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    Extracellular Histones H3 as a Prognostic Blood Marker for Delayed Liver Function Recovery After Donor Hepatectomy
    (Elsevier Science Inc, 2021) Novruzov, Namig; Ersan, Veysel; Bayramov, Nuru; Otlu, Baris; Aliyev, Eldar; Ince, Volkan; Isik, Burak
    Background. Early prediction of liver dysfunction after liver resection remains a challenge. We hypothesized that extracellular histone concentrations are a promising new biomarker for the detection of liver injury after donor hepatectomy. Methods. This prospective study considered 93 living donors who underwent hepatectomy. Blood samples of donors were collected on postoperative day 1, and histone levels in the plasma samples of the patients were measured with total histone H3 sandwich ELISA kits. Among 86 right lobe donors, 23 (26.7%) were deemed to have a delayed liver function recovery according to the International Study Group of Liver Surgery's definition of posthepatectomy liver failure, whereas 63 (73.3%) were considered to have an adequate liver function recovery. Results. The area under the receiver operating characteristic (ROC) curve for circulating histo-nes in predicting persistent liver dysfunction was 0.618 +/- 0.06 (95% confidence interval [CI], 0.501-0.735; P = .091). The cutoff point value obtained from the analysis of ROC curves was 0.895, with a sensitivity of 95.7% and a specificity of 32.9%, respectively, for examining a delayed liver function recovery (P = .015). The Fisher analysis significantly verified these results empirical influence function % 7.90 (95% CI, 3.91-11.90; P = .006). The univariate analysis determined that postoperative histones were identified as an independent risk factor of delayed liver function recovery (odds ratio, 10.8; 95% CI, 1.4-84.9; P = .024). Conclusions. The circulating histone negatively correlates with liver dysfunctions after donor hepatectomy and had the best value in predicting liver dysfunction within 24 hours after liver resection.
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    Prognostic Significance of Laboratory Parameters for Survival of Recipients after Living Donor Liver Transplantation
    (Egyptian Society Surgeons, 2026) Novruzov, Namig; Ersan, Veysel; Bayramov, Nuru; Aliyev, Eldar; Ince, Volkan; Isik, Burak; Yilmaz, Sezai
    Background: The routine laboratory factors affecting the 1-year survival of recipients after transplantation, and the predictive value of the parameters were investigated in this study. Materials and Methods: For this purpose, early post-operative laboratory parameters were recorded in 93 living donor liver transplant recipients, and were analyzed for their association with mortality during 1 year period. Univariate and multivariate logistic regression analyses and logistic Forward Wald and Logistic Backward Wald regression analysis were performed for predicting the survival of the recipients. Results: The calculated AUC value for the mortality in recipients was 0.762, (95% CI 0.607-0.917) (P= 0.005) for neutrophil-lymphocyte ratio, and the AUC value for albumin was 0.711, (95% CI 0.573-0.848) (P= 0.025). These dates were considered strong predictive factors and were higher than other liver functional tests. A cut-off value of total bilirubin >8.76mg/dL, was superior to standard liver tests, showing a sensitivity of 72.4 +/- 13.4% and a specificity of 84.1 +/- 4.4% for predicting 1-year lethal outcomes (P<0.001), ammonia cutoff level >190ug/dl showed 63.6 +/- 14.5% sensitivity and 87.0 +/- 4.1% specificity, the neutrophil-lymphocyte ratio achieved a sensitivity of 54.5 +/- 15.0% and a specificity of 88.4 +/- 3.9% with a cut-off value of 6.5. Conclusions: The overall diagnostic values of total bilirubin, ammonia, and neutrophil-lymphocyte ratio for predicting a 1-year lethal outcome were higher than other parameters, being 81.5%, 82.7%, and 82.7%, respectively. The combined prognostic sensitivity of albumin, total bilirubin, and neutrophil-lymphocyte ratio for 1-year survival was 91.3% (P>0.001). These findings may be potentially translatable for clinical use.