C-BIL CLD

• Research type

  Research Study

• Full title

  Conjugated Bilirubin and hepatocyte senescence as a diagnostic tool for prognostication and stratification of outcomes in patients with Chronic Liver Disease

• IRAS ID

  346572

• Contact name

  Aloysious D Aravinthan

• Contact email

  a.aravinthan@nhs.net

• Sponsor organisation

  Nottingham University Hospitals NHS Trust

• Duration of Study in the UK

  3 years, 0 months, 0 days

• Research summary

  When hepatocytes (liver cells) are damaged, they transform into ‘senescent hepatocytes’ – which no longer replicate but remain active. Up to 80% of hepatocytes become senescent in advanced chronic liver disease (ACLD).
  ACLD increases the risk of life-threatening adverse outcomes such as liver failure, liver cancer and death, however, it is not currently possible to quantify the risk for the spectrum of patients with ACLD. Therefore all patients are seen regularly in specialised NHS liver clinics.
  The proportion of senescent hepatocytes on liver biopsy strongly correlates with adverse outcomes. Senescent hepatocytes are unable to process bilirubin (a normal waste product in cell recycling) and this leads to a rise in one type of bilirubin in the blood known as ‘conjugated bilirubin’.
  We propose that measuring conjugated bilirubin in patients with ACLD
  and following them up will demonstrate how conjugated bilirubin could mirror senescent hepatocyte proportion on liver biopsy and predict the risk of adverse outcomes. Measurement of total bilirubin is a routine blood test. It can be analysed further to see what types of bilirubin constitute the ‘total’ amount for only £8.62. This test could change guidelines in the next few years so that patients can be followed up by GPs while their conjugated bilirubin remains low, saving precious secondary care resources. This could also lead to care being given closer to home for patients with ACLD by their GPs.

• REC name

  Yorkshire & The Humber - Bradford Leeds Research Ethics Committee

• REC reference

  25/YH/0048

• Date of REC Opinion

  19 Mar 2025

• REC opinion

  Further Information Favourable Opinion