measurements in 41 [living donor liver transplant] recipients and 43 [deceased donor liver transplant] recipients at baseline and at serial post-transplant time points.”

All patients were enrolled in the Genomics and Regeneration in Transplant study at the University of Pennsylvania and also had serum examined for whether or not serum lipid/apolipoprotein levels correlated with the degree of liver regeneration or segmental graft dysfunction (SGD) in living donor liver transplant (LDLT) recipients.

Overall, in contrast to deceased donor liver transplant (DDLT), lipid levels decreased early after LDLT. However, lipids returned to the same baseline level by 30 days.

The odds ratio for achieving robust regeneration, or a greater than 90% volume increase, was 2.53 (95% CI, 1.15-5.52) for every 1 mg/dL increase in serum apolipoprotein at 30 days. The OR of SGD for every year increase in donor age was 1.19 (95% CI, 1.02-1.39), and OR was 0.61 for every 1 mg/dL increase in serum high-density lipoprotein cholesterol at 7 days (95% CI, 0.34-1.11), according to the research.

Researchers did not observe any associations between preoperative serum lipids/ apolipoproteins in LDLT donors and SGD or percentage volume increase in recipients.

The researchers concluded: “We suggest that initiation of regeneration prevents the liver from participating fully in lipid transport and metabolism. Inability to meet systemic metabolic needs may result in compromised liver function and SGD.” – by Melinda Stevens

Disclosure: Healio.com/Hepatology was unable to confirm relevant financial disclosures at the time of publication.