Evidence map›Paper›PMID 41937479›Full record

ArticleClinical transplantation and research2026

Temporal profile of serum total bile acid levels and their value in the evaluation of early graft dysfunction in living donor liver transplantation: a prospective cohort study.

Venkatesh Balaraman Sundararajan, Senthil Kumar, Ragini Kilambi, Sherin Thomas

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Article in Clinical transplantation and research, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

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1citing papers in PubMed
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1 · What the graph read from it

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2 · The registry

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3 · Its place in the literature

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1 citing paper in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

4 authors.

Venkatesh Balaraman SundararajanInstitute of Multi-Visceral and Abdominal Organ Transplant, MGM Healthcare, Chennai, India.ORCID https://orcid.org/0000-0002-8597-9785
Senthil KumarDepartment of HPB and Liver Transplants, Continental Hospitals, Hyderabad, India.ORCID https://orcid.org/0000-0001-7635-9018
Ragini KilambiDepartment of Hepato-Pancreato-Biliary and Liver Transplant Surgery, Institute of Liver and Biliary Sciences, New Delhi, India.ORCID https://orcid.org/0000-0002-4164-289X
Sherin ThomasDepartment of Biochemistry, Institute of Liver and Biliary Sciences, New Delhi, India.ORCID https://orcid.org/0000-0001-5720-3288

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Early graft dysfunction (EGD) after liver transplantation is currently defined using clinical and laboratory parameters. This study aimed to characterize serum total bile acid (STBA) trends in the early posttransplant period following living donor liver transplantation (LDLT) and to evaluate their utility in detecting EGD and acute cellular rejection (ACR). Methods: STBA levels were measured preoperatively and daily from postoperative day (POD) 1 to POD 14 in LDLT recipients. EGD was defined using Olthoff's criteria, and ACR was diagnosed using pragmatic clinical criteria. Results: Among 63 LDLT recipients, EGD occurred in 25.4% and ACR in 26.9%. The median baseline STBA level in cirrhotic patients awaiting LDLT was 95.1 μmol/L (range, 15.5-578.6 μmol/L). STBA levels decreased to near-normal values on POD 1 and remained relatively stable through POD 14. The median STBA value on POD 1 was 10.43 µmol/L (interquartile range [IQR], 6.725-33.635 µmol/L), and on POD 14 was 11.92 µmol/L (IQR, 8.57-44.098 µmol/L). In patients with EGD, STBA levels were consistently higher and demonstrated a rising trend from POD 3 to POD 14. In cases of ACR, STBA levels increased 24 to 48 hours prior to elevations in liver enzymes, suggesting early biochemical changes preceding conventional markers. The sensitivity and specificity of rising STBA for predicting ACR were 94.1% and 61.9%, respectively, with an area under the receiver operating characteristic curve of 0.78 (95% confidence interval, 0.65-0.87). Conclusions: Elevated and progressively rising STBA levels during the first postoperative week are associated with EGD. Trends in STBA may also aid in the early differentiation of ACR from sepsis, offering a useful adjunct in posttransplant monitoring.

Indexed as

Bile acidsEarly allograft dysfunctionGraft rejectionLiver transplantationSepsis

Identifiers

PMID41937479
PMCPMC13349797

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