Liver fatty acid-binding protein: an early and sensitive plasma marker of hepatocellular damage and a reliable predictor of graft viability after liver transplantation from non-heart-beating donors.
OBJECTIVE
Liver fatty acid-binding protein (L-FABP) is a small protein (15 kD) involved in the intracellular transport of long-chain fatty acids in the liver. The L-FABP is regarded as a sensitive marker for liver cell damage. In a pig model for liver transplantation (LTx) from non-heart-beating donors (NHBD), we evaluated plasma changes of L-FABP early after reperfusion of grafts exposed to increasing periods of warm ischemia (WI).


METHODS
Porcine livers were procured after 0, 15, 30, 45, and 60 minutes' WI. After 4 hours' cold ischemia (CI), LTx was performed. Primary graft nonfunction (PNF) and day 4 survival were recorded. Plasma samples were collected prior to and 15, 60, and 180 minutes after graft reperfusion for determination of L-FABP and aspartate transaminase (AST).


RESULTS
Early after reperfusion, levels of L-FABP correlated well with the duration of WI. The PNF developed in 100% of animals after 60 minutes of WI, 50% after 30, and 45 minutes' WI, and was absent after no WI and 15 minutes of WI. Day 4 survival was 100% in 0 minutes' WI, 83% in 15 minutes' WI, 50% in 30 and 45 minutes' WI, and 0% in 60 minutes of WI.


CONCLUSIONS
Plasma levels of L-FABP correlated well with WI and concomitant hepatocellular damage in LTx from NHBD. Monitoring of posttransplant L-FABP plasma levels is a valuable new tool to quantify early the extent of parenchymal cell damage of NHBD livers and to predict their viability and function.
Monbaliu
D
D
University Hospitals Leuven Leuven, Belgium. Diethard.Monbaliu@uz.kuleuven.ac.be
de Vries
B
B
Crabbé
T
T
van Heurn
E
E
Verwaest
C
C
Roskams
T
T
Fevery
J
J
Pirenne
J
J
Buurman
W A
WA
D000818:Animals; D015415:Biomarkers / Q000097:blood; D002352:Carrier Proteins / Q000097:blood*; D050556:Fatty Acid-Binding Proteins; D006085:Graft Survival / Q000502:physiology*; D006323:Heart Arrest; D007511:Ischemia; D008099:Liver / Q000473:pathology*; D016031:Liver Transplantation / Q000473:pathology / Q000502:physiology*; D011237:Predictive Value of Tests; D015424:Reperfusion; D016019:Survival Analysis; D013552:Swine
D015415:Biomarkers; D002352:Carrier Proteins; D050556:Fatty Acid-Binding Proteins