Published online Mar 16, 2023. doi: 10.12998/wjcc.v11.i8.1753
Peer-review started: December 13, 2022
First decision: January 19, 2023
Revised: January 20, 2023
Accepted: February 21, 2023
Article in press: February 21, 2023
Published online: March 16, 2023
Processing time: 83 Days and 21.9 Hours
Fas ligand (FasL) is one ligand that activates extrinsic apoptosis pathway. High expression in lymphocytes of FasL have been found in patients with acute rejection of liver transplantation (LT). No high blood concentrations of soluble FasL (sFasL) have been found in patients with acute LT rejection; however, the samples size of those studies was small.
To determine whether patients with hepatocellular carcinoma (HCC) that dead during the first year of LT have higher blood sFasL concentrations previously to LT that those who that remain alive in a study of higher sample size.
Patients underwent LT due to HCC were included in this retrospective study. Serum sFasL levels prior to LT were measured and one-year LT mortality was registered.
Non-surviving patients (n = 14) showed higher serum sFasL levels [477 (269-496) vs 85 (44-382) pg/mL; P < 0.001] than surviving patients (n = 113). Serum sFasL levels (pg/mL) were associated with mortality (OR = 1.006; 95%CI = 1.003-1.010; P = 0.001) independently of age of LT donor in the logistic regression analysis.
We report for the first time that HCC patients who die within the first year of HT have higher blood sFasL concentrations prior to HT than those who remain alive.
Core Tip: Fas ligand (FasL) is one of the main ligands that activate apoptosis via the extrinsic pathway. Elevated blood concentrations of soluble FasL (sFasL) have not been found in patients with acute liver transplant (LT) rejection; however, the sample sizes of those studies were small. We found in this retrospective study of 127 patients with hepatocellular carcinoma underwent to LT that patients that die during the first year of LT have higher blood sFasL concentrations previously to LT than those who that remain alive. The beneficial results of blockade of the Fas system in animal models could motivate its investigation in these patients.