Serum Caspase-Cleaved Cytokeratin (M30) Indicates Severity of Liver Dysfunction and Predicts Liver Outcome
Hani Oweira, Mahmoud Sadeghi, Daniel Volker, Markus Mieth, Ahmed Zidan, Elias Khajeh, Omid Ghamarnejad, Hamidreza Fonouni, Karl Heinz Weiss, Jan Schmidt, Imad Lahdou, Arianeb Mehrabi
Department of General, Visceral, and Transplant Surgery, University of Heidelberg, Heidelberg, Switzerland
Ann Transplant 2018; 23:393-400
The Model for End-Stage Liver Disease (MELD) score is a well-established tool for assessing hepatic failure. The present retrospective study investigated whether serum keratin 18 (M65) and caspase-cleaved cytokeratin (M30) were associated with liver dysfunction and post-transplant graft failure.
MATERIAL AND METHODS: A total of 147 patients with liver cirrhosis were categorized into 2 groups according to their baseline MELD score (group I: MELD score <20, n=87, and group II: MELD score ≥20, n=60). Serum M65 and M30 levels were measured by ELISA.
RESULTS: Cirrhotic patients had significantly higher serum M65 and M30 levels than healthy controls (p<0.0001). Serum M65 was correlated with the MELD score and serum bilirubin (p≤0.007) and serum M30 was correlated with the MELD score, international normalized ratio, and serum bilirubin (p≤0.001). Group II had significantly higher serum M65 and M30 levels than group I (M65, p=0.025 and M30, p<0.001). Patients who lost the allograft during the first post-transplant year had significantly higher serum M30 levels than patients with a graft survival of >1 year (p=0.004). In the regression analysis, serum M30 was associated with the MELD score (odds ratio [OR]=2.545, p=0.005), serum bilirubin (OR=2.605, p=0.005) and 1-year graft loss (OR=3.61, p=0.006).
CONCLUSIONS: Our data indicate that serum M30 levels reflect the degree of liver dysfunction and can predict 1-year graft loss.
Keywords: Inflammation, Keratin-18, Liver Cirrhosis