Poster
Transplant 		  
PT03 Transplantation: Science (Immunology) (ePoster) 
Selection of ePoster Presentations from Abstract Submissions
PT03-05 Neutrophil CD 64 - Is it an Accurate Marker for Predicting Sepsis in Post LDLT Scenario?
Lohit Shetty Raju, India

L. Shetty Raju, M. Michael, S.T. Binoj, J. Shaji Mathew, R. Menon, G. UnniKrishnan, S. Sudhindran
GI Surgery and Multi Organ Transplant, Amrita Institute of Medical Sciences, India

Introduction: Sepsis continuous to be a major cause of post op mortality following Liver transplantation[LT]. Survival in sepsis hinges around early diagnosis & source control.Search for early marker for sepsis continues .Expression of Fc receptor CD64 on surface of neutrophils [Ncd64] has been shown in many studies to be an accurate biomarker in detecting sepsis.
Methods: Prospective observational study, to evaluate diagnostic accuracy of neutrophil CD64, comparing it with C-reactive protein (CRP) and procalcitonin (PCT) for the diagnosis of sepsis in adult patients undergoing LT.Blood samples were collected D -1, D1, D3, D7. All samples were tested for CRP, PCT & Ncd64 using flow cytometry.Ncd64 values were expressed both as % and mean fluroscence intensity[MFI].Gold standard for diagnosing sepsis was blood/Drain culture positivity.
Results: Preliminary results from 24 patients were analysed.In 6 patients who were diagnosed sepsis neither CRP,PCT nor Ncd64 had statistically significant P value in diagnosing sepsis.But while analysing trend of elevation from Baseline to D7, estimation of Ncd64 and CRP looks hopeful in predicting sepsis.
Conclusion: As these are preliminary results & study is on-going, role of Ncd64 is yet to be discovered in post LT scenario.
[Table 1]
PT03-06 Our Strategy to Overcome Hepatic Ischemia Reperfusion Injury -From Bench to Bedside-
Junya Kawasoe, Japan

J. Kawasoe1,2, Y. Uchida1,2, T. Miyauchi1,2, K. Saga1,2, K. Kadono1, H. Hirao1, T. Watanabe3, H. Terajima1,2, S. Uemoto1
1Division of Hepato-Pancreato-Biliary Surgery and Transplantation, Department of Surgery, Graduate School of Medicine, Kyoto University, Japan, 2Department of Gastroenterological Surgery and Oncology, The Tazuke Kofukai Medical Research Institute, Kitano Hospital, Japan, 3Division of Immunology, Institute for Frontier Life and Medical Sciences, Kyoto University, Japan


Background: In the field of liver surgery, especially transplantation, ischemia reperfusion injury (IRI) causes approximately 10% of early graft failure and leads to a higher incidence of acute and chronic rejection. It is an urgent issue to overcome IRI from the viewpoint of organ preservation. This study aims to reveal the molecular mechanism and develop the effective protective way to prevent the liver IRI for a safer liver surgery. Methods :We applied the established partial warm hepatic IRI model in mice and investigated changes of immune responses due to IR, and compared the efficacy of various biological molecules (neutrophil elastase inhibitor, recombinant Galectin-9, recombinant thrombomodulin and so on), antioxidant agents (vitamins C and E) and maneuvers (preoperative short-term fasting). The liver damage was assessed by serum alanine aminotransferase (sALT) level, histological observations, change in expression profile of various cytokines and analysis of intracellular molecules.
Results: The most effective way to improve IRI was the preoperative short-term (12 hours) fasting. It exhibited a remarkable therapeutic effect compared with any other drug or diet we have so far examined. The up-regulation of Forkhead Box O1 (FOXO-1) induced by the raised acetylated histone and β-hydroxybutyric acid was a crucial factor for the short-term fasting to ameliorate the liver injury due to IR.
Conclusion: Preoperative short-term dietary restriction might play an important role to overcome liver IRI and have a therapeutic potential for clinical setting.