title: Serum lipid expression correlates with function and regeneration following living donor liver transplantation.
abstract: Following living donor liver transplantation (LDLT; and unlike deceased donor liver transplantation [DDLT]), the liver must rapidly regenerate, and sometimes segmental graft dysfunction (SGD) is observed. Hepatic regeneration requires substantial de novo lipid synthesis, and we previously reported that expression of lipid-related genes is dysregulated in LDLT. Here, we compare serum lipid measurements in 41 LDLT recipients and 43 DDLT recipients at baseline and at serial posttransplant time points. In addition, we examined whether serum lipid/apolipoprotein (apo) levels correlate with the degree of liver regeneration (measured using percent volume increase [%VI] at 3 months) or SGD in LDLT recipients. In contrast to DDLT, lipid levels declined early after LDLT but returned to baseline by 30 days. The odds ratio (OR) for achieving robust regeneration (>90 %VI) was 2.53 (95% confidence interval [CI], 1.15-5.52) for every 1 mg/dL increase in serum apoE at 30 days. The OR of SGD for every year increase in donor age was 1.19 (95% CI, 1.02-1.39), and 0.61 for every 1 mg/dL increase in serum high-density lipoprotein cholesterol at 7 days (95% CI, 0.34-1.11). No associations were detected between preoperative serum lipids/apos in LDLT donors and SGD or %VI in recipients. In conclusion, we suggest that initiation of regeneration prevents the liver from participating fully in lipid transport and metabolism. Inability to meet systemic metabolic needs may result in compromised liver function and SGD. Certain serum lipid concentrations correlate with extent of liver regeneration and function.
authors.affiliation: Liver Transplant Program, Department of Surgery.
authors.forename: Joshua H
authors.initials: JH
authors.lastname: Wolf
authors.affiliation: Liver Transplant Program, Department of Surgery.
authors.forename: Michael V
authors.initials: MV
authors.lastname: Holmes
authors.affiliation: Liver Transplant Program, Department of Surgery.
authors.forename: Suomi
authors.initials: S
authors.lastname: Fouraschen
authors.affiliation: Liver Transplant Program, Department of Surgery.
authors.forename: Brendan J
authors.initials: BJ
authors.lastname: Keating
authors.affiliation: Department of Surgery, Northwestern University, Chicago, IL.
authors.forename: Talia
authors.initials: T
authors.lastname: Baker
authors.affiliation: Center for Liver Disease and Transplantation, Columbia University, New York, NY.
authors.forename: Jean
authors.initials: J
authors.lastname: Emond
authors.affiliation: Institute for Translational Medicine and Therapeutics, University of Pennsylvania, Philadelphia, PA.
authors.forename: Daniel J
authors.initials: DJ
authors.lastname: Rader
authors.affiliation: Liver Transplant Program, Department of Surgery.
authors.forename: Abraham
authors.initials: A
authors.lastname: Shaked
authors.affiliation: Liver Transplant Program, Department of Surgery.
authors.forename: Kim M
authors.initials: KM
authors.lastname: Olthoff
mesh_terms: D000328:Adult; D000368:Aged; D001053:Apolipoproteins / Q000097:blood*; D005260:Female; D006801:Humans; D008115:Liver Regeneration; D016031:Liver Transplantation; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D055815:Young Adult
chemical_list: D001053:Apolipoproteins