Retrospective Study
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Hepatol. Jun 27, 2022; 14(6): 1182-1189
Published online Jun 27, 2022. doi: 10.4254/wjh.v14.i6.1182
DNA and RNA oxidative damage in hepatocellular carcinoma patients and mortality during the first year of liver transplantation
Leonardo Lorente, Sergio T Rodriguez, Pablo Sanz, Agustín F González-Rivero, Antonia Pérez-Cejas, Javier Padilla, Dácil Díaz, Antonio González, María M Martín, Alejandro Jiménez, Purificación Cerro, Julián Portero, Manuel A Barrera
Leonardo Lorente, Department ofIntensive Care, Hospital Universitario de Canarias, La Laguna 38320, Tenerife, Spain
Sergio T Rodriguez, María M Martín, Intensive Care Unit, Hospital Universitario Nuestra Señora Candelaria, Santa Cruz de Tenerife 38010, Spain
Pablo Sanz, Javier Padilla, Manuel A Barrera, Department of Surgery, Hospital Universitario Nuestra Señora de Candelaria, Santa Cruz de Tenerife 38010, Spain
Agustín F González-Rivero, Antonia Pérez-Cejas, Department of Laboratory, Hospital Universitario de Canarias, La Laguna 38320, Spain
Dácil Díaz, Antonio González, Department of Digestive, Hospital Universitario Nuestra Señora de Candelaria, Santa Cruz de Tenerife 38010, Spain
Alejandro Jiménez, Research Unit, Hospital Universitario de Canarias, La Laguna 38320, Spain
Purificación Cerro, Transplant Unit, Hospital Universitario Nuestra Señora Candelaria, Santa Cruz de Tenerife 38010, Spain
Julián Portero, Department of Radiology, Hospital Universitario Nuestra Señora Candelaria, Santa Cruz de Tenerife 38010, Spain
Author contributions: Lorente L was responsible for conception, design and coordination of the study, made substantial contributions to acquisition of data and analysis and interpretation of data and drafted the manuscript; Rodriguez ST, Sanz P, Portero J, Díaz D, González A, Martín MM, Cerro P, Portero J and Barrera MA made substantial contributions to acquisition of data and provided useful suggestions; González-Rivero AF and Pérez-Cejas A participated in blood determination levels; Jiménez A made substantial contributions to analysis and interpretation of data; All authors critically read and approved the manuscript and agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.
Institutional review board statement: The Institutional Board of the Hospital Universitario Nuestra Señora de Candelaria (Santa Cruz de Tenerife, Spain) approved the study protocol.
Informed consent statement: All study participants or their legal guardian provided informed written consent about personal and medical data collection prior to study enrolment.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: The datasets generated during the current study are available from the corresponding author on reasonable request.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Leonardo Lorente, MD, PhD, Attending Doctor, Medical Assistant, Department of Intensive Care, Hospital Universitario de Canarias, Ofra, s/n., La Laguna 38320, Tenerife, Spain. lorentemartin@msn.com
Received: January 14, 2022
Peer-review started: January 14, 2022
First decision: March 24, 2022
Revised: March 28, 2022
Accepted: May 22, 2022
Article in press: May 22, 2022
Published online: June 27, 2022
Abstract
BACKGROUND

Oxidative damage of DNA and RNA has been associated with mortality of patients with different diseases. However, there is no published data on the potential use of DNA and RNA oxidative damage to predict the prognosis of patients with hepatocellular carcinoma (HCC) undergoing liver transplantation (LT).

AIM

To determine whether patients with increased DNA and RNA oxidative damage prior to LT for HCC have a poor LT prognosis.

METHODS

Patients with HCC who underwent LT were included in this observational and retrospective study. Serum levels of all three oxidized guanine species (OGS) were measured prior to LT since guanine is the nucleobase that forms DNA and RNA most prone to oxidation. LT mortality at 1 year was the end-point study.

RESULTS

Surviving patients (n = 101) showed lower serum OGS levels (P = 0.01) and lower age of the liver donor (P = 0.03) than non-surviving patients (n = 13). An association between serum OGS levels prior to LT and 1-year LT (odds ratio = 2.079; 95% confidence interval = 1.356-3.189; P = 0.001) was found in the logistic regression analysis.

CONCLUSION

The main new finding was that high serum OGS concentration prior to LT was associated with the mortality 1 year after LT in HCC patients.

Keywords: DNA oxidative damage, Hepatocellular carcinoma, Liver transplantation, Mortality, Oxidized guanine species

Core Tip: The potential use of DNA and RNA oxidative damage to predict prognosis of patients with hepatocellular carcinoma who underwent liver transplantation is unknown. In this retrospective study serum levels of the three oxidized guanine species before liver transplantation in 114 patients were measured. One-year survivor patients showed lower serum oxidized guanine specie levels than non-survivor patients (P = 0.01). These preliminary results could induce studies to clarify the potential role of oxidative damage in the prognosis of liver transplantation patients due to hepatocellular carcinoma and to explore the use of antioxidant agents to reduce oxidative stress in those patients.