Plasma thrombospondin 1 as a predictor of postoperative liver dysfunction

Area of Science:

• Hepatology
• Surgical Oncology
• Biomarker Discovery

Background:

• Liver regeneration is a complex process involving growth factors and antagonists.
• Thrombospondin 1 (TSP-1) inhibits liver regeneration by activating transforming growth factor β1 in mice.
• Preliminary data suggest TSP-1's relevance in human liver regeneration.

Purpose of the Study:

• To validate the role of thrombospondin 1 (TSP-1) as an inhibitor of liver regeneration in humans.
• To assess perioperative circulating TSP-1 levels as a predictor of postoperative liver dysfunction.
• To confirm TSP-1's clinical relevance in an independent patient cohort.

Main Methods:

• Measured perioperative plasma thrombospondin 1 (TSP-1) levels in 85 patients undergoing liver resection.
• Defined postoperative liver dysfunction using International Study Group of Liver Surgery criteria.
• Classified patient morbidity based on Dindo et al. criteria.

Main Results:

• Plasma TSP-1 levels significantly increased on postoperative day 1 (P=0.001).
• Postoperative day 1 TSP-1 concentration predicted liver dysfunction (AUC 0.818, P=0.003).
• High TSP-1 levels correlated with increased liver dysfunction, severe morbidity, and doubled hospital stay.

Conclusions:

• Thrombospondin 1 (TSP-1) shows potential as a clinical marker for predicting postoperative liver dysfunction.
• Early detection of liver dysfunction risk is possible using TSP-1 levels on postoperative day 1.
• TSP-1 may aid in managing patients undergoing liver resection.