A search of novel biomarkers in detecting early allograft dysfunction afterliving donor liver transplantation
A lipidomics study in the early detection of early allograft dysfunction after living donor liver transplantation
Chang Gung Memorial Hospital
120 participants
Oct 16, 2018
Observational
Conditions
Summary
Liver transplantation has become the ultimate treatment for patients with end-stage liver disease. EAD has a strong effect on graft failure and recipient mortality. In the study, we will examine the metabolomic differences between EAD and non-EAD patients among recipients of different etiologies. While EAD is defined as deterioration in the coagulation profiles and liver functions compared to non-EAD recipients on postoperative day 7, we expect to find earlier changes in the distribution of metabolites in EAD patients. A lipidomic study of their corresponding donors will also be conducted. Further in-depth metabolomic studies may reveal disturbances in the distribution of amino acid and lipids, providing potential biomarkers for the early detection of EAD.
Eligibility
Inclusion Criteria1
- We plan to consecutively enroll recipients of living donor liver transplantation over a 3 year period
Exclusion Criteria1
- septic or shocked status, an anticipated pulmonary hypertension with a preoperative pulmonary wedge pressure greater than 35 mmHg or refusal to provide informed consent.
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Interventions
We plan to enroll 120 living liver donors and 120 corresponding recipients over a 3-year period (roughly 40 pairs per year). Demographic data including age, gender, blood type, serum bilirubin, albumin, prothrombin levels, international normalized ratio (INR), serum alanine aminotransferase (ALT) activity, serum aspartate amniotransferase (AST) activity, serum gamma-glutamyltransferase (GGT) activity, platelet count, cholesterol profile and Model for End-Stage Liver Disease (MELD) score will be collected. Sample collection Blood and urine samples will be collected from the donors pre-operatively and from recipients at 6 different time points as follows: (T1) before induction of general anesthesia as baseline, (T2) 20 minutes after the start of anhepatic phase, (T3) 2 hours post reperfusion, (T4) day 1 post-operatively (T5) day 3 post-operatively, and (T6) day 7 post-operatively. Bile samples will be extracted from donors and recipients from their gallbladders after being removed by the surgeons. Recipients’ remnant liver tissues will also be extracted before livers are to be sent to pathology laboratory. Hemodynamic data will also be collected at these time points. The blood will be centrifuged immediately at 1,000 g, 4 °C, for 10 minutes to obtain plasma. Samples were stored at -80 °C until batch analysis. The routine biochemical data will be measured by the clinical laboratory within the hospital.
Locations(1)
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ACTRN12619000386134