Oweira Hani, Sadeghi Mahmoud, Volker Daniel, Mieth Markus, Zidan Ahmed, Khajeh Elias, Ghamarnejad Omid, Fonouni Hamidreza, Weiss Karl Heinz, Schmidt Jan, Lahdou Imad, Mehrabi Arianeb
Department of General, Visceral, and Transplant Surgery, University of Heidelberg, Heidelberg, Switzerland.
Surgical Center Zürich, Hirslanden Hospital, Zürich, Switzerland.
Ann Transplant. 2018 Jun 8;23:393-400. doi: 10.12659/AOT.908031.
BACKGROUND The Model for End-Stage Liver Disease (MELD) score is a well-established tool for assessing hepatic failure. The present retrospective study investigated whether serum keratin 18 (M65) and caspase-cleaved cytokeratin (M30) were associated with liver dysfunction and post-transplant graft failure. MATERIAL AND METHODS A total of 147 patients with liver cirrhosis were categorized into 2 groups according to their baseline MELD score (group I: MELD score <20, n=87, and group II: MELD score ≥20, n=60). Serum M65 and M30 levels were measured by ELISA. RESULTS Cirrhotic patients had significantly higher serum M65 and M30 levels than healthy controls (p<0.0001). Serum M65 was correlated with the MELD score and serum bilirubin (p≤0.007) and serum M30 was correlated with the MELD score, international normalized ratio, and serum bilirubin (p≤0.001). Group II had significantly higher serum M65 and M30 levels than group I (M65, p=0.025 and M30, p<0.001). Patients who lost the allograft during the first post-transplant year had significantly higher serum M30 levels than patients with a graft survival of >1 year (p=0.004). In the regression analysis, serum M30 was associated with the MELD score (odds ratio [OR]=2.545, p=0.005), serum bilirubin (OR=2.605, p=0.005) and 1-year graft loss (OR=3.61, p=0.006). CONCLUSIONS Our data indicate that serum M30 levels reflect the degree of liver dysfunction and can predict 1-year graft loss.
背景 终末期肝病模型（MELD）评分是评估肝衰竭的成熟工具。本回顾性研究调查了血清角蛋白18（M65）和半胱天冬酶切割的细胞角蛋白（M30）是否与肝功能障碍及移植后移植物失功相关。
材料与方法 147例肝硬化患者根据基线MELD评分分为2组（I组：MELD评分<20，n = 87；II组：MELD评分≥20，n = 60）。采用酶联免疫吸附测定法检测血清M65和M30水平。
结果 肝硬化患者血清M65和M30水平显著高于健康对照（p<0.0001）。血清M65与MELD评分及血清胆红素相关（p≤0.007），血清M30与MELD评分、国际标准化比值及血清胆红素相关（p≤0.001）。II组血清M65和M30水平显著高于I组（M65，p = 0.025；M30，p<0.001）。移植后第1年失去移植物的患者血清M30水平显著高于移植物存活>1年的患者（p = 0.004）。回归分析显示，血清M30与MELD评分（比值比[OR]=2.545，p = 0.005）、血清胆红素（OR = 2.605，p = 0.005）及1年移植物丢失（OR = 3.61，p = 0.006）相关。
结论 我们的数据表明，血清M30水平反映肝功能障碍程度，并可预测1年移植物丢失。
