Is biliary bile acid a good predictor for acute cellular rejection in living donor liver transplantation?
BACKGROUND
In liver transplantation, acute cellular rejection (ACR) is still a major complication that can lead to mortality. Bile secretion has been considered as a marker of early graft function.


METHODS
The study included 41 adults who received living donor liver transplantation (LDLT) at Kyoto University Hospital between April 2007 and February 2008. The patients were stratified according to the presence or absence of ACR. Bile samples were collected from donors once and from recipients every other day for the first 2 weeks after transplantation. Total bile acid (BA) and taurine-conjugated bile acid (TCBA) in bile were measured by magnetic resonance spectroscopy. The recipient/donor (R/D) BA ratio and R/D TCBA ratio were calculated.


RESULTS
The ACR group (n=12) showed a greater decrease in BA post-transplantation than the non-ACR group, but this difference was not statistically significant. On both day 7 and day 9 post-transplantation the R/D TCBA was significantly different between the two groups (P=0.038 on day 7 and P=0.036 on day 9). The R/D TCBA ratio >or=0.5 on days 7 and 9, and >or=0.38 on day 11 post-transplantation were associated with better ACR-free survival.


CONCLUSIONS
The recipient/donor TCBA ratio can be a predictor for ACR after LDLT as early as post-transplantation day 7.
Hedaya
Mohammed Saied
MS
Department of Hepato-pancreatic-biliary Surgery and Liver Transplantation, Kyoto University Hospital, Kyoto, Japan. hedayamsm@yahoo.com
El Moghazy
Walid M
WM
Yasutomo
Yamamoto
Y
Kiyoshi
Tomioka
T
Kaido
Toshimi
T
Egawa
Hiroto
H
Uemoto
Shinji
S
Takada
Yasutsugu
Y
D000328:Adult; D001646:Bile / Q000378:metabolism*; D001647:Bile Acids and Salts / Q000378:metabolism*; D005260:Female; D006084:Graft Rejection / Q000175:diagnosis* / Q000378:metabolism; D006801:Humans; D016031:Liver Transplantation; D019520:Living Donors; D009682:Magnetic Resonance Spectroscopy; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011379:Prognosis; D012189:Retrospective Studies
D001647:Bile Acids and Salts