دورية أكاديمية

Donor Hepatic Occult Collagen Deposition Predisposes to Peritransplant Stress and Impacts Human Liver Transplantation.

التفاصيل البيبلوغرافية
العنوان: Donor Hepatic Occult Collagen Deposition Predisposes to Peritransplant Stress and Impacts Human Liver Transplantation.
المؤلفون: Hirao H; The Dumont-UCLA Transplantation Center, Division of Liver and Pancreas Transplantation, Department of Surgery, David Geffen School of Medicine at University of California, Los Angeles, CA., Ito T; The Dumont-UCLA Transplantation Center, Division of Liver and Pancreas Transplantation, Department of Surgery, David Geffen School of Medicine at University of California, Los Angeles, CA., Kadono K; The Dumont-UCLA Transplantation Center, Division of Liver and Pancreas Transplantation, Department of Surgery, David Geffen School of Medicine at University of California, Los Angeles, CA., Kojima H; The Dumont-UCLA Transplantation Center, Division of Liver and Pancreas Transplantation, Department of Surgery, David Geffen School of Medicine at University of California, Los Angeles, CA., Naini BV; Department of Pathology, David Geffen School of Medicine at University of California, Los Angeles, CA., Nakamura K; The Dumont-UCLA Transplantation Center, Division of Liver and Pancreas Transplantation, Department of Surgery, David Geffen School of Medicine at University of California, Los Angeles, CA.; Division of Hepato-Biliary-Pancreatic Surgery and Transplantation, Department of Surgery, Kyoto University, Kyoto, Japan., Kageyama S; The Dumont-UCLA Transplantation Center, Division of Liver and Pancreas Transplantation, Department of Surgery, David Geffen School of Medicine at University of California, Los Angeles, CA.; Division of Hepato-Biliary-Pancreatic Surgery and Transplantation, Department of Surgery, Kyoto University, Kyoto, Japan., Busuttil RW; The Dumont-UCLA Transplantation Center, Division of Liver and Pancreas Transplantation, Department of Surgery, David Geffen School of Medicine at University of California, Los Angeles, CA., Kupiec-Weglinski JW; The Dumont-UCLA Transplantation Center, Division of Liver and Pancreas Transplantation, Department of Surgery, David Geffen School of Medicine at University of California, Los Angeles, CA., Kaldas FM; The Dumont-UCLA Transplantation Center, Division of Liver and Pancreas Transplantation, Department of Surgery, David Geffen School of Medicine at University of California, Los Angeles, CA.
المصدر: Hepatology (Baltimore, Md.) [Hepatology] 2021 Nov; Vol. 74 (5), pp. 2759-2773. Date of Electronic Publication: 2021 Aug 30.
نوع المنشور: Journal Article; Research Support, N.I.H., Extramural
اللغة: English
بيانات الدورية: Publisher: Wolters Kluwer Health, Inc Country of Publication: United States NLM ID: 8302946 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1527-3350 (Electronic) Linking ISSN: 02709139 NLM ISO Abbreviation: Hepatology Subsets: MEDLINE
أسماء مطبوعة: Publication: 2023- : [Philadelphia] : Wolters Kluwer Health, Inc.
Original Publication: Baltimore, MD : Williams & Wilkins, [c1981]-
مواضيع طبية MeSH: Collagen/*analysis , Donor Selection/*methods , Liver Cirrhosis/*diagnosis , Liver Transplantation/*adverse effects , Primary Graft Dysfunction/*epidemiology, Adolescent ; Adult ; Aged ; Allografts/pathology ; Biopsy ; Female ; Graft Survival ; Humans ; Incidence ; Liver/pathology ; Liver Cirrhosis/complications ; Liver Cirrhosis/pathology ; Male ; Middle Aged ; Primary Graft Dysfunction/etiology ; Primary Graft Dysfunction/prevention & control ; Prospective Studies ; Retrospective Studies ; Young Adult
مستخلص: Background and Aims: Environmentally triggered chronic liver inflammation can cause collagen deposits, whereas early stages of fibrosis without any specific symptoms could hardly be detectable. We hypothesized that some of the human donor grafts in clinical liver transplantation (LT) might possess unrecognizable fibrosis, affecting their susceptibility to LT-induced stress and hepatocellular damage. This retrospective study aimed to assess the impact of occult hepatic fibrosis on clinical LT outcomes.
Approach and Results: Human (194) donor liver biopsies were stained for collagen with Sirius red, and positive areas (Sirius red-positive area; SRA) were measured. The body mass index, aspartate aminotransferase/alanine aminotransferase ratio, diabetes score was calculated using 962 cases of the donor data at the procurement. LT outcomes, including ischemia-reperfusion injury (IRI), early allograft dysfunction (EAD), and survival rates, were analyzed according to SRA and BARD scores. With the median SRA in 194 grafts of 9.4%, grafts were classified into low-SRA (<15%; n = 140) and high-SRA (≥15%; n = 54) groups. Grafts with high SRA suffered from higher rates of IRI and EAD (P < 0.05) as compared to those with low SRA. Interestingly, high SRA was identified as an independent risk factor for EAD and positively correlated with the donor BARD score. When comparing low-BARD (n = 692) with high-BARD (n = 270) grafts in the same period, those with high BARD showed significantly higher post-LT transaminase levels and higher rates of IRI and EAD.
Conclusions: These findings from the largest clinical study cohort to date document the essential role of occult collagen deposition in donor livers on LT outcomes. High-SRA and donor BARD scores correlated with an increased incidence of hepatic IRI and EAD in LT recipients. This study provides the rationale for in-depth and prospective assessment of occult fibrosis for refined personalized LT management.
(© 2021 The Authors. Hepatology published by Wiley Periodicals LLC on behalf of American Association for the Study of Liver Diseases.)
التعليقات: Comment in: Hepatology. 2022 Mar;75(3):754. (PMID: 34478571)
Comment in: Hepatology. 2022 Mar;75(3):755. (PMID: 34478574)
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معلومات مُعتمدة: P01 AI120944 United States AI NIAID NIH HHS; PO1 AI120944 United States NH NIH HHS
المشرفين على المادة: 9007-34-5 (Collagen)
تواريخ الأحداث: Date Created: 20210625 Date Completed: 20220113 Latest Revision: 20220731
رمز التحديث: 20240628
مُعرف محوري في PubMed: PMC9291051
DOI: 10.1002/hep.32030
PMID: 34170562
قاعدة البيانات: MEDLINE
الوصف
تدمد:1527-3350
DOI:10.1002/hep.32030