Is Alkaline Phosphatase a Predictor of Mortality in Liver Transplant Patients?

Document Type

Conference Proceeding

Publication Date

6-1-2023

Publication Title

Am J Transplant

Abstract

Purpose: We aim to evaluate the association between alkaline phosphatase (ALP) and rejection and mortality rates in patients who underwent liver transplantation at 1 and 3 years. Methods: A retrospective study was performed. Patients who received a liver transplant from 2015-2019 were included in the study. Patients’ indication of transplant and date of transplant and death were recorded. ALP was measured at the time of transplant, 3 months, 6 months, and 1 year after transplant when available. Mortality rates at 1 and 3 years were measured for patients with an ALP greater than 130 and with an ALP greater than 200 at the respective time periods. ALP values were stratified based on the available literature that suggests that a value great that 130 IU/L is abnormal. Patients who had evidence of rejection were excluded to not have a confounding variable affecting mortality and were analyzed separately. A chi-square was calculated to compare the relationships. Results: 220 patients met the study criteria and were included. A significant positive correlation was demonstrated between ALP level at the time of transplant and death at 1 and 3 years; the chi-square statistic at 1 year was 9.65 (p=0.008) and at 3 years was 6.55 (p=0.04). ALP level at 3 months after transplant had no statistical significance with mortality. ALP level at 6 months after transplant had a statistically significant positive correlation with mortality at 1 year with a chi-square of 7.67 (p=0.022) but did not have a statistically significant correlation at 3 years (p=0.089). ALP level at 12 months after transplant had a statistically significant positive correlation with mortality at 3 years with chi-square 15.17 (p=0.005). Rates of death per group are listed in Table 1. Of the 383 total transplant patients, 41% (n=157), developed transplant rejection. Of these patients, 28.7% (n=45), had an ALP of greater than 130 at the time of transplant; however, there was no statistically significant correlation between ALP level and rejection as the chi-square was 1.25 (p=0.264). Conclusions: ALP level measured at the time of liver transplant has a statistically significant positive correlation with mortality at 1 and 3 years. ALP level measured at 3, 6, and 12 months had varying levels of statistical significance, although they demonstrated a similar positive correlation. ALP appears to be a promising prognostic marker for post-transplant complications. Further data is necessary to understand the identified correlation. CITATION INFORMATION: Obri M., Sarowar A., Almajed M., Jafri S. Is Alkaline Phosphatase a Predictor of Mortality in Liver Transplant Patients? AJT, Volume 23, Issue 6, Supplement 1. DISCLOSURES: M.S.Obri: None. A.Sarowar: n/a. M.R.Almajed: n/a. S.Jafri: Speakers Bureau;; Gilead, Takeda, Abbvie. [Figure presented]

PubMed ID

Not assigned.

Volume

23

Issue

Suppl 1

First Page

S1182

Last Page

S1183

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