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Primary graft non-function (PNF) is a rare, life-threatening complicationof liver transplantation. Increasing use of extended criteria donor pools andhigh-risk recipients seem to influence the incidence of PNF. Primary failure isassociated with high patient morbidity and inferior graft survival. The only availabletreatment for PNF is emergency hepatic retransplantation, which is also correlatedwith significant morbidity and mortality. Therefore, researchers are working toidentify risk factors of diagnostic value to prevent PNF. The current study attemptedto explore liver proteomic patterns in patients with PNF. Using two-dimensionalgel electrophoresis and liquid chromatography-mass spectrometry (LC-MS), we comparedliver protein homogenates from 3 patients with PNF to those obtained from 6 healthyliver samples to identify potential new biomarkers of PNF. Our comparisons revealed21 proteins with differential expression (13 upregulated and 8 downregulated).Most of these proteins are involved in energy metabolism, lipid metabolism, peptidecleavage, cell differentiation, and apoptosis. Although none of these proteinsappeared more than once in separate analyses, this preliminary study shows thattwo-dimensional gel electrophoresis and LC-MS may allow identification of characteristicproteins to be used as biomarkers of a life-threatening complication of livertransplantation. Larger-scale analyses could improve patient care by finding suitableprognostic and therapeutic options. These data represent the first global proteomicapproach to study PNF.

Application of a proteomic approach to identify proteins associated with primary graft non-function after liver transplantation