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Liver transplant failure 2.7X more-likely if low vitamin D - Nov 2023


Vitamin D status as a predictor for liver transplant outcomes - Nov 2023

Sci Rep. 2023 Nov 29;13(1):21018. doi: 10.1038/s41598-023-48496-5.
Danial Fotros 1, Mohammadhassan Sohouli 1, Zahra Yari 2, Hanie Sakhdari 3, Mojtaba Shafiekhani 4 5, Hamed Nikoupour 4 5, Mohammad Amin Jafarzadeh 6, Keynoosh Jafari 6, Seyedeh Sara Afiatjoo 6, Seyed Amirreza Fatemi 6, Mahmoud Amiri 7, Hesameddin Eghlimi 8, Amirhassan Rabbani 8, Nasrin Broumandnia 9, Ghazaleh Mahdavi Mazdeh 1, Ali Jafarian 10, Azita Hekmatdoost 11

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It is well known that vitamin D plays a pivotal role in immune system modulation; however, its role in liver transplantation (LT) has not yet been well elucidated. This study aimed to assess the association between vitamin D status and LT outcomes. This retrospective cohort study was conducted on 335 registered cirrhotic patients with end-stage liver disease (ESLD) who underwent LT during 2019-2021 and had measurement of serum vitamin D before LT. The association of vitamin D levels before LT with the odds of acute cellular rejection (ACR) and risk mortality was assessed by applying logistic and cox regression, respectively. The mean MELD-Na and serum level of vitamin D were 20.39 ± 9.36 and 21.52 ± 15.28 ng/ml, respectively. In the final adjusted model, there was a significant association between vitamin D deficiency in the pre-transplant period and odds of ACR (odds ratio [OR] 2.69; 95% confidence interval [CI] 1.50-4.68).
Although in the crude model, vitamin D deficiency in the pre-transplant period was significantly associated with an increased risk of mortality after two years of follow-up (Hazard ratio (HR) = 2.64, 95% CI 1.42-4.33), after adjustment for potential confounders, the association of vitamin D status and mortality became non-significant (HR = 1.46, 95% CI 0.71-3.00). The present study provides evidence that pre-transplant serum vitamin D levels may be a predictor for ACR in patients with cirrhosis undergoing LT.
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