Development and Internal Validation of a Pretransplant Biomarker Panel for Mortality Prediction Following Liver Transplant

作者：Guergana G. Panayotova, Sopio Simonishvili, Lianhua Jin, D. NGUYEN, Edward A. Graviss, Yong Qin, A. Xynogala, Tumininu Ayorinde, Laurie J. Minze, Alexander Lemenze, Krupa R. Mysore, Julie Corkrean, Linda Moore, Flavio Paterno, Ashish Saharia, Constance M. Mobley, Arpit Amin, Mark J. Hobeika, X. William Li, Paul J. Gaglio, R. Mark Ghobrial, James V. Guarrera, Keri E. Lunsford · 发表于：JAMA Surgery · 年份：2026 · DOI：10.1001/jamasurg.2025.6539 · 被引用次数：2 · 研究领域：Renal Transplantation Outcomes and Treatments、Organ Transplantation Techniques and Outcomes、Liver Disease and Transplantation

Importance: Current pretransplant clinical scoring systems fail to accurately estimate post-liver transplant (LT) survival, making recipient selection challenging. Persistent immune dysfunction contributes to early LT recipient mortality but is not captured by existing models. Objective: To identify plasma biomarkers of pretransplant immune dysfunction and to develop a biomarker-based pre-LT risk stratification tool to predict post-LT mortality. Design, Setting, and Participants: Prospective biomarker analysis of consecutively enrolled adult LT recipients was conducted. Healthy controls were included for baseline comparison. Patients undergoing LT at Houston Methodist Hospital (October 1, 2013, to December 31, 2017) and Rutgers/University Hospital (January 1, 2019, to March 31, 2021) were enrolled under an institutional review board-approved protocol, and data were censored on March 31, 2023, and analyzed. Patients with cirrhosis older than 18 years undergoing deceased donor LT were included. Exclusion criteria were age greater than 70 years, cancer other than hepatocellular carcinoma, retransplant, status 1A, intraoperative mortality, multivisceral transplant (except liver-kidney), and sample availability. Exposures: Plasma cytokine, chemokine, and immune exhaustion biomarkers were quantified using multiplex Luminex assays at the time of transplant. Clinical, demographic, and laboratory data were extracted from institutional databases. Main Outcomes and Measures: The primary...