A new dimension of ¹H‐NMR spectroscopy in assessment of liver graft dysfunction

Abstract

High-resolution 1H-NMR spectroscopy of serum and urine samples of an 11-year-old male living related orthotopic liver transplant recipient is reported. Serum glutamine increased to abnormal levels along with simultaneous abnormal excretion of urinary glutamine post-transplantation. High levels of glutamine in both blood and urine and concomitant reduced urea levels in urine were found to be evidence of impairment in urea cycle and compatible with persistently abnormal graft function. Thus glutamine levels in serum and urine, and urea in the urine as observed by 1H-NMR spectroscopy highlight their important roles in monitoring liver graft function; increased glutamine levels lead to brain damage, if untreated.

1H NMR spectroscopy for the prediction of therapeutic outcome in patients with fulminant hepatic failure

“…It is known that in hepatic failure, the resultant impairment in urea cycle leads to elevated levels of toxic ammonia, thereby triggering the formation of glutamine from glutamate. As a consequence, there is elevation in serum-glutamine and depletion in urine urea (15). Abnormal concentration of glutamine leads to hepatic H NMR spectra obtained using a WATERGATE sequence of urine from five surviving patients (a-e) [same patients as in Fig.…”

Metabonomics Study of Intestinal Transplantation Using Ultrahigh-Performance Liquid Chromatography Time-of-Flight Mass Spectrometry

“…Recently, most metabolomic studies were focused on kidney transplantation to assess biomarkers associated with posttransplantation function, renal dysfunction, acute rejection and subclinical rejection [1,9,10,11,12,13,14,15,16,17] and others on liver and heart transplantation [18,19,20,21] to identify prognostic and diagnostic markers of organ rejection and dysfunction [22,23,24]. This is the first time that the metabonomics technique has been applied to human intestinal transplantation.…”

Improved quantification from 1H-NMR spectra using reduced repetition times

“…Considerable progress has been achieved in this field over last few years. The technique has been applied to identify biomarkers for various diseases (Gang et al 2007;Lindon et al 2000Lindon et al , 2004Viant et al 2003) such as diagnosis of Malabsorption syndrome (Bala et al 2004(Bala et al , 2006, Meningitis (Subramanian et al 2005), Tyrosinemia (Bell et al 1989), Alkaptonuria (Shuchi et al 1989), Dicarboxylic aciduria (Daviesa et al 1992), and identification of organs dysfunction like chronic Renal failure (Bell et al 1991), Hepatic failure , monitoring Liver graft dysfunction (Singh et al 2006) etc. However, there are some experimental factors associated with quantitative determination from NMR which need careful consideration (Pauli et al 2006).…”