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

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.
 Download the PDF from VitaminDWiki

---

49 References

1. Philips, C. A. & Kedarisetty, C. K. Palliative care for patients with end-stage liver disease. J. Clin. Exp. Hepatol. 13(2), 319-328 (2023).
2. Swindell, W. R. Genes and gene expression modules associated with caloric restriction and aging in the laboratory mouse. BMC Genom. 10(1), 585 (2009).
3. Lan, Y. et al. The burden of liver cirrhosis and underlying etiologies: Results from the Global Burden of Disease Study 2019. Hepatol. Commun. 7(2), e0026 (2023).
4. Duffy, J. P et al. Long-term patient outcome and quality of life after liver transplantation: Analysis of 20-year survivors. Ann. Surg. 252(4), 652-661 (2010).
5. VanBuskirk, A. M., Pidwell, D. J., Adams, P W. & Orosz, C. G. Transplantation immunology. Jama 278(22), 1993-1999 (1997).
6. Liu, L. U. et al. Marked Differences in acute cellular rejection rates between living-donor and deceased-donor liver transplant recipients. Transplantation 80(8), 1072-1080 (2005).
7. Ikegami, T. et al. A high MELD score, combined with the presence of hepatitis C, is associated with a poor prognosis in living donor liver transplantation. Surg. Today 44(2), 233-240 (2014).
8. Wiesner, R. H., Ludwig, J., Krom, R. A., Hay, J. E. & van Hoek, B. Hepatic allograft rejection: New developments in terminology, diagnosis, prevention, and treatment. Mayo Clin. Proc. 68(1), 69-79 (1993).
9. Lizaola-Mayo, B. C. & Rodriguez, E. A. Cytomegalovirus infection after liver transplantation. World J Transpl. 10(7), 183-190 (2020).
10. Chen, X. B. & Xu, M. Q. Primary graft dysfunction after liver transplantation. Hepatobiliary Pancreatic Dis. Int. 13(2), 125-137 (2014).
11. Doi, J. et al. Nutrition support in liver transplantation and postoperative recovery: The effects of vitamin D level and vitamin D supplementation in liver transplantation. Nutrients 12(12), 3677 (2020).
12. Rashidi-Alavijeh, J. et al. Primary sclerosing cholangitis as an independent risk factor for cytomegalovirus infection after liver transplant. Transpl. Infect. Dis. 23(3), e13553 (2021).
13. Holick, M. F. Vitamin D and bone health. J. Nutr. 126(4 Suppl), 1159S-S1164 (1996).
14. Dimitrov, V. et al. Vitamin D-regulated gene expression profiles: Species-specificity and cell-specific effects on metabolism and immunity. Endocrinology 162(2), bqaa218 (2021).
15. Christakos, S., Dhawan, P., Porta, A., Mady, L. J. & Seth, T. Vitamin D and intestinal calcium absorption. Mol. Cell. Endocrinol. 347(1), 25-29 (2011).
16. Kubesch, A. et al. Vitamin D deficiency is associated with hepatic decompensation and inflammation in patients with liver cir­rhosis: A prospective cohort study. PloS one 13(11), e0207162 (2018).
17. Zhou, Q. et al. Vitamin D supplementation could reduce the risk of acute cellular rejection and infection in vitamin D deficient liver allograft recipients. Int. Immunopharmacol. 75, 105811 (2019).
18. Lange, C. M. et al. Vitamin D receptor and Jak-STAT signaling crosstalk results in calcitriol-mediated increase of hepatocellular response to IFN-a. J. Immunol. 192(12), 6037-6044 (2014).
19. Saleh, M. et al. Differential modulation of hepatitis C virus replication and innate immune pathways by synthetic calcitriol-analogs. J. Steroid Biochem. Mol. Biol. 183, 142-151 (2018).
20. Arteh, J., Narra, S. & Nair, S. Prevalence of vitamin D deficiency in chronic liver disease. Dig. Dis. Sci. 55, 2624-2628 (2010).
21. Fisher, L. & Fisher, A. Vitamin D and parathyroid hormone in outpatients with noncholestatic chronic liver disease. Clin. Gastro­enterol. Hepatol. 5(4), 513-520 (2007).
22. Lee, J. R. et al. Circulating levels of 25-hydroxyvitamin D and acute cellular rejection in kidney allograft recipients. Transplantation 98(3), 292 (2014).
23. Lowery, E. M. et al. Low vitamin D levels are associated with increased rejection and infections after lung transplantation. J. Heart Lung Transpl. 31(7), 700-707 (2012).
24. Freitas, A. C. T., Rampim, A. T., Nunes, C. P. & Coelho, J. C. U. Impact of meld sodium on liver transplantation waiting list. Arquivos brasileiros de cirurgia digestive. ABCD 32(3), e1460 (2019).
25. Krenzien, F. et al. Diagnostic biomarkers to diagnose acute allograft rejection after liver transplantation: Systematic review and meta-analysis of diagnostic accuracy studies. Front. Immunol. 10, 758 (2019).
26. Bitetto, D. et al. Vitamin D and the risk of acute allograft rejection following human liver transplantation. liver Int 30(3), 417-444 (2010).
27. Grant, C. A vitamin D protocol post-liver transplantation. J. Am. Assoc. Nurse Pract. 29(11), 658-666 (2017).
28. Kamath, P. S. et al. A model to predict survival in patients with end-stage liver disease. Hepatology 33(2), 464-470 (2001).
29. Traub, J., Reiss, L., Aliwa, B. & Stadlbauer, V. Malnutrition in patients with liver cirrhosis. Nutrients 13(2), 540 (2021).
30. Lange, C. M. et al. Vitamin D deficiency and a CYP27B1-1260 promoter polymorphism are associated with chronic hepatitis C and poor response to interferon-alfa based therapy. J. Hepatol. 54(5), 887-893 (2011).
31. Mazurak, V. C., Tandon, P. & Montano-Loza, A. J. Nutrition and the transplant candidate. liver Transpl. 23(11), 1451-1464 (2017).
32. Englesbe, M. J. et al. Sarcopenia and mortality after liver transplantation. J. Am. Coll. Surg. 211, 271-278 (2010).
33. Palmer, M. T. et al. Lineage-specific effects of 1, 25-dihydroxyvitamin D3 on the development of effector CD4 T cells. J. Biol. Chem. 286, 997-1004 (2011).
34. Reichel, H., Koeffler, H. P, Tobler, A. & Norman, A. W. 1 alpha,25-Dihydroxyvitamin D3 inhibits gamma-interferon synthesis by normal human peripheral blood lymphocytes. Proc. Natl. Acad. Sci. U. S. A. 84(10), 3385-3389 (1987).
35. Colin, E. M. et al. 1, 25-dihydroxyvitamin D3 modulates Th17 polarization and interleukin-22 expression by memory T cells from patients with early rheumatoid arthritis. Arthritis Rheum. 62, 132-142 (2010).
36. Ferreira, G. B. et al. 1,25-Dihydroxyvitamin D3 alters murine dendritic cell behaviour in vitro and in vivo. Diabetes Metab. Res. Rev. 27(8), 933-941 (2011).
37. Fisher, S.A.-O. et al. The role of vitamin D in increasing circulating T regulatory cell numbers and modulating T regulatory cell phenotypes in patients with inflammatory disease or in healthy volunteers: A systematic review. PloS one. 14, e0222313 (2019).
38. Sakaguchi, S. Taking regulatory T cells into medicine. J. Exp. Med. 218(6), e20210831 (2021).
39. Adorini, L. & Penna, G. Induction of tolerogenic dendritic cells by vitamin D receptor agonists. Handb. Exp. Pharmacol. 188, 251-73 (2009).
40. Zhang, X.A.-O. et al. Active vitamin D regulates macrophage M1/M2 phenotypes via the STAT-1-TREM-1 pathway in diabetic nephropathy. J. Cell. Physiol. 234, 6917-6926 (2019).
41. Arora, S., Dev, K., Agarwal, B., Das, P. & Syed, M. A. Macrophages: Their role, activation and polarization in pulmonary diseases. Immunobiology 223(4-5), 383-396 (2018).
42. Wang, Q. et al. Vitamin D inhibits COX-2 expression and inflammatory response by targeting thioesterase superfamily member 4. J. Biol. Chem. 289, 11681-11694 (2014).
43. Fantini, C., Corinaldesi, C., Lenzi, A., Migliaccio, S. & Crescioli, C. Vitamin D as a shield against aging. Int. J. Mol. Sci. 24(5), 4546 (2023).
44. Mori, D. N., Kreisel, D., Fullerton, J. N., Gilroy, D. W. & Goldstein, D. R. Inflammatory triggers of acute rejection of organ allografts. Immunol. Rev. 258, 132-144 (2014).
45. Zhang, Y., Garrett, S., Carroll, R. E., Xia, Y. & Sun, J. Vitamin D receptor upregulates tight junction protein claudin-5 against colitis-associated tumorigenesis. Mucosal immunol. 15, 683-697 (2022).
46. White, J. H. Emerging roles of vitamin D-induced antimicrobial peptides in antiviral innate immunity. Nutrients 14(2), 284 (2022).
47. Zhang, Q.-Y. et al. Antimicrobial peptides: Mechanism of action, activity and clinical potential. Mil. Med. Res. 8(1), 48 (2021).
48. Gubatan, J. et al. Antimicrobial peptides and the gut microbiome in inflammatory bowel disease. World J. Gastroenterol. 27, 7402-7422 (2021).
49. Lu, Z., Ding, L., Lu, Q. & Chen, Y. H. Claudins in intestines: Distribution and functional significance in health and diseases. Tissue Barriers 1, e24978 (2013).

---

VitaminDWiki - Vitamin D helps organ transplant 33+ items as of Nov 2023

---

VitaminDWiki - 38 studies in both categories Surgery and Vitamin D Loading Dose

This list is automatically updated