Early allograft dysfunction (EAD) after
liver transplantation (LT) accompanies poor prognosis. This study aims to explore the relationship between pretransplant intrahepatic
proteins and the incidence of EAD, and the value of combined EAD and
protein profiles for predicting recipient and graft survival prognosis. Liver biopsy specimens of 105 pretransplant grafts used for LT were collected and used for immunohistochemistry analysis of 5
proteins. And matched clinical data of donor, recipient,
transplantation, and prognosis were analyzed. The incidence of EAD was 41.9% (44/105) in this cohort. Macrovesicular steatosis (P = 0.016), donor body mass index (P = 0.013), recipients' pretransplant serum
creatinine (P = 0.036), and intrahepatic expression of
heme oxygenase 1 (HO1) (P = 0.015) and
tumor necrosis factor α (TNF-α) (P = 0.039) were independent predictors of EAD. Inferior graft and recipient prognosis were observed in patients who experienced EAD (P = 0.028 and 0.031) or received grafts with higher expression of
sirtuin 1 (P = 0.005 and 0.013). The graft and recipient survival were worst in patients with both EAD and high expression of
sirtuin 1 (P = 0.001 and 0.004). In conclusion, pretransplant intrahepatic expression of HO1 and TNF-α are associated with the incidence of EAD. The combination of EAD and EAD-unrelated
proteins showed superiority in distinguishing recipients with worse prognosis.