title: Serum fibrosis biomarkers predict death and graft loss in liver transplantation recipients.
abstract: Noninvasive serum fibrosis biomarkers predict clinical outcomes in pretransplant patients with chronic liver disease. We investigated the role of serum fibrosis biomarkers and of changes in biomarkers in predicting death and graft loss after liver transplantation (LT). We included 547 patients who underwent LT between 1991 and 2012 and who met the following criteria: patient and graft survival > 12 months; serum fibrosis biomarkers aspartate aminotransferase-to-platelet ratio index (APRI), fibrosis score 4 (FIB-4), and nonalcoholic fatty liver disease (NAFLD) fibrosis score available at 1 year after LT; and a minimum follow-up of 1 year. Delta of fibrosis biomarkers was defined as (end of follow-up score--baseline score)/follow-up duration. Baseline and delta fibrosis biomarkers were associated with death: APRI > 1.5 (adjusted hazard ratio [aHR], 2.2; 95% confidence interval [CI], 1.4-3.3; P < 0.001) and delta APRI > 0.5 (aHR, 5.3; 95% CI, 3.4-8.2; P < 0.001); FIB-4 > 3.3 (aHR, 1.9; 95% CI, 1.3-2.8; P = 0.002) and delta FIB-4 > 1.4 (aHR, 2.4; 95% CI, 1.4-4.1; P = 0.001); and NAFLD fibrosis score > 0.7 (aHR, 1.9; 95% CI, 1.3-2.9; P = 0.002) and delta NAFLD fibrosis score (aHR, 3.7; 95% CI, 2.6-5.4; P < 0.001). Baseline and delta fibrosis biomarkers were associated also with graft loss. In conclusion, serum fibrosis biomarkers 1 year after LT and changes in serum fibrosis biomarkers predict death and graft loss in LT recipients. They may help in risk stratification of LT recipients and identify patients requiring closer monitoring.
authors.affiliation: Division of Gastroenterology and Hepatology, McGill University Health Center, Montreal, Canada.
authors.forename: Mamatha
authors.initials: M
authors.lastname: Bhat
authors.affiliation: Division of Gastroenterology and Hepatology, McGill University Health Center, Montreal, Canada.
authors.forename: Peter
authors.initials: P
authors.lastname: Ghali
authors.affiliation: Chronic Viral Illness Service, Department of Medicine, McGill University Health Center, Montreal, Canada.
authors.forename: Kathleen C
authors.initials: KC
authors.lastname: Rollet-Kurhajec
authors.affiliation: Division of Gastroenterology and Hepatology, McGill University Health Center, Montreal, Canada.
authors.forename: Aparna
authors.initials: A
authors.lastname: Bhat
authors.affiliation: Division of Gastroenterology and Hepatology, McGill University Health Center, Montreal, Canada.
authors.forename: Philip
authors.initials: P
authors.lastname: Wong
authors.affiliation: Division of Gastroenterology and Hepatology, McGill University Health Center, Montreal, Canada.
authors.forename: Marc
authors.initials: M
authors.lastname: Deschenes
authors.affiliation: Division of Gastroenterology and Hepatology, McGill University Health Center, Montreal, Canada.|Chronic Viral Illness Service, Department of Medicine, McGill University Health Center, Montreal, Canada.
authors.forename: Giada
authors.initials: G
authors.lastname: Sebastiani
mesh_terms: D000368:Aged; D015415:Biomarkers / Q000097:blood*; D005260:Female; D005500:Follow-Up Studies; D006084:Graft Rejection / Q000097:blood / Q000209:etiology / Q000401:mortality*; D006801:Humans; D008103:Liver Cirrhosis / Q000097:blood / Q000150:complications / Q000401:mortality*; D017093:Liver Failure / Q000601:surgery*; D016031:Liver Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011792:Quebec / Q000453:epidemiology; D012189:Retrospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D015996:Survival Rate / Q000639:trends; D013997:Time Factors; D066027:Transplant Recipients
chemical_list: D015415:Biomarkers