1 Hepatobiliary MicroRNA expression & outcome in liver transplantation
Research type
Research Study
Full title
The relationship of hepatobiliary microRNA expression profile and clinical outcome in liver transplantation
IRAS ID
145234
Contact name
Stephen O'Neill
Contact email
Sponsor organisation
University of Edinburgh
Research summary
Liver transplantation is the gold standard of care for liver failure but despite outstanding success, it has been strictly rationed by the shortage of donor organs.
An important source of livers that has been used to expand the donor pool is donation after cardiac death donors (DCD), which are donors for whom death is declared on the basis of cardiopulmonary criteria rather than cessation of brain function. DCD donors provide 20% of livers used for transplantation in the UK, however serious concerns exist regarding negative results.Ischemic cholangiopathy (IC) is damage to one or more bile ducts probably caused by inadequate blood flow. Following transplantation, IC occurs in 16% of livers obtained and transplanted from DCD donors. It typically presents weeks to months after liver transplantation, is often refractory to treatment and can result in a requirement for re-transplantation.
Although not all patients with IC require re-transplantation, this complication can result in considerable patient morbidity including bile duct infection, prolonged antibiotic therapy, and the requirement for multiple invasive procedures thus increasing the cost of liver transplantation. Unfortunately, IC and associated complications are impossible to predict and thus cannot be prevented.
MicroRNAs (miRNAs) are small molecules that regulate gene expression and therefore the development of various diseases. In this study biopsies will be taken from the donor liver and bile duct at the time of liver transplantation.
The aim is to analyse the miRNA profile in these biopsies and correlate the results with the outcome of the patient following transplantation. This will provide a novel means of predicting IC and its complications following liver transplantation. It will also greatly increase our understanding of the underlying cause of IC.
Non-transplant patients undergoing biliary/liver surgery in the Hepatobiliary Unit in the Royal Infirmary of Edinburgh will be used as a non-transplant population control group.
REC name
North East - Newcastle & North Tyneside 2 Research Ethics Committee
REC reference
14/NE/0111
Date of REC Opinion
2 Apr 2014
REC opinion
Favourable Opinion