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Serum fibrosis biomarkers predict death and graft loss in liver transplantation recipients
Author(s) -
Bhat Mamatha,
Ghali Peter,
RolletKurhajec Kathleen C.,
Bhat Aparna,
Wong Philip,
Deschenes Marc,
Sebastiani Giada
Publication year - 2015
Publication title -
liver transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.814
H-Index - 150
eISSN - 1527-6473
pISSN - 1527-6465
DOI - 10.1002/lt.24217
Subject(s) - medicine , fibrosis , gastroenterology , liver transplantation , hazard ratio , nonalcoholic fatty liver disease , biomarker , confidence interval , transplantation , disease , fatty liver , biochemistry , chemistry
Noninvasive serum fibrosis biomarkers predict clinical outcomes in pretransplant patients with chronic liver disease. We investigated the role of serum fibrosis biomarkers and of changes in biomarkers in predicting death and graft loss after liver transplantation (LT). We included 547 patients who underwent LT between 1991 and 2012 and who met the following criteria: patient and graft survival > 12 months; serum fibrosis biomarkers aspartate aminotransferase–to‐platelet ratio index (APRI), fibrosis score 4 (FIB‐4), and nonalcoholic fatty liver disease (NAFLD) fibrosis score available at 1 year after LT; and a minimum follow‐up of 1 year. Delta of fibrosis biomarkers was defined as (end of follow‐up score – baseline score)/follow‐up duration. Baseline and delta fibrosis biomarkers were associated with death: APRI > 1.5 (adjusted hazard ratio [aHR], 2.2; 95% confidence interval [CI], 1.4‐3.3; P < 0.001) and delta APRI > 0.5 (aHR, 5.3; 95% CI, 3.4‐8.2; P < 0.001); FIB‐4 > 3.3 (aHR, 1.9; 95% CI, 1.3‐2.8; P = 0.002) and delta FIB‐4 > 1.4 (aHR, 2.4; 95% CI, 1.4‐4.1; P = 0.001); and NAFLD fibrosis score > 0.7 (aHR, 1.9; 95% CI, 1.3‐2.9; P = 0.002) and delta NAFLD fibrosis score (aHR, 3.7; 95% CI, 2.6‐5.4; P < 0.001). Baseline and delta fibrosis biomarkers were associated also with graft loss. In conclusion, serum fibrosis biomarkers 1 year after LT and changes in serum fibrosis biomarkers predict death and graft loss in LT recipients. They may help in risk stratification of LT recipients and identify patients requiring closer monitoring. Liver Transpl 21:1383‐1394, 2015 . © 2015 AASLD.