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The Role of Donor Gamma-Glutamyl Transferase as a Risk Factor for Early Graft Function after Liver Transplantation

Background: Growing interest has been recently reported in the potential detrimental role of donor gamma-glutamyl transferase (GGT) peak at the time of organ procurement regarding the risk of poor outcomes after liver transplantation (LT). However, the literature on this topic is scarce and controve...

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Autores principales: Lai, Quirino, Melandro, Fabio, Manzia, Tommaso M., Spoletini, Gabriele, Crovetto, Anna, Gallo, Gaetano, Hassan, Redan, Mennini, Gianluca, Angelico, Roberta, Avolio, Alfonso W., Berrevoet, Frederik, Abreu de Carvalho, Luís, Agnes, Salvatore, Tisone, Giuseppe, Rossi, Massimo
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10380680/
https://www.ncbi.nlm.nih.gov/pubmed/37510859
http://dx.doi.org/10.3390/jcm12144744
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author Lai, Quirino
Melandro, Fabio
Manzia, Tommaso M.
Spoletini, Gabriele
Crovetto, Anna
Gallo, Gaetano
Hassan, Redan
Mennini, Gianluca
Angelico, Roberta
Avolio, Alfonso W.
Berrevoet, Frederik
Abreu de Carvalho, Luís
Agnes, Salvatore
Tisone, Giuseppe
Rossi, Massimo
author_facet Lai, Quirino
Melandro, Fabio
Manzia, Tommaso M.
Spoletini, Gabriele
Crovetto, Anna
Gallo, Gaetano
Hassan, Redan
Mennini, Gianluca
Angelico, Roberta
Avolio, Alfonso W.
Berrevoet, Frederik
Abreu de Carvalho, Luís
Agnes, Salvatore
Tisone, Giuseppe
Rossi, Massimo
author_sort Lai, Quirino
collection PubMed
description Background: Growing interest has been recently reported in the potential detrimental role of donor gamma-glutamyl transferase (GGT) peak at the time of organ procurement regarding the risk of poor outcomes after liver transplantation (LT). However, the literature on this topic is scarce and controversial data exist on the mechanisms justifying such a correlation. This study aims to demonstrate the adverse effect of donor GGT in a large European LT cohort regarding 90-day post-transplant graft loss. Methods: This is a retrospective international study investigating 1335 adult patients receiving a first LT from January 2004 to September 2018 in four collaborative European centers. Results: Two different multivariable logistic regression models were constructed to evaluate the risk factors for 90-day post-transplant graft loss, introducing donor GGT as a continuous or dichotomous variable. In both models, donor GGT showed an independent role as a predictor of graft loss. In detail, the log-transformed continuous donor GGT value showed an odds ratio of 1.46 (95% CI = 1.03–2.07; p = 0.03). When the donor GGT peak value was dichotomized using a cut-off of 160 IU/L, the odds ratio was 1.90 (95% CI = 1.20–3.02; p = 0.006). When the graft-loss rates were investigated, significantly higher rates were reported in LT cases with donor GGT ≥160 IU/L. In detail, 90-day graft-loss rates were 23.2% vs. 13.9% in patients with high vs. low donor GGT, respectively (log-rank p = 0.004). Donor GGT was also added to scores conventionally used to predict outcomes (i.e., MELD, D-MELD, DRI, and BAR scores). In all cases, when the score was combined with the donor GGT, an improvement in the model accuracy was observed. Conclusions: Donor GGT could represent a valuable marker for evaluating graft quality at transplantation. Donor GGT should be implemented in scores aimed at predicting post-transplant clinical outcomes. The exact mechanisms correlating GGT and poor LT outcomes should be better clarified and need prospective studies focused on this topic.
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spelling pubmed-103806802023-07-29 The Role of Donor Gamma-Glutamyl Transferase as a Risk Factor for Early Graft Function after Liver Transplantation Lai, Quirino Melandro, Fabio Manzia, Tommaso M. Spoletini, Gabriele Crovetto, Anna Gallo, Gaetano Hassan, Redan Mennini, Gianluca Angelico, Roberta Avolio, Alfonso W. Berrevoet, Frederik Abreu de Carvalho, Luís Agnes, Salvatore Tisone, Giuseppe Rossi, Massimo J Clin Med Article Background: Growing interest has been recently reported in the potential detrimental role of donor gamma-glutamyl transferase (GGT) peak at the time of organ procurement regarding the risk of poor outcomes after liver transplantation (LT). However, the literature on this topic is scarce and controversial data exist on the mechanisms justifying such a correlation. This study aims to demonstrate the adverse effect of donor GGT in a large European LT cohort regarding 90-day post-transplant graft loss. Methods: This is a retrospective international study investigating 1335 adult patients receiving a first LT from January 2004 to September 2018 in four collaborative European centers. Results: Two different multivariable logistic regression models were constructed to evaluate the risk factors for 90-day post-transplant graft loss, introducing donor GGT as a continuous or dichotomous variable. In both models, donor GGT showed an independent role as a predictor of graft loss. In detail, the log-transformed continuous donor GGT value showed an odds ratio of 1.46 (95% CI = 1.03–2.07; p = 0.03). When the donor GGT peak value was dichotomized using a cut-off of 160 IU/L, the odds ratio was 1.90 (95% CI = 1.20–3.02; p = 0.006). When the graft-loss rates were investigated, significantly higher rates were reported in LT cases with donor GGT ≥160 IU/L. In detail, 90-day graft-loss rates were 23.2% vs. 13.9% in patients with high vs. low donor GGT, respectively (log-rank p = 0.004). Donor GGT was also added to scores conventionally used to predict outcomes (i.e., MELD, D-MELD, DRI, and BAR scores). In all cases, when the score was combined with the donor GGT, an improvement in the model accuracy was observed. Conclusions: Donor GGT could represent a valuable marker for evaluating graft quality at transplantation. Donor GGT should be implemented in scores aimed at predicting post-transplant clinical outcomes. The exact mechanisms correlating GGT and poor LT outcomes should be better clarified and need prospective studies focused on this topic. MDPI 2023-07-18 /pmc/articles/PMC10380680/ /pubmed/37510859 http://dx.doi.org/10.3390/jcm12144744 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Lai, Quirino
Melandro, Fabio
Manzia, Tommaso M.
Spoletini, Gabriele
Crovetto, Anna
Gallo, Gaetano
Hassan, Redan
Mennini, Gianluca
Angelico, Roberta
Avolio, Alfonso W.
Berrevoet, Frederik
Abreu de Carvalho, Luís
Agnes, Salvatore
Tisone, Giuseppe
Rossi, Massimo
The Role of Donor Gamma-Glutamyl Transferase as a Risk Factor for Early Graft Function after Liver Transplantation
title The Role of Donor Gamma-Glutamyl Transferase as a Risk Factor for Early Graft Function after Liver Transplantation
title_full The Role of Donor Gamma-Glutamyl Transferase as a Risk Factor for Early Graft Function after Liver Transplantation
title_fullStr The Role of Donor Gamma-Glutamyl Transferase as a Risk Factor for Early Graft Function after Liver Transplantation
title_full_unstemmed The Role of Donor Gamma-Glutamyl Transferase as a Risk Factor for Early Graft Function after Liver Transplantation
title_short The Role of Donor Gamma-Glutamyl Transferase as a Risk Factor for Early Graft Function after Liver Transplantation
title_sort role of donor gamma-glutamyl transferase as a risk factor for early graft function after liver transplantation
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10380680/
https://www.ncbi.nlm.nih.gov/pubmed/37510859
http://dx.doi.org/10.3390/jcm12144744
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