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Hyperhomocysteinemia is associated with severity of cirrhosis and negative impact after liver transplantation

Rahima A Bhanji1,2, Mang Ma1,2, Vincent G Bain1,2

  • 1Division of Gastroenterology & Liver Unit, University of Alberta Hospital, Edmonton, AB, Canada.

Liver International : Official Journal of the International Association for the Study of the Liver
|October 17, 2015
PubMed

Insights

Hyperhomocysteinemia is common in cirrhosis patients and linked to severe liver disease. This condition, a risk factor for thrombosis, negatively impacts liver transplant survival, independent of thrombosis.

Area of Science:

  • Hepatology
  • Transplantation Medicine
  • Cardiovascular Risk Factors

Background:

  • Hyperhomocysteinemia is an independent risk factor for thrombosis and oxidative stress-induced cellular injury.
  • Its clinical significance in cirrhosis and post-liver transplantation outcomes is not well-established.

Purpose of the Study:

  • To determine the prevalence of hyperhomocysteinemia in cirrhosis patients.
  • To evaluate its association with thrombosis and liver disease severity.
  • To assess its impact on post-liver transplantation survival.

Main Methods:

  • Analysis of 450 cirrhosis patients undergoing liver transplantation (2001-2010).
  • Retrospective data collection from medical charts.
  • Pre-transplant serum homocysteine levels were measured.

Main Results:

  • 37% of patients had hyperhomocysteinemia (median homocysteine: 11 μmol/L).
  • Hyperhomocysteinemia correlated with higher MELD and Child-Pugh scores.
  • No significant difference in thrombosis rates; however, hyperhomocysteinemia was linked to reduced graft and patient survival.

Conclusions:

  • Hyperhomocysteinemia is frequent in cirrhosis and associated with disease severity.
  • It negatively impacts graft and patient survival post-liver transplantation.
  • This survival impact is not attributable to thrombosis.
Abstract

Keywords:
cirrhosishomocysteinehyperhomocysteinemialiver transplantationsurvival

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