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Lopez-Lopez V, Martínez-Caceres C, Ferreras D, Peña-Moral JDL, Cruz JDL, Royo-Villanova M, Rodríguez JM, Fernández-Hernández JA, Zambudio AR, Pons JA, Martínez-Barba E, Sánchez-Bueno F, Campos RR, Ramírez P. Biomarkers of Early Liver Graft Damage in Circulatory Death and Brain Death Donors: A Propensity Score Matching Analysis. Transplant Proc 2021; 53:2659-2662. [PMID: 34602295 DOI: 10.1016/j.transproceed.2021.07.055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Accepted: 07/16/2021] [Indexed: 11/15/2022]
Abstract
BACKGROUND Donation after circulatory death (DCD) is related to a warm ischemia time and more complications compared with traditional donors (donation after brain death [DBD]). METHODS This study included biopsy samples retrospectively collected from November 2014 to December 2018 to compare histologic and biological markers of DCD and DBD liver grafts. The analysis includes marker of early apoptosis (p21), senescence (telomerase reverse transcriptase [TERT]), cell damage (caspase-3 active), endothelial damage (vascular endothelial growth factor), stem cell (CD90), hypoxia (HIF1A), inflammatory activation (COX-2), and cross-organ allograft rejection (CD44). A propensity score matching (PSM) was used to match patients receiving DCD livers to those receiving DBD livers. We analyzed the immunohistochemical initial liver damage-related warm ischemia time. RESULTS Positive staining expression of liver damage biomarkers (COX-2, CD44, TERT, HIF1A, and CD90) was found, but no significant differences were found between DCD and DBD and with ischemic cholangiopathy. After PSM, there was a significant relationship between CD90 and male donors (odds ratio [OR], 0.26; 95% confidence interval [CI], 0.07-0.91), TERT with donor sodium (OR, 1.11; 95% CI, 1.02-1.2), HIF1A with steatosis (OR, 0.33; 95% CI, 0.13-0.83), and CD44 with donor vasoactive drugs (OR, 0.36; 95% CI, 0.13-1) and glutamic oxaloacetic transaminase 1 week increase (OR, 1.01; 95% CI, 1-1.03). CONCLUSIONS DCD immunohistochemical initial liver damage was found to behave similarly to DBD. The increase in complications and cholangiopathy associated with warm ischemia could be related to a different later phenomenon.
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Affiliation(s)
- Víctor Lopez-Lopez
- Department of Surgery, Virgen de la Arrixaca University Hospital, Biomedical Research Institute of Murcia-Virgen de la Arrixaca (IMIB-Arrixaca), Murcia, Spain.
| | | | - David Ferreras
- Department of Surgery, Virgen de la Arrixaca University Hospital, Biomedical Research Institute of Murcia-Virgen de la Arrixaca (IMIB-Arrixaca), Murcia, Spain
| | | | - Juan De La Cruz
- Group of Applied Mathematics in Science and Engineering, Faculty of Computer Science, University of Murcia, Murcia, Spain
| | - Mario Royo-Villanova
- Intensive Care Unit, Hospital Clínico Universitario Virgen de la Arrixaca, Murcia, Spain
| | - Jose Manuel Rodríguez
- Department of Surgery, Virgen de la Arrixaca University Hospital, Biomedical Research Institute of Murcia-Virgen de la Arrixaca (IMIB-Arrixaca), Murcia, Spain
| | - Juan Angel Fernández-Hernández
- Department of Surgery, Virgen de la Arrixaca University Hospital, Biomedical Research Institute of Murcia-Virgen de la Arrixaca (IMIB-Arrixaca), Murcia, Spain
| | - Antonio Ríos Zambudio
- Department of Surgery, Virgen de la Arrixaca University Hospital, Biomedical Research Institute of Murcia-Virgen de la Arrixaca (IMIB-Arrixaca), Murcia, Spain
| | - Jose Antonio Pons
- Department of Hepatology, Hospital Clínico Universitario Virgen de la Arrixaca, Murcia, Spain
| | | | - Francisco Sánchez-Bueno
- Department of Surgery, Virgen de la Arrixaca University Hospital, Biomedical Research Institute of Murcia-Virgen de la Arrixaca (IMIB-Arrixaca), Murcia, Spain
| | - Ricardo Robles Campos
- Department of Surgery, Virgen de la Arrixaca University Hospital, Biomedical Research Institute of Murcia-Virgen de la Arrixaca (IMIB-Arrixaca), Murcia, Spain
| | - Pablo Ramírez
- Department of Surgery, Virgen de la Arrixaca University Hospital, Biomedical Research Institute of Murcia-Virgen de la Arrixaca (IMIB-Arrixaca), Murcia, Spain
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