Association Between Donor/recipient Gene Polymorphisms And The Risk Of New-onset Neurological Complications After Liver Transplantation

Objective: nervous system complications are common complications after liver transplantation,which have significant influence on prognosis and quality of life of patients after liver transplantation.In this study,we aimed to assess the relationship between donor / receptor gene polymorphism and post transplantation neurological complications,and then to establish an effective prediction model.Methods: 166 patients underwent liver transplantation in Affiliated Hospital of Qingdao University from January 2015 to July 2017.The clinical data of the patients were collected and analyzed from the preoperative evaluation,intraoperative records,postoperative indicators and follow-up.The neurological complications of the recipients were analyzed according to the clinical symptoms and laboratory examination.The genomic DNA of donor / recipient liver cells was extracted from the paraffin embedded liver tissue samples during liver transplantation.The single nucleotide polymorphism was obtained by using the biomark real-time PCR analysis software.The single nucleotide polymorphisms(MTRR rs1802059,MTRR rs1532268,MTHFR rs1801131,MTHFR rs1801131)closely related to neurological complications were selected Rs1801133)was used to analyze the correlation between different alleles and the susceptibility of neurological complications after liver transplantation,and the related risk factors were included in the regression model,so as to obtain the independent risk factors related to neurological complications after liver transplantation.To establish a prediction model which only contains clinical risk factors and risk factors with gene polymorphism,and to predict the neurological complications.Results: the donor and recipient MTRR rs1802059 polymorphism(AA genotype)was significantly associated with neurological complications.However,the polymorphisms of MTRR rs1532268,MTHFR rs1801131 and MTHFR rs1801133 were not associated with neurological complications.In univariate analysis,neurological complications were significantly associated with intraperitoneal infection(or = 6.1787 [1.518 – 25.139],p =0.011),donor MTRR rs1802059(or = 3.394 [1.196 – 9.634]),A allele,p = 0.022),and receptor MTRR rs1802059(or = 11.375 [3.186 – 40.617],p < 0.001).In multivariate analysis,intraperitoneal infection(or = 9.828 [1.751 – 55.182],p = 0.009),recipient MTRR rs1802059 polymorphism(or = 11.801 [2.802 – 49.705],A allele,p = 0.001),donor MTRR rs1802059 polymorphism(or = 4.427 [1.333 – 14.696],a allele,p = 0.015)were independent risk factors for neurological complications after liver transplantation.In addition,compared with the model only considering clinical parameters,the model with donor or receptor MTRR rs1802059 polymorphism was more effective in predicting neurological complications(p < 0.05).Conclusion: the donor / recipient MTRR rs1802059 gene polymorphism is associated with increased risk of neurological complications after liver transplantation,which has potential clinical value in predicting neurological complications.