ATC Abstracts

American Transplant Congress abstracts

  • Home
  • Meetings Archive
    • 2022 American Transplant Congress
    • 2021 American Transplant Congress
    • 2020 American Transplant Congress
    • 2019 American Transplant Congress
    • 2018 American Transplant Congress
    • 2017 American Transplant Congress
    • 2016 American Transplant Congress
    • 2015 American Transplant Congress
    • 2013 American Transplant Congress
  • Keyword Index
  • Resources
    • 2021 Resources
    • 2016 Resources
      • 2016 Welcome Letter
      • ATC 2016 Program Planning Committees
      • ASTS Council 2015-2016
      • AST Board of Directors 2015-2016
    • 2015 Resources
      • 2015 Welcome Letter
      • ATC 2015 Program Planning Committees
      • ASTS Council 2014-2015
      • AST Board of Directors 2014-2015
      • 2015 Conference Schedule
  • Search

Changes in Graft Gene Expression Contribute to Coagulopathy in UDCD Liver Transplantation

A. Hessheimer, M. Vendrell, D. Sabater, J. Muñoz, A. Blasi, J. García-Valdecasas, A. Ruíz, M. Navasa, C. Fondevila.

Hospital Clínic, Barcelona, Spain.

Meeting: 2018 American Transplant Congress

Abstract number: A274

Keywords: Donors, non-heart-beating

Session Information

Session Name: Poster Session A: Liver: MELD, Allocation and Donor Issues (DCD/ECD)

Session Type: Poster Session

Date: Saturday, June 2, 2018

Session Time: 5:30pm-7:30pm

 Presentation Time: 5:30pm-7:30pm

Location: Hall 4EF

Uncontrolled donation after circulatory death donors suffer cardiac arrest followed by unsuccessful resuscitation. Their livers have been successfully transplanted, though strict maintenance and selection criteria are necessary to avoid adverse outcomes, namely ischemic type biliary lesions. We previously demonstrated that uDCD liver recipients develop severe coagulopathy and fibrinolysis (Blasi 2016). Given the liver is the major source of clotting and fibrinolytic factors, we hypothesized that changes in gene expression may be detected in uDCD livers and provide a basis for abnormalities observed.

METHODS Cardiac arrest was witnessed and resuscitation attempts unsuccessful. Death was declared based on absence of cardiorespiratory activity during a 5-min no-touch period. Femoral vessels were cannulated to establish normothermic regional perfusion, which was run during evaluation and recovery. 32 samples were taken from 16 uDCD livers: “A” before cold preservation and “B” after reperfusion. Total RNA was extracted and analyzed using microarrays; results were confirmed using RT-PCR. Finally, 61 biopsies from 38 uDCD livers were evaluated by light microscopy to rule out fibrin microthrombi.

RESULTS Both before preservation and after reperfusion, uDCD livers had significantly upregulated expression of genes that provoke fibrinolysis and inhibit coagulation, including tissue plasminogen activator, urokinase plasminogen activator, urokinase plasminogen activator receptor, and thrombomodulin. There was also decreased expression of genes implicated in hemostasis (von Willebrand factor) and inhibition of fibrinolysis (alpha-2-macroglobulin):

Gene FC FDR
"A"
PLAUR 2.5 0.0002
VWF -2.4 0.0004
PLAT 1.9 0.002
PLAU 2.0 0.005
A2M -2.2 0.006
"B"
PLAUR 3.2 2E-5
PLAT 2.7 0.0002
PLAU 2.2 0.0008
A2M -2.6 0.0009
VWF -2.1 0.001
TM 1.5 <0.01

On histology, no fibrin microthrombi were detected, even in cases that developed ITBL (13%).

CONCLUSION Changes in gene expression in uDCD livers help explain severe coagulopathy and fibrinolysis seen in recipients. Endogenous fibrinolysis is upregulated in these livers most at risk for ITBL, and clinical DCD protocols using TPA to help prevent ITBL should undergo critical appraisal.

CITATION INFORMATION: Hessheimer A., Vendrell M., Sabater D., Muñoz J., Blasi A., García-Valdecasas J., Ruíz A., Navasa M., Fondevila C. Changes in Graft Gene Expression Contribute to Coagulopathy in UDCD Liver Transplantation Am J Transplant. 2017;17 (suppl 3).

  • Tweet
  • Click to email a link to a friend (Opens in new window) Email
  • Click to print (Opens in new window) Print

To cite this abstract in AMA style:

Hessheimer A, Vendrell M, Sabater D, Muñoz J, Blasi A, García-Valdecasas J, Ruíz A, Navasa M, Fondevila C. Changes in Graft Gene Expression Contribute to Coagulopathy in UDCD Liver Transplantation [abstract]. https://atcmeetingabstracts.com/abstract/changes-in-graft-gene-expression-contribute-to-coagulopathy-in-udcd-liver-transplantation/. Accessed June 6, 2025.

« Back to 2018 American Transplant Congress

Visit Our Partner Sites

American Transplant Congress (ATC)

Visit the official site for the American Transplant Congress »

American Journal of Transplantation

The official publication for the American Society of Transplantation (AST) and the American Society of Transplant Surgeons (ASTS) »

American Society of Transplantation (AST)

An organization of more than 3000 professionals dedicated to advancing the field of transplantation. »

American Society of Transplant Surgeons (ASTS)

The society represents approximately 1,800 professionals dedicated to excellence in transplantation surgery. »

Copyright © 2013-2025 by American Society of Transplantation and the American Society of Transplant Surgeons. All rights reserved.

Privacy Policy | Terms of Use | Cookie Preferences