Bile acid level in the bile of patients within 14 days after liver transplantation and its predictive value for occurrence of ischemic-type biliary lesions

SUN Xiaoye; KANG Yongzhen; SHEN Zhongyang

doi:10.3969/j.issn.1002-266X.2016.12.002

Abstract：Objective To detect the levels of bile acids in the bile of patients within 14 days after liver transplantation and to investigate their predictive value for the occurrence of ischemic-type biliary lesion ( ITBL) .Methods Thirty-nine orthotopic liver transplant patients were selected.Using LC-MSMS to detect the contents of six kinds of bile acids including glycocholic acid ( GCA) , taurocholic acid ( TCA) , TLCA, glycochenodeoxycholic acid ( GCDCA) , glycine combined with deoxycholic acid (GDCA) and taurine combined with deoxycholic acid(TDCA) on day 1, 3, 7 and 14.They were followed up for three months after surgery, and then we determined whether ITBL occurred according to cholangiography results which served as gold standard, and compared the content of each bile acid on day 1, 3, 7 and 14 between patients with IT-BL ( ITBL group) and patients without ITBL ( N-ITBL group) .We used ROC curve to assess the predictive value of bile acids for the occurrence of ITBL.Results On day 1, the content of GDCA was lower in the ITBL group than that in the N-ITBL group;on day 7, the contents of GCA and GDCA were higher in the ITBL group than those in the N-ITBL group;on day 14, the contents of TLCA, GCDCA and GDCA were higher in the ITBL group than those in the N-ITBL group, and sig-nificant difference was found between these two groups (all P＜0.05).Analysis results of ROC carve showed that the AUC of GCDCA on day 14 for the occurrence of ITBL was 0.751, AUC of GCA on day 7 was 0.717, and AUC of TLCA on day 14 was 0.764.Conclusion The contents of GCDCA, GCA and TLCA within 14 days after liver transplantation are in-creased and they all can be used as reliable indexes to predict whether ITBL occurs within 3 months after surgery.