O037 VEGF-A: a potential prognostic biomarker for donor liver viability

Abstract

Abstract Introduction Waitlist mortality for liver transplant recipients may be tackled by increasing graft utilisation from marginal donors. At present, there are no reliable methods of assessing the quality of potential donor grafts prior to post-transplantation complications such as early allograft dysfunction (EAD). This pilot study evaluates the validity of a patented biomarker panel on flush effluent samples collected on the backbench after organ retrieval. Methods All flush effluent samples were collected and stored with patient consent and ethical approval. Flush effluents were retrieved from cold-stored donor liver grafts on the backbench for both transplantation and research purposes. Meso Scale Diagnostics multiplex assays were used to quantify biomarker levels in each sample with a BCA protein assay for data normalisation. Graft utilisation was assessed as our primary outcome measure and post-operative EAD incidence was our secondary outcome. Results Thirteen donor livers were sampled, out of which 61.5% (n=8) were transplanted and 38.5% (n=5) were declined. Utilisation outcomes analysis demonstrated that only VEGF-A levels were significantly different between the transplanted and declined grafts (p<0.001). EAD incidence was 37.5% (n=3) from the 8 transplant recipients. There was no statistical significance between each biomarker level and the development of EAD post-transplantation. Conclusion Liver flush effluents are a rich, novel source of protein biomarkers. Flush VEGF-A may be a prognostic biomarker for donor liver viability. Further evaluation is warranted for point of care testing.