Hyaluronic Acid as Early Biomarker of Graft Loss after Liver Transplantation: A Prospective Study
1Department of Surgical Gastroenterology and Transplantation, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
2Department of Clinical Immunology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
3CHIP, Department of Infectious Diseases, Section 2100, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.
Meeting: 2018 American Transplant Congress
Abstract number: A32
Keywords: Graft survival, Liver transplantation
Session Information
Session Name: Poster Session A: Biomarkers, Immune Monitoring and Outcomes
Session Type: Poster Session
Date: Saturday, June 2, 2018
Session Time: 5:30pm-7:30pm
Presentation Time: 5:30pm-7:30pm
Location: Hall 4EF
Introduction: Improved diagnosis and understanding the pathophysiology of early allograft dysfunction is essential to improve the short-term outcome after liver transplantation (LT). Hyaluronic acid (HA) is produced in connective tissue and is cleared from the blood by hepatic sinuisoidal endothelial cells with a low half-life. We investigated if HA measured after liver transplantation is associated with increased risk of graft loss.
Methods: Plasma sample were obtained on all consecutive adult DBD liver transplant recipients at a single centre. Samples were taken pretransplant and at day 1, 3, 7 and 14 days after LT. HA was measured by an enzyme-linked hyaluronic acid binding protein assay. Uni- and multivariate Cox regression assessed the association between HA and graft loss (all-cause mortality or retransplantation) up to 1 year with a minimum of 4 months.
Results: We included 106 patients of which 12 had graft loss. Hyaluronic acid was significantly higher for patients with graft loss at day 3, 7 and 14, but not pretransplant or at day 1. 
In the serial measurements day 3 HA was best at predicting graft loss (hazard ratio (HR) 1.15 per 50 [micro]g/l increase, 95% CI: 1.03 – 1.29, P = 0.01). The day 3 HA remained predictive of graft loss (HR 1.14 per 50 [micro]g/l increase, 95% CI: 1.01 – 1.29) when adjusted for eurotransplant donor risk index and renal replacement therapy at day 3. The optimal cut-off for HA to predict graft loss was 172 [micro]g/l, if below the graft survival was 96% (95% CI: 86 – 99%) if above 79% (95% CI: 62 – 89 %).
Conclusion: HA predicted short term graft loss and potentially a valuable biomarker of early allograft dysfunction. Elevated HA levels may reflect damage to hepatic sinusoidal endothelial cells and thus may reflect ischemic reperfusion injury.
CITATION INFORMATION: Rostved A., Ostrowski S., Peters L., Lundgren J., Sørensen C., Pommergaard H-.C., Hillingsø J., Rasmussen A. Hyaluronic Acid as Early Biomarker of Graft Loss after Liver Transplantation: A Prospective Study Am J Transplant. 2017;17 (suppl 3).
To cite this abstract in AMA style:
Rostved A, Ostrowski S, Peters L, Lundgren J, Sørensen C, Pommergaard H-C, Hillingsø J, Rasmussen A. Hyaluronic Acid as Early Biomarker of Graft Loss after Liver Transplantation: A Prospective Study [abstract]. https://atcmeetingabstracts.com/abstract/hyaluronic-acid-as-early-biomarker-of-graft-loss-after-liver-transplantation-a-prospective-study/. Accessed May 17, 2025.« Back to 2018 American Transplant Congress