Canlı vericili karaciğer naklinde yağ asidi bağlayan proteinlerin donör ve alıcılardaki değişimleri: İskemi ve reperfüzyon hasarını değerlendiren prospektif olgu kontrollü bir çalışma
Küçük Resim Yok
Tarih
2022
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
İnönü Üniversitesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Amaç: Bu çalışmanın amacı, canlı vericili karaciğer naklinde donörlerde ve alıcılarda iskemi/reperfüzyon hasarıyla ilişkili greft disfonksiyonu, relaparotomi ve mortaliteye yol açan postoperatif erken dönem komplikasyonlar gibi durumları aydınlatmak için olası biyobelirteçlerden A-FABP, I-FABP ve L-FABP düzeylerini değerlendirmektir. Gereç ve Yöntem: İnönü Üniversitesi Karaciğer Nakli Enstitüsü'nde Haziran 2020 ve Şubat 2021tarihleri arasında 307 hastadan oluşan bir kohorttan (alıcılar (n=158) ve donörler (n=149)) canlı vericili karaciğer nakli yapılan 55 alıcı ve canlı donör hepatektomisi yapılan 33 donör prospektif vaka kontrol çalışmasının analizi için dahil edildi. Alıcıların 46'sında Clavien-Dindo derece 3 ve 4 komplikasyonları varken 9'unda postoperatif normal seyir vardı. Donörlerin postoperatif seyri sorunsuzdu. Hastaların demografik, klinik, laboratuvar ve operatif özellikleri prospektif olarak kaydedildi. A-FABP, I-FABP, L-FABP, IL-6 ve MDA gibi spesifik laboratuvar parametreleri, enstitümüzün hepatoloji araştırma laboratuvarlarında enzim bağlantılı immünosorbent testi (ELISA) kullanılarak analiz edildi. Ameliyat öncesi, ameliyat sonrası 1., 8. ve 30. günlerde rutin laboratuvar tetkikleri ve spesifik laboratuvar parametreleri için serum örnekleri alındı. Bulgular: Serum I-FABP, A-FABP, L-FAP ve IL-6 belirlenen zaman periyotlarında donörler ve alıcılar arasında anlamlı fark göstermedi (p>0.05). Ancak, belirlenen tüm zaman dilimlerinde alıcılarda MDA anlamlı olarak daha yüksekti (p<0.05). Belirlenen zaman dilimlerinde I-FABP, A-FABP, L-FAP, MDA ve IL-6'nın seyrinin değerlendiğinde, belirlenen zaman noktalarında bu parametrelerin düzeylerindeki değişikliklerin anlamlı olduğunu gösterildi(tümü, p< 0.05). Spesifik laboratuvar parametreleri, alıcılarda belirlenen zaman aralığında önemli bir değişiklik göstermedi (tümü, p>0.05). Preoperatif A-FABP, L-FABP komplikasyonlu alıcılarda anlamlı olarak daha yüksekti (p<0.05). Ameliyat öncesi I-FABP, A-FABP ve L-FAP, yeniden laparotomi gerektiren alıcılarda anlamlı olarak daha yüksekti (p<0.05). Sonuç: Komplikasyon gelişen hastalarda FABP, A-FABP ve L-FABP seviyeleri anlamlı olarak daha yüksekti. Komplikasyonların öngörülmesi için yararlı bir belirteç olabilirler. Hastaların demografik, klinik ve ameliyat verilerine bağlı olmayan bu biyobelirteçlerin öngörüsü diğer herhangi bir laboratuvar parametresinden daha yüksektir. Bu yeni biyobelirteçlerin etkinliğinin değerlendirilmesi için daha ileri çalışmalara ihtiyaç vardır. Anahtar Kelimeler: İskemi-reperfüzyon hasarı, karaciğer nakli, yağ asidi bağlayıcı proteinler
Aim: The aim of the present study is to evaluate the levels of A-FABP, I-FABP, and L-FABP in donors and recipients of living donor liver transplantation (LDLT) in order to elucidate possible biomarkers for ischemia/reperfusion injury and related complications such as graft dysfunction, postoperative early complications leading to re-laparotomy and mortality. Materials and Methods: Fifty-five recipients who underwent LDLT and 33 donors who received living donor hepatectomy were included for analysis to this prospective case control study from a cohort of 307 patients (recipients [n=158] and donors [n=149]) who were operated between June 2020 and February 2021 in Inonu University Liver Transplant Institute. 46 of the recipients had Clavien-Dindo grade 3 and 4 complications and 9 had normal postoperative course. The donors had uneventful postoperative course. The demographic, clinical, laboratory and operative characteristics of the patients were prospectively recorded. Specific laboratory parameters including A-FABP, I-FABP, L-FABP, IL-6 and MDA were analyzed using enzyme linked immunosorbent assay (ELISA) in our institute's hepatology research laboratories. The routine laboratory work-up and serum samples for the specific laboratory parameters were collected in the preoperative, postoperative 1st, 8th and 30th days. Results: The serum I-FABP, A-FABP, L-FAP, and IL-6 did not show significant difference between the donors and recipients at designated time periods (p>0.05). However, MDA was significantly higher in the recipients in all designated time periods (p<0.05). The evaluation of the course of I-FABP, A-FABP, L-FAP, MDA and IL-6 in the designated time periods showed that the changes in the levels of these parameters at the designated time points were significant (all, p<0.05). Specific laboratory parameters did not show significant change at designated time period in the recipients (all, p>0.05). Preoperative A-FABP, L-FABP was significantly higher in recipients with complications (p<0.05). Preoperative I-FABP, A-FABP, and L-FAP was significantly higher in recipients who required re-laparotomy (p<0.05). Conclusions: Preoperative FABP, A-FABP, and L-FABP levels were significantly higher in patients with complicatons. They may be a useful toll for prediction of complications. They are higher than any other laboratory parameter and do not depend on the demographic, clinical an operative data of the patients. Further studies are required for evaluation of the efficacy of these new biomarkers. Key Words: Ischemia and reperfusion injury, liver transplantation, fatty acid binding proteins
Aim: The aim of the present study is to evaluate the levels of A-FABP, I-FABP, and L-FABP in donors and recipients of living donor liver transplantation (LDLT) in order to elucidate possible biomarkers for ischemia/reperfusion injury and related complications such as graft dysfunction, postoperative early complications leading to re-laparotomy and mortality. Materials and Methods: Fifty-five recipients who underwent LDLT and 33 donors who received living donor hepatectomy were included for analysis to this prospective case control study from a cohort of 307 patients (recipients [n=158] and donors [n=149]) who were operated between June 2020 and February 2021 in Inonu University Liver Transplant Institute. 46 of the recipients had Clavien-Dindo grade 3 and 4 complications and 9 had normal postoperative course. The donors had uneventful postoperative course. The demographic, clinical, laboratory and operative characteristics of the patients were prospectively recorded. Specific laboratory parameters including A-FABP, I-FABP, L-FABP, IL-6 and MDA were analyzed using enzyme linked immunosorbent assay (ELISA) in our institute's hepatology research laboratories. The routine laboratory work-up and serum samples for the specific laboratory parameters were collected in the preoperative, postoperative 1st, 8th and 30th days. Results: The serum I-FABP, A-FABP, L-FAP, and IL-6 did not show significant difference between the donors and recipients at designated time periods (p>0.05). However, MDA was significantly higher in the recipients in all designated time periods (p<0.05). The evaluation of the course of I-FABP, A-FABP, L-FAP, MDA and IL-6 in the designated time periods showed that the changes in the levels of these parameters at the designated time points were significant (all, p<0.05). Specific laboratory parameters did not show significant change at designated time period in the recipients (all, p>0.05). Preoperative A-FABP, L-FABP was significantly higher in recipients with complications (p<0.05). Preoperative I-FABP, A-FABP, and L-FAP was significantly higher in recipients who required re-laparotomy (p<0.05). Conclusions: Preoperative FABP, A-FABP, and L-FABP levels were significantly higher in patients with complicatons. They may be a useful toll for prediction of complications. They are higher than any other laboratory parameter and do not depend on the demographic, clinical an operative data of the patients. Further studies are required for evaluation of the efficacy of these new biomarkers. Key Words: Ischemia and reperfusion injury, liver transplantation, fatty acid binding proteins
Açıklama
Anahtar Kelimeler
Genel Cerrahi, General Surgery
