Glycome Patterns of Perfusate in Livers Before Transplantation Associate With Primary Nonfunction

Area of Science:

• Transplantation immunology
• Glycomics
• Biomarker discovery

Background:

• Primary nonfunction (PNF) is a rare but critical complication following liver transplantation, often necessitating retransplantation.
• PNF is frequently associated with grafts from extended criteria donors.
• Current clinical and biochemical factors lack reliability in predicting graft function post-transplantation.

Purpose of the Study:

• To identify specific protein glycosylation patterns in liver perfusate associated with PNF.
• To investigate the potential of N-glycans as biomarkers for predicting PNF in liver grafts.

Main Methods:

• Prospective study involving 122 liver transplant recipients (66 derivation, 56 validation sets).
• Perfusate samples collected from donor livers before transplantation.
• Analysis of protein-linked N-glycans using multicapillary electrophoresis.

Main Results:

• Significantly increased abundance of agalacto core-alpha-1,6-fucosylated biantennary glycan (NGA2F) in perfusate of livers that developed PNF.
• NGA2F demonstrated 100% accuracy in identifying PNF in both derivation and validation cohorts.
• NGA2F was the sole significant predictor of PNF in multivariate analysis.

Conclusions:

• Graft perfusate NGA2F levels accurately predict PNF in liver transplantation.
• NGA2F serves as a reliable glycomarker for assessing graft viability before transplantation.
• This biomarker is particularly valuable for evaluating high-risk donor livers.