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Endotoxin Metabolism Reflects Hepatic Functional Reserve in End-Stage Liver Disease

The hepatic clearance of endotoxin (Et) may reflect hepatic functional reserve and ischemic injury to hepatocytes. Therefore, we examined the relationships between Et activity (EA) and the metrics Pediatric End-Stage Liver Disease (PELD)/Model of End-Stage Liver Disease (MELD) score and alanine tran...

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Bibliographic Details
Published in:Transplantation proceedings 2018-06, Vol.50 (5), p.1360-1364
Main Authors: Okada, N., Sanada, Y., Urahashi, T., Ihara, Y., Yamada, N., Hirata, Y., Katano, T., Otomo, S., Ushijima, K., Mizuta, K.
Format: Article
Language:English
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Summary:The hepatic clearance of endotoxin (Et) may reflect hepatic functional reserve and ischemic injury to hepatocytes. Therefore, we examined the relationships between Et activity (EA) and the metrics Pediatric End-Stage Liver Disease (PELD)/Model of End-Stage Liver Disease (MELD) score and alanine transaminase (ALT) levels in the postoperative period. We performed 8 living-donor liver transplantations (LDLTs) for biliary atresia at our center from April 2012 to December 2012. EA was measured by means of an Et activity assay (EAA) in samples collected from a vein 1 day before LDLT, from the portal vein during the intraoperative anhepatic phase, from an artery 1 hour after reperfusion, from an artery on postoperative day (POD) 1, and from an artery or vein at PODs 7 and 14. EAs generally remained at low levels. EA at the reperfusion period was significantly lowest. The correlation coefficient for the preoperative MELD/PELD score and the EAA was 0.837, and the corresponding P value was .009; thus, there was a significant relationship between the preoperative MELD/PELD score and the EAA. The correlation coefficients for ALT at POD 1 and EA during the anhepatic phase, at 1 hour after reperfusion, and at POD 1 were 0.64, 0.43, and 0.38, respectively, and the P values for these correlations were .08, .67, and .34. Thus, we observed that ALT and EA generally tended to be somewhat directly correlated, but no significant relationships between these 2 metrics were observed. Endotoxin metabolism reflects the hepatic functional reserve capacity of end-stage liver disease. •The relationships between endotoxin activity and pre-transplantation PELD/MELD score were examined.•There was a significant relationship between the preoperative PELD/MELD score and the endotoxin activity assay.•Endotoxin metabolism reflects the hepatic functional reserve of end-stage liver disease.
ISSN:0041-1345
1873-2623
DOI:10.1016/j.transproceed.2018.01.052