Clinical Significance of Plasma Tenascin-C Levels in Recipients With Prolonged Jaundice After Living Donor Liver Transplantation

• Published in: Transplantation proceedings 2023-05, Vol.55 (4), p.913-923
• Main Authors: Shinkai, Toru, Kuriyama, Naohisa, Usui, Masanobu, Hayasaki, Aoi, Fujii, Takehiro, Iizawa, Yusuke, Tanemura, Akihiro, Murata, Yasuhiro, Kishiwada, Masashi, Katoh, Daisuke, Matsumoto, Takeshi, Wada, Hideo, Yoshida, Toshimichi, Isaji, Shuji, Mizuno, Shugo
• Format: Article
• Language: English
• Subjects: Adult; Clinical Relevance; Humans; Jaundice - etiology; Liver Transplantation - adverse effects; Living Donors; Tenascin - metabolism
• ISSN: 0041-1345; 1873-2623
• DOI: 10.1016/j.transproceed.2023.01.028

•We focused on tenascin-C (TNC), whose expression is enhanced during tissue remodeling. The present study aimed to clarify if serum TNC levels after living donor liver transplantation (LDLT) could be a predictor of irreversible liver damage in recipients with prolonged jaundice.•As for the risk factors for 90-day mortality after living donor liver transplantation, multivariate analysis identified TNC at postoperative day 14 (TNC-POD14) as a single significant independent prognostic factor.•In conclusion, plasma TNC-POD14 can be used as a predictive marker of prognosis in patients after LDLT. Especially in cases of prolonged jaundice after LDLT, plasma TNC-POD14 is very useful in the early diagnosis of postoperative liver regeneration disorders. Focusing on tenascin-C (TNC), whose expression is enhanced during the tissue remodeling process, the present study aimed to clarify whether plasma TNC levels after living donor liver transplantation (LDLT) could be a predictor of irreversible liver damage in the recipients with prolonged jaundice (PJ). Among 123 adult recipients who underwent LDLT between March 2002 and December 2016, the subjects were 79 recipients in whom we could measure plasma TNC levels preoperatively (pre-) and on postoperative days 1 to 14 (POD1 to POD14). Prolonged jaundice was defined as serum total bilirubin level >10 mg/dL on POD14, and 79 recipients were divided into 2 groups: 56 in the non-PJ (NJ) group and 23 in the PJ group. The PJ group had significantly increased pre-TNC; smaller grafts; decreased platelet counts POD14; increased TB-POD1, -POD7, and -POD14; increased prothrombin time–international normalized ratio on POD7 and POD14; and higher 90-day mortality than the NJ group. As for the risk factors for 90-day mortality, multivariate analysis identified TNC-POD14 as a single significant independent prognostic factor (P = .015). The best cut-off value of TNC-POD14 for 90-day survival was determined to be 193.7 ng/mL. In the PJ group, the patients with low TNC-POD14 (