Patients with hepatocellular carcinoma that die during the first year of liver transplantation have high blood sFasL concentrations

BACKGROUND Fas ligand(FasL)is one ligand that activates extrinsic apoptosis pathway.High expression in lymphocytes of FasL have been found in patients with acute rejection of liver transplantation(LT).No high blood concentrations of soluble FasL(sFasL)have been found in patients with acute LT rejection;however,the samples size of those studies was small.AIM To determine whether patients with hepatocellular carcinoma(HCC)that dead during the first year of LT have higher blood sFasL concentrations previously to LT that those who that remain alive in a study of higher sample size.METHODS Patients underwent LT due to HCC were included in this retrospective study.Serum sFasL levels prior to LT were measured and one-year LT mortality was registered.RESULTS Non-surviving patients(n=14)showed higher serum sFasL levels[477(269-496)vs 85(44-382)pg/mL;P<0.001]than surviving patients(n=113).Serum sFasL levels(pg/mL)were associated with mortality(OR=1.006;95%CI=1.003-1.010;P=0.001)independently of age of LT donor in the logistic regression analysis.CONCLUSION We report for the first time that HCC patients who die within the first year of HT have higher blood sFasL concentrations prior to HT than those who remain alive.

DNA and RNA oxidative damage in hepatocellular carcinoma patients and mortality during the first year of liver transplantation

BACKGROUND Oxidative damage of DNA and RNA has been associated with mortality of patients with different diseases.However,there is no published data on the potential use of DNA and RNA oxidative damage to predict the prognosis of patients with hepatocellular carcinoma(HCC)undergoing liver transplantation(LT).AIM To determine whether patients with increased DNA and RNA oxidative damage prior to LT for HCC have a poor LT prognosis.METHODS Patients with HCC who underwent LT were included in this observational and retrospective study.Serum levels of all three oxidized guanine species(OGS)were measured prior to LT since guanine is the nucleobase that forms DNA and RNA most prone to oxidation.LT mortality at 1 year was the end-point study.RESULTS Surviving patients(n=101)showed lower serum OGS levels(P=0.01)and lower age of the liver donor(P=0.03)than non-surviving patients(n=13).An association between serum OGS levels prior to LT and 1-year LT(odds ratio=2.079;95%confidence interval=1.356-3.189;P=0.001)was found in the logistic regression analysis.CONCLUSION The main new finding was that high serum OGS concentration prior to LT was associated with the mortality 1 year after LT in HCC patients.