Open AccessHigh preoperative bilirubin values protect against reperfusion injury after live donor liver transplantation
Author(s) -
Spetzler Vinzent N.,
Goldaraceicolas,
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
Publication year - 2015
Publication title -
transplant international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.998
H-Index - 82
eISSN - 1432-2277
pISSN - 0934-0874
DOI - 10.1111/tri.12634
Subject(s) - bilirubin , medicine , liver transplantation , gastroenterology , aspartate transaminase , transplantation , alanine transaminase , reperfusion injury , liver function , surgery , liver function tests , ischemia , alkaline phosphatase , biochemistry , chemistry , enzyme
Summary 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 ( n = 348) and ≤24 μmol/l ( n = 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, P = 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 ( P < 0.001). Despite this, overall complication rate (21.0% vs. 21.2%, P = 0.88), hospital stay [13 (4–260) vs. 14 (6–313) days, P = 0.93), and 1‐year graft survival (90.8% vs. 89.0%, P = 0.62) were similar in both groups. High bilirubin levels of liver recipients before live donor transplantation is associated with decreased postoperative IRI .