Background: Transient elevation of aminotransferases, alkaline phosphatase and/or bilirubin are common findings post living donor liver transplantation, however, when enzymes showed marked or prolonged elevation, complications should be considered including acute rejection, hepatic artery thrombosis, infections or recurrence of the original disease. Aim of the Study: To demonstrate whether serum renalase can be used as a potential biomarker of hepatocellular inflammation following living donor liver transplantation especially when combined with the standard LFT, CRP & TLC. Patients and Methods: The study was performed on 50 patients with End Stage Liver Disease (ESLD) undergone Living Donor Liver Transplantation (LDLT). Measurement of CBC, CRP, LFT and KFT were done daily for seven days and three months following liver transplantation. Immunoassay of serum renalase, six hours, one week and three months after transplantation. Results: By comparing different laboratory data on day seven and third month to laboratory data on day one postliving donor liver transplantation, there was a statistically significant decline regarding AST, ALT, INR reflecting graft function, our study also revealed statistically significant positive correlation between serum Renalase levels and CRP and total leukocyte count three months after transplantation. Conclusion: Serum renalase in the blood may help in early detection and possible prevention of hepatocellular inflammation and injury. In the future serum renalase may help in diagnosing acute cellular rejection post-living donor liver transplantation to improve the clinical outcomes of such major procedure.
Background: Ischemia refers to diminished blood supply, causing a lack of oxygen and when blood supply is reestablished this is reperfusion. The Ischemia-Reperfusion (I/R) process is a common event after living donor liver transplantation, trauma, and hemorrhagic shock. Renalase, a ubiquitous flavoprotein, is highly expressed in kidney, liver, heart, skeletal muscles and adipose tissues. Renalase has been verified that it is the only enzyme involved in the catecholamine metabolism that can be secreted into the blood cycle hitherto. Considering renalase close relationship with oxidative stress, renalase is thought to play a role, or at least responsive, in the process of hepatic ischemia reperfusion injury. Aim of Study: To demonstrate whether serum Renalase can be used as a potential biomarkers of hepatic ischemia reperfusion injury following living donor liver transplantation especially when combined with the standard LFT panel. Patients and Methods: The present study was conducted on 50 patients with End Stage Liver Disease (ESLD) undergoing Living Donor Liver Transplantation (LDLT). Patients were evaluated pre-operatively laboratory by using the Child-Pugh score and Model for End-Stage Liver Disease (MELD) Score and radiological by abdominal Doppler ultrasonography. Intra-operative evaluation of patients included: Operative details including ischemia time, intraoperative bleeding and amount of blood transfused. Post-operative workup included daily examinations as regards vital signs, drains and fluid balance. Daily measurement of CBC, LFT and KFT was done for seven days. Results: By comparing different laboratory data day seven to laboratory data on day one post-living donor liver transplantation, there was a statistically significant decline regarding AST, ALT, INR reflecting graft function, our study demonstrated no statistically significant correlation between serum Renalase levels and operative ischemia time predisposing to ischemia reperfusion injury. Conclusion: Clinical treatment decisions based on the serial detection of renalase activities in the blood did not help
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