GLUTATHIONE-S-TRANSFERASE SUBTYPES α AND π AS A TOOL TO PREDICT AND MONITOR GRAFT FAILURE OR REGENERATION IN A PILOT STUDY OF LIVING DONOR LIVER TRANSPLANTATION

Objective: Glutathione-S-Transferase (GST) subtype a and pi are differentially expressed in adult liver tissue. Objective of the study was if GST alpha and pi may serve as predictive markers for liver surgery, especially transplantations. Methods: 13 patients receiving living donor liver transplantation (LDLT) and their corresponding donors were analyzed for standard serum parameters (ALT, AST, gamma GT, bilirubin) as well as GST-alpha and -pi before LDLT and daily for 10 days after LDLT. Patients (R) and donors (D) were grouped according to graft loss (R1/D1) or positive outcome (R2/D2) and above named serum parameters were compared between the groups. Results: R1 showed significantly increased GST-alpha and significantly lower GST-pi levels than R2 patients or the donors. There was a positive correlation between GST-alpha and ALT, AST as well as bilirubin and a negative correlation to gamma GT. However, gamma GT correlated positively with GST-pi. Graft failure was associated with combined low GST-pi levels in donors and their recipients before living donor liver transplantation. Conclusion: Our data suggest that high GST-alpha serum levels reflect ongoing liver damage while GST-pi indicates the capacity and process of liver regeneration. Additionally, GST-pi may be useful as marker for optimizing donor and recipient pairs in living donor liver transplantation.