AP-HP Hôpital Paul Brousse, Centre Hépato-Biliaire, Université Paris Saclay, Villejuif, France.
Universidade Federal de São Paulo, São Paulo, Brazil.
Transpl Int. 2021 Nov;34(11):2247-2256. doi: 10.1111/tri.13978. Epub 2021 Sep 14.
The impact of aspartate transaminases (AST) and gamma-glutamyl transferase (GGT) in serum of deceased donors on outcomes after liver transplantation (LT) is unclear. This study aimed to explore the relationship between donor highest AST value or first donor GGT value and graft survival. All consecutive patients who underwent a primary LT in a single center with available donor AST (N = 1253) and GGT value (N = 1152) were included. There was no significant association between donor AST and 90-day graft survival. We found a moderate association between GGT and 90-day graft survival. We found a significant interaction with a donor history of alcohol abuse (HAA). The risk of graft loss was associated with AST and GGT in donors with an HAA but remains unchanged in donors without HAA. There was no difference in graft survival according to donor AST or GGT with a cutoff ≥95th percentile (475 UI/l for AST and 170 UI/l for GGT). However, graft survival was significantly decreased when donors combined GGT ≥ 170 UI/l and HAA (61% at one year). Hepatic grafts from donors with high AST or high GGT but without alcohol history and no additional risk factors can be transplanted in low-risk recipient.
血清中天冬氨酸转氨酶(AST)和γ-谷氨酰转移酶(GGT)对肝移植(LT)后结局的影响尚不清楚。本研究旨在探讨供者最高 AST 值或首次供者 GGT 值与移植物存活率之间的关系。本研究纳入了在单中心接受初次 LT 的所有连续患者,这些患者均有可获得的供者 AST(N=1253)和 GGT 值(N=1152)。供者 AST 与 90 天移植物存活率之间无显著相关性。我们发现 GGT 与 90 天移植物存活率之间存在中度相关性。我们发现与供者酒精滥用史(HAA)存在显著交互作用。在有 HAA 的供者中,AST 和 GGT 与移植物丢失风险相关,但在无 HAA 的供者中,这种相关性不变。根据 AST 或 GGT 的 95 百分位值(AST 为 475 UI/l,GGT 为 170 UI/l)作为截断值,供者 AST 或 GGT 水平与移植物存活率无差异。然而,当供者 GGT≥170 UI/l 且有 HAA 时,移植物存活率显著降低(1 年时为 61%)。来自无酒精史且无其他危险因素的高 AST 或高 GGT 供者的肝移植可以在低危受者中进行。