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Donor des-gamma-carboxy prothrombin positivity is a risk factor for poor early graft function in liver
1Department of Surgery, Mount Sinai School of Medicine, New York, NY 10029, USA.
Insights
Des-gamma-carboxy prothrombin (DCP) in organ donors indicates poorer early graft function. DCP positivity in donors is a significant risk factor for increased intraoperative transfusions and reduced post-transplant graft performance.
Area of Science:
- Transplantation immunology
- Hepatology
- Clinical biochemistry
Background:
- Des-gamma-carboxy prothrombin (DCP) is an inactive form of prothrombin.
- Assessing donor organ quality is crucial for successful transplantation outcomes.
- Identifying reliable biomarkers for predicting graft function is an ongoing challenge.
Purpose of the Study:
- To investigate whether Des-gamma-carboxy prothrombin (DCP) levels in organ donors can serve as a predictive marker for post-transplant graft function.
- To correlate donor DCP levels with intraoperative and early post-transplant graft performance.
Main Methods:
- Serum samples and clinical data were collected from 90 organ donors.
- DCP levels were measured and correlated with donor-specific factors.
- Graft function was assessed intraoperatively and during the early post-transplant period.
Main Results:
- Thirty percent (27/90) of donors exhibited positive DCP levels.
- Livers from DCP-positive donors were associated with significantly higher intraoperative transfusion requirements.
- Donor DCP positivity was a significant preoperative risk factor for poor early graft function (OR=6.58, P=0.0032).
Conclusions:
- Des-gamma-carboxy prothrombin (DCP) is a valuable marker for assessing donor liver quality.
- DCP positivity in donors may predict suboptimal early graft function after transplantation.
- Further research can explore integrating DCP levels into donor selection protocols.
Abstract:
Des-gamma-carboxy prothrombin (DCP) is an abnormal prothrombin that lacks coagulating activity. The aim of this study was to determine if the presence of DCP in the donor could be used as a marker of post-transplant graft function. We collected data and serum samples on 90 organ donors. DCP level was correlated with donor-specific factors and with graft function intraoperatively and in the early post-transplant period. Twenty-seven donors (30.0%) had positive DCP levels before harvesting. Although recipients were similar in demographics, preoperative liver function, and primary disease distribution, patients transplanted with livers from DCP-positive donors needed significantly more intraoperative transfusion. Furthermore, donor DCP positivity was identified as a preoperative risk factor for poor early graft function based on multivariate analysis (odds ratio = 6.58, P = 0.0032). Our findings suggest that DCP is another valuable marker for evaluating the quality of donor livers.