High preoperative bilirubin values protect against reperfusion injury after live donor liver transplantation. (23rd July 2015)

• Record Type: Journal Article
• Authors: Spetzler, Vinzent N.; Goldaracena, Nicolas; Kaths, Johann M.; Marquez, Max; Selzner, Nazia; Cattral, Mark S.; Greig, Paul D.; Lilly, Les; McGilvray, Ian D.; Levy, Gary A.; Ghanekar, Anand; Renner, Eberhard L.; Grant, David R.; Selzner, Markus
• Is Part Of: Transplant international. Volume 28:Number 11(2015:Nov.)
• Page Start: 1317
• Page End: 1325
• Publication Date: 2015-07-23
• Subjects: Transplantation of organs, tissues, etc -- Periodicals; 617.95405
• DOI: 10.1111/tri.12634
• Languages: English
• ISSNs: 0934-0874

Abstract

<abstract abstract-type="main" id="tri12634-abs-0001"> <title>Summary</title> <p>Heme Oxygenase‐1 and its product biliverdin/bilirubin have been demonstrated to protect against ischemia/reperfusion injury (IRI). We investigated whether increased preoperative bilirubin values of transplant recipients decrease IRI. Preoperative bilirubin levels of live donor liver recipients were correlated to postoperative liver transaminase as a marker of IRI. Additionally, two recipient groups with pretransplant bilirubin levels >24 μmol/l (<italic>n</italic> = 348) and ≤24 μmol/l (<italic>n</italic> = 118) were compared. Post‐transplant liver function, complications, length of hospital stay, and patient and graft survival were assessed. Preoperative bilirubin levels were negatively correlated to the postoperative increase in transaminases suggesting a protective effect against IRI. The maximal rise of ALT after transplantation in high versus low bilirubin patients was 288 (−210–2457) U/l vs. 375 (−11–2102) U/l, <italic>P </italic>=<italic> </italic>0.006. Bilirubin remained a significant determining factor in a multivariate linear regression analysis. The MELD score and its individual components as a marker of severity of chronic liver disease were significantly higher in the high versus low bilirubin group (<italic>P </italic><<italic> </italic>0.001). Despite this, overall complication rate (21.0% vs. 21.2%, <italic>P </italic>=<italic> </italic>0.88), hospital stay [13 (4–260) vs. 14 (6–313) days, <italic>P </italic>=<italic> </italic>0.93), and 1‐year graft survival (90.8% vs. 89.0%, <italic>P </italic>=<italic> </italic>0.62) were similar in both groups. High bilirubin levels of liver recipients before live donor transplantation is associated with decreased postoperative IRI.</p> </abstract>