title: Impact of the serum ferritin concentration in liver transplantation.
abstract: The serum ferritin (SF) concentration is a widely available and objective laboratory parameter. SF is also widely recognized as an acute-phase reactant. The purpose of the present study was to identify the chronological changes in the recipient's SF concentration during liver transplantation (LT) and to clarify factors having an effect on the recipient's intraoperative SF level. In addition, the study retrospectively evaluated the usefulness of measuring SF during LT. Ninety-eight pediatric recipients were retrospectively analyzed. The data were analyzed and compared according to the SF level in the recipient. Patients were classified into 2 groups based on the intraoperative peak SF levels of ≤ 1000 ng/mL (low-SF group) or >1000 ng/mL (high-SF group). The SF value increased dramatically after reperfusion and fell to normal levels within the early postoperative period. The warm ischemia time (WIT) was significantly longer in the high-SF group (47.0 versus 58.5 minutes; P = 0.003). In addition, a significant positive correlation was observed between the peak SF value and WIT (r = 0.35; P < 0.001). There were significant positive correlations between the peak SF value and the donors' preoperative laboratory data, including transaminases, cholinesterase, hemoglobin, transferrin saturation, and SF, of which SF showed the strongest positive correlation (r = 0.74; P < 0.001). The multivariate analysis revealed that WIT and donor's SF level were a significant risk factor for high SF level in the recipient (P = 0.007 and 0.02, respectively). In conclusion, the SF measurement can suggest the degree of ischemia/reperfusion injury (IRI). A high SF level in the donor is associated with the risk of further acute reactions, such as IRI, in the recipient.
authors.affiliation: Departments of Transplant Surgery, Jichi Medical University, Shimotsuke City, Japan.|Department of Gastroenterological Surgery, Graduate School of Medicine, Hirosaki University, Hirosaki, Japan.
authors.forename: Taiichi
authors.initials: T
authors.lastname: Wakiya
authors.affiliation: Departments of Transplant Surgery, Jichi Medical University, Shimotsuke City, Japan.
authors.forename: Yukihiro
authors.initials: Y
authors.lastname: Sanada
authors.affiliation: Departments of Transplant Surgery, Jichi Medical University, Shimotsuke City, Japan.
authors.forename: Taizen
authors.initials: T
authors.lastname: Urahashi
authors.affiliation: Departments of Transplant Surgery, Jichi Medical University, Shimotsuke City, Japan.
authors.forename: Yoshiyuki
authors.initials: Y
authors.lastname: Ihara
authors.affiliation: Departments of Transplant Surgery, Jichi Medical University, Shimotsuke City, Japan.
authors.forename: Naoya
authors.initials: N
authors.lastname: Yamada
authors.affiliation: Departments of Transplant Surgery, Jichi Medical University, Shimotsuke City, Japan.
authors.forename: Noriki
authors.initials: N
authors.lastname: Okada
authors.affiliation: Departments of Transplant Surgery, Jichi Medical University, Shimotsuke City, Japan.
authors.forename: Yuta
authors.initials: Y
authors.lastname: Hirata
authors.affiliation: Department of Gastroenterological Surgery, Graduate School of Medicine, Hirosaki University, Hirosaki, Japan.
authors.forename: Kenichi
authors.initials: K
authors.lastname: Hakamada
authors.affiliation: Department of Surgery, Jichi Medical University, Shimotsuke City, Japan.
authors.forename: Yoshikazu
authors.initials: Y
authors.lastname: Yasuda
authors.affiliation: Departments of Transplant Surgery, Jichi Medical University, Shimotsuke City, Japan.
authors.forename: Koichi
authors.initials: K
authors.lastname: Mizuta
mesh_terms: D015415:Biomarkers / Q000097:blood; D002648:Child; D002675:Child, Preschool; D005260:Female; D005293:Ferritins / Q000097:blood*; D005500:Follow-Up Studies; D006084:Graft Rejection / Q000097:blood* / Q000453:epidemiology / Q000209:etiology; D006801:Humans; D007165:Immunosuppression Therapy / Q000379:methods*; D015994:Incidence; D007223:Infant; D007564:Japan / Q000453:epidemiology; D016031:Liver Transplantation / Q000009:adverse effects*; D019520:Living Donors; D008297:Male; D016343:Monitoring, Intraoperative / Q000379:methods; D011379:Prognosis; D015427:Reperfusion Injury / Q000097:blood* / Q000150:complications / Q000517:prevention & control; D012189:Retrospective Studies; D015996:Survival Rate / Q000639:trends; D013997:Time Factors
chemical_list: D015415:Biomarkers; D005293:Ferritins