Exosomes as a biomarker in postoperative complications: a literature review

Surgery remains a common treatment, but it can lead to various potential complications. The incidence of complications after major surgery, in particular, is notably high. Postoperative complications contribute to increased patient morbidity and mortality. Timely and effective identification of these complications is essential for appropriate clinical management and improved patient outcomes. Exosomes are nano-sized membrane vesicles released by a variety of cell types, and play important roles in intercellular communications. Exosomal proteins and nucleic acids are involved in numerous physiological and pathological processes and are increasingly recognized as valuable biomarkers for disease diagnosis. Exosomes are present in all body fluids, which underlies their considerable potential as novel biomarkers in liquid biopsy. Previous research has reported that exosomes can serve as predictive biomarkers for several common postoperative complications, including neurocognitive disorders, allograft rejection, septic shock, atrial fibrillation, and sleep disturbance. These findings suggested that exosomes hold potential for application in the prevention and management of postoperative complications, representing an emerging direction in the investigation of postoperative biomarkers. Therefore, this review highlights the roles of exosomes in postoperative complications and discusses the challenges and opportunities of exosome-based diagnosis for these conditions.