ArticleTransplantation direct2026
Heme Oxygenase-1 as a Predictor of Early Allograft Dysfunction in Liver Transplantation: A Prospective Observational Pilot Study.
Article in Transplantation direct, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
1 citing paper in PubMed.
- Pathophysiological mechanisms of cell death affecting graft survival in liver transplantation.World journal of transplantation · 2026Review
Corrections and comments
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Authors and funding
8 authors.
Funding
Abstract
Background: Early allograft dysfunction (EAD), defined as hepatic insufficiency within a week of orthotopic liver transplantation (OLT), affects up to 25% of recipients and is associated with morbidity and mortality. Ischemia-reperfusion injury (IRI), the primary driver of EAD, reflects immune and cellular dysregulation triggered by transient tissue oxygen deprivation. Heme oxygenase-1 (HO-1), a cytoprotective enzyme, plays a central role in mitigating hepatic IRI. We hypothesized a distinct perioperative HO-1 signature correlates with EAD. Methods: We conducted a prospective observational pilot study of 43 primary adult, deceased donor OLT recipients at Emory University Hospital between August 2023 and July 2024. EAD was defined by the Olthoff criteria, using serum bilirubin, international normalized ratio (INR), and aminotransferases. Perioperative arterial serum was assayed preimplantation at anesthesia induction (timepoint, T1), and 2 (T2), and 48 h (T3) postimplantation to measure HO-1 using multiplex immunoassay and compared between recipients with and without EAD. Group comparisons (EAD versus non-EAD) used Mann-Whitney U for continuous variables (reported as medians) and chi-square or Fisher exact test for categorical variables. HO-1 changes over time were assessed with the Friedman test and post hoc comparisons. The Spearman correlation evaluated associations between HO-1 and clinical parameters. Results: EAD occurred in 9 of 43 patients (20.9%). Recipients who developed EAD exhibited significantly higher HO-1 levels 2 h postimplantation (T2) (22,665 pg/mL [interquartile range (IQR): 17 881, 25 361] versus 10,765 pg/mL [IQR: 8060, 18 903], Conclusions: Peri-implantation HO-1 kinetics may represent a novel biomarker of EAD. Larger validation studies and mechanistic investigations are warranted to refine risk stratification and guide targeted interventions to mitigate EAD.
Identifiers
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Registered trials
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