title: Biomarkers to assess graft quality during conventional and machine preservation in liver transplantation.
abstract: A global rising organ shortage necessitates the use of extended criteria donors (ECD) for liver transplantation (LT). However, poor preservation and extensive ischemic injury of ECD grafts have been recognized as important factors associated with primary non-function, early allograft dysfunction, and biliary complications after LT. In order to prevent for these ischemia-related complications, machine perfusion (MP) has gained interest as a technique to optimize preservation of grafts and to provide the opportunity to assess graft quality by screening for extensive ischemic injury. For this purpose, however, objective surrogate biomarkers are required which can be easily determined at time of graft preservation and the various techniques of MP. This review provides an overview and evaluation of biomarkers that have been investigated for the assessment of graft quality and viability testing during different types of MP. Moreover, studies regarding conventional graft preservation by static cold storage (SCS) were screened to identify biomarkers that correlated with either allograft dysfunction or biliary complications after LT and which could potentially be applied as predictive markers during MP. The pros and cons of the different biomaterials that are available for biomarker research during graft preservation are discussed, accompanied with suggestions for future research. Though many studies are currently still in the experimental setting or of low evidence level due to small cohort sizes, the biomarkers presented in this review provide a useful handle to monitor recovery of ECD grafts during clinical MP in the near future.
authors.affiliation: Department of Surgery, Erasmus MC - University Medical Center, Rotterdam, The Netherlands.
authors.forename: Cornelia J
authors.initials: CJ
authors.lastname: Verhoeven
authors.affiliation: Department of Surgery, Erasmus MC - University Medical Center, Rotterdam, The Netherlands.
authors.forename: Waqar R R
authors.initials: WR
authors.lastname: Farid
authors.affiliation: Department of Surgery, Erasmus MC - University Medical Center, Rotterdam, The Netherlands.
authors.forename: Jeroen
authors.initials: J
authors.lastname: de Jonge
authors.affiliation: Department of Gastroenterology & Hepatology, Erasmus MC - University Medical Center, Rotterdam, The Netherlands. Electronic address: h.j.metselaar@erasmusmc.nl.
authors.forename: Herold J
authors.initials: HJ
authors.lastname: Metselaar
authors.affiliation: Department of Surgery, VU University Medical Center Amsterdam, The Netherlands.
authors.forename: Geert
authors.initials: G
authors.lastname: Kazemier
authors.affiliation: Department of Surgery, Erasmus MC - University Medical Center, Rotterdam, The Netherlands.
authors.forename: Luc J W
authors.initials: LJ
authors.lastname: van der Laan
mesh_terms: D000227:Adenine Nucleotides / Q000378:metabolism; D000410:Alanine Transaminase / Q000378:metabolism; D001219:Aspartate Aminotransferases / Q000378:metabolism; D015415:Biomarkers / Q000378:metabolism*; D006085:Graft Survival; D006801:Humans; D006820:Hyaluronic Acid / Q000378:metabolism; D008099:Liver / Q000378:metabolism* / Q000601:surgery; D016031:Liver Transplantation; D009926:Organ Preservation / Q000379:methods*; D011237:Predictive Value of Tests; D018180:Thrombomodulin / Q000378:metabolism
chemical_list: D000227:Adenine Nucleotides; D015415:Biomarkers; D018180:Thrombomodulin; D006820:Hyaluronic Acid; D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase
keywords: Biliary complications; Graft dysfunction; Marker; Prediction; Viability testing