Weismueller, Tobias J. and Kirchner, Gabriele I. and Scherer, Marcus N. and Negm, Ahmed A. and Schnitzbauer, Andreas A. and Lehner, Frank and Klempnauer, Juergen and Schlitt, Hans J. and Manns, Michael P. and Strassburg, Christian P. (2011) Serum Ferritin Concentration and Transferrin Saturation Before Liver Transplantation Predict Decreased Long-Term Recipient Survival. HEPATOLOGY, 54 (6). pp. 2114-2124. ISSN 0270-9139, 1527-3350
Full text not available from this repository. (Request a copy)Abstract
Serum ferritin (SF) concentration is a widely available parameter used to assess iron homeostasis. It has been described as a marker to identify high-risk patients awaiting liver transplantation (LT) but is also elevated in systemic immune-mediated diseases, metabolic syndrome, and in hemodialysis where it is associated with an inferior prognosis. This study analyzed whether SF is not only a predictor of liver-related mortality prior to LT but also an independent marker of survival following LT. In a dual-center, retrospective study, a cohort of 328 consecutive first-LT patients from Hannover Medical School, Germany (2003-2008, follow-up 1260 days), and 82 consecutive LT patients from Regensburg University Hospital, Germany (2003-2007, follow-up 1355 days) as validation cohort were analyzed. In patients exhibiting SF >= 365 mu g/L versus <365 mu g/L prior to LT, 1-, 3-, and 5-year post-LT survival was 73.3% versus 81.1%, 64.4% versus 77.3%, and 61.1% versus 74.4%, respectively (overall survival P = 0.0097), which was confirmed in the validation cohort (overall survival of 55% versus 83.3%, P = 0.005). Multivariate analyses identified SF >= 365 mu g/L combined with transferrin saturation (TFS) < 55%, hepatocellular carcinoma, and the survival after LT (SALT) score as independent risk factors for death. In patients with SF concentrations >= 365 mu g/L and TFS < 55%, overall survival was 54% versus 74.8% in the remaining group (P = 0.003). In the validation cohort, it was 28.6% versus 72% (P = 0.017), respectively. Conclusion: SF concentration >= 365 mu g/L in combination with TFS < 55% before LT is an independent risk factor for mortality following LT. Lower TFS combined with elevated SF concentrations indicate that acute phase mechanisms beyond iron overload may play a prognostic role. SF concentration therefore not only predicts pre-LT mortality but also death following LT. (HEPATOLOGY 2011; 54: 2114-2124)
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | HEPATIC IRON OVERLOAD; PRETRANSPLANT MELD SCORE; ACUTE-PHASE RESPONSE; WAITING-LIST; HEMODIALYSIS-PATIENTS; ORGAN ALLOCATION; MORTALITY; DISEASE; HEMOCHROMATOSIS; SODIUM; |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Lehrstuhl für Chirurgie Medicine > Lehrstuhl für Innere Medizin I |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 26 May 2020 07:16 |
| Last Modified: | 26 May 2020 07:16 |
| URI: | https://pred.uni-regensburg.de/id/eprint/19730 |
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