Ann Surg Treat Res.  2018 Nov;95(5):249-257. 10.4174/astr.2018.95.5.249.

Alteration of MRP2 expression and the graft outcome after liver transplantation

Affiliations
  • 1Department of Surgery, Seoul National University College of Medicine, Seoul, Korea. kssuh2000@gmail.com
  • 2Department of Transplant Surgery, Medical College of Wisconsin, Milwaukee, WI, USA.
  • 3Department of Pathology, Seoul National University College of Medicine, Seoul, Korea.
  • 4Department of Radiology, Seoul National University College of Medicine, Seoul, Korea.

Abstract

PURPOSE
Multidrug resistance-associated protein (MRP) 2 is a glutathione conjugate in the canalicular membrane of hepatocytes. Early graft damage after liver transplantation (LT) can result in alteration of MRP2 expression. The purpose of this study was to evaluate the relationship between the pattern of MRP2 alteration and graft outcome.
METHODS
Forty-one paraffin-embedded liver graft tissues obtained by protocol biopsy within 2 months after LT; these were stained using monoclonal antibodies of MRP2. We selected 15 live donor biopsy samples as a control, that showed homogenous canalicular staining for MRP2. The pattern of canalicular MRP2 staining of graft was classified into 3 types: homogenous (type C0), focal (type C1), and no (type C2,) staining of the canaliculi.
RESULTS
In total, 17.1% graft tissues were type C0, 36.6% were type C1, and 46.3% were type C2. The median operation time was longer in patients with type C2 (562.6 minutes) than in patients with type C0 (393.8 minutes) (P = 0.038). The rates of posttransplant complications were higher in patients with type C2 (100%) than in patients with type C0 (42.9%) and C1 (73.3%) (P < 0.001).
CONCLUSION
MRP2 expression pattern was altered in 82.9% after LT. The pattern of MRP2 alteration was associated with longer operation time and higher rates of post-LT complications.

Keyword

Multidrug resistance-associated protein; Liver transplantation
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