227 Investigating the Use of Flavin Mononucleotide & Cell Free Mitochondrial DNA as a Biomarkers of Ischaemic Damage to Livers & Kidneys Before Transplant Surgery

Abstract

Abstract Aim Before accepting an organ for transplantation, it is important to ensure it is safe to use. Flavin mononucleotide (FMN) has been demonstrated to be an accurate predictor of 90-day graft loss in liver transplant surgery. Previous studies revealed that cell free mitochondrial DNA (cf mtDNA) is predictive of ischemic acute kidney injury in kidney transplantation. There is no validated scoring system or biomarker in clinical use to aid the decision-making process before transplantation. Consequently, transplant surgeons accept or decline organs based on their clinical judgement. There is a need for an objective method to assess organ quality before transplantation. Method Patient consent and demographics were noted prior to transplant surgery. Perfusion solution was flushed through donor livers or kidneys. FMN concentration was measured by fluorescence spectroscopy and cf mtDNA concentration was measured by digital droplet polymerase chain reaction. The concentrations of FMN and cf mtDNA were correlated with donor age & BMI and total length of recipient intensive treatment unit (ITU) stay. Results Amongst 8 transplanted livers, the study showed a negative trend between donor BMI and both FMN & cf mtDNA. There was a strong correlation between FMN concentration and ITU duration (r = 0.7353, p = 0.0376). Amongst 14 transplanted kidneys, MT-ND6 subunit concentration strongly correlated with donor BMI (r = 0.8473, p = 0.0003). Conclusions Despite more research being required to consolidate the role of these biomarkers, the study reinforces the idea that FMN and cf mtDNA can play a role as point of care tests in assessing organ quality prior to transplantation.