title: Is biliary bile acid a good predictor for acute cellular rejection in living donor liver transplantation?
abstract: 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.
authors.affiliation: Department of Hepato-pancreatic-biliary Surgery and Liver Transplantation, Kyoto University Hospital, Kyoto, Japan. hedayamsm@yahoo.com
authors.forename: Mohammed Saied
authors.initials: MS
authors.lastname: Hedaya
authors.forename: Walid M
authors.initials: WM
authors.lastname: El Moghazy
authors.forename: Yamamoto
authors.initials: Y
authors.lastname: Yasutomo
authors.forename: Tomioka
authors.initials: T
authors.lastname: Kiyoshi
authors.forename: Toshimi
authors.initials: T
authors.lastname: Kaido
authors.forename: Hiroto
authors.initials: H
authors.lastname: Egawa
authors.forename: Shinji
authors.initials: S
authors.lastname: Uemoto
authors.forename: Yasutsugu
authors.initials: Y
authors.lastname: Takada
mesh_terms: 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
chemical_list: D001647:Bile Acids and Salts