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General liver II
PWE-269 Heat shock protein-70 (hsp-70) a novel surrogate marker for hypoxia induced liver injury (HILI)—a prospective open level control clinical pilot study
  1. P Basu1,2,
  2. T Nair3,
  3. S Farhat3
  1. 1Department of Gastroenterology and Hepatology, Columbia University of Physicians and Surgeons, New York, New York, USA
  2. 2Department of Gastroenterology, North Shore University, New York, New York, USA
  3. 3Internal Medicine, North Shore University, New York, New York, USA

Abstract

Introduction Hypoxic hepatopathy (HH) is a common entity in hospital with impaired hepatic perfusion secondary to transient altered cardio pulmonary haemodynamics, manifesting with sharp rise of transaminases with perfusion injury rarely requiring transplantation. Transaminases are non-specific index of reperfusion injury (IR). HSP are reperfusion signal proteins represent sheer stress. HSP-70 is one of specific signals of IR impacts on specific target. This study evaluates the utility of a novel marker of HILI.

Methods Sixty (n=60) patients were recruited from Hospital. Group A control (n=20) Group B (n=20) HILI, GroupC (n=20) Acute Hepatitis [(Tylenol 8/20 (40%), Acute hepatitis B 8/20 (40%) herpes simplex 1/20 (5%) EBV 1/20 (5%) acute hepatitis A 1/20 (5%) unknown 1/20 (5%)]. All groups underwent serial blood levels of HSP70, Liver and renal functions, MELD score, SOFA score, from day 0, 4, 7 and 10. Exclusion; Cardio respiratory failure, Renal failure, Acute alcoholic hepatitis, sepsis, organ transplant haemolytic Syndromes, CVA, MELD >20, MAP <90.

Conclusion Results: Group A; HSP 70 was normal. Group B was intermediate on day 0 and very high on day 4, 7 and reverting back to lower levels on day 10. Group C had a low level (mildly elevated) of HSP-70 on all days with the exception of the Tylenol group where it was intermediate levels. Conclusion: HSP-70 is a relevant surrogate marker for hypoxia induced hepatopathy. HSP-70 levels strongly correlated with HILI and poorly with Tylenol induced liver injury. But negatively with other non-vascular liver injuries. Larger study needed to validate this finding.

Competing interests None declared.

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