studies

232A AASLD ABSTRACTS HEPATOLOGY, October, 2015
black tea. The mean ALT noted in 657 individuals within 3
months of TE was 60.6 U/L. The average BMI was 25.7 kg/m 2
and weight was 71.7 kg. Average daily alcohol consumption
was 5 g/day. The average liver stiffness for the 1155 individuals
was 8.4 kPa. CAP was available from 2013 in 719 individuals
with average steatosis measures of 214 dB/m. After
MLR taking into account age, alcohol, smoking and weight,
individuals with HCV benefited from coffee intake with LSM
on average 2 kPa less with intake of 2 or more cups of coffee
daily (p = 0.026). This was not seen in those with HBV or
NAFLD. In NAFLD a decrease in CAP of 23 dB/m (9%) was
noted in individuals who drank ≥2 cups of coffee (p = 0.032).
There was no effect of coffee consumption on CAP in other
groups. Conclusions: Individuals with self-reported daily coffee
intake ≥2 cups of coffee/ day had a significant decrease in
liver stiffness, which was not seen in those with HBV or NAFLD.
Similar daily coffee intake resulted in significant decrease in
liver steatosis in NAFLD. These findings are consistent with the
literature to date and add to the growing body of evidence
suggesting coffee may be a beneficial supplement in some
liver diseases.
Disclosures:
The following authors have nothing to disclose: Alexander Hodge, Sarah P. Lim,
Evan Goh, Ophelia H. Wong, Philip Marsh, Virginia Knight, Yong Song
48
Serum Lipidomic Profiling for Screening Potential Biomarkers
of Liver Cirrhosis among Patients with Chronic
Hepatitis C
Ana Maria Passos-Castilho 1 , Maria Lucia Ferraz 2 , Valdemir M.
Carvalho 3 , Karina H. Cardozo 3 , Luciana Kikuchi 4 , Aline Chagas 4 ,
João Renato R. Pinho 4 , Michele S. Gomes-Gouvêa 4 , Fernanda
Malta 4 , Flair J. Carrilho 4 , Celso Granato 1,3 ; 1 Division of Infectious
Diseases, Federal University of Sao Paulo, Sao Paulo, Brazil;
2 Department of Gastroenterology, Federal University of Sao Paulo,
Sao Paulo, Brazil; 3 Fleury SA Group, Sao Paulo, Brazil; 4 Department
of Gastroenterology, University of Sao Paulo School of Medicine,
Sao Paulo, Brazil
Background: Liver cirrhosis (LC) is the 14th most common cause
of death in adults worldwide, resulting in 1.03 million deaths
per year. Chronic hepatitis C (CHC) is one of the main causes
of LC. Non-invasive markers of fibrosis have been increasingly
studied as they may represent a more informative, safe and
accessible diagnostic and/or screening tool for at-risk patients.
Aim: To explore the serum lipidome profiles of LC to identify
potential biomarkers. Methods: A total of 182 subjects were
enrolled from 2011 to 2014. An ultraperformance liquid chromatography–mass
spectrometry (UPLC-MS) lipidomic method
was used to characterize serum profiles from LC (n=59), CHC
(n=65) and healthy subjects (n=58). Patients were diagnosed
by clinical, laboratory and imaging evidence of LC while
healthy controls had normal liver function and no infectious diseases.
Reversed-phased analysis was performed on a Waters
ACQUITY IClass UPLC system coupled to a Waters Synapt-MS
hidrid quadrupole-time of flight mass spectrometer operating
in the positive ion electrospray mode with a mass scan range
200–1200 m/z for data acquisition in continuous mode. All
data were processed with Progenesis software (Waters). The
resulting multivariate data set was analyzed with MetaboAnalyst
(TMIC) using supervised partial least-squares discriminate
analysis (PLS-DA). Potential biomarkers were selected according
to the variable importance in the projection (VIP) and statistical
significance was evaluated using Mann-Whitney test. The
receiver operating characteristic (ROC) curve was performed
to assess the accuracy of selected biomarkers in LC diagnosis.
To identify the potential biomarkers, the HMDB and Lipid
Maps databases were queried with the exact mass. Results:
The UPLC–MS-based serum lipidomic profile detected 51 of
59 LC cases, performing with a diagnostic accuracy of 87%.
The 3 potential biomarkers differentiated LC from CHC individually
with 76 to 88% sensitivity and 72 to 74% specificity.
They all presented with fold change higher than 2 and p <
0.0001 in univariate analyses. The combination of the 3 potential
biomarkers resulted in an area under the curve of 0.95,
86% sensitivity and 88% specificity. The model was validated
with 1000 permutation tests (p < 0.001) to prevent overfitting.
3-Hydroxy-cis-5-tetradecenocylcarnitine, a hydroxy fatty acid
involved in many metabolic and proinflammatory pathways,
exhibited a significant increase in LC and a decrease in CHC
and was proposed as an important indicator of LC. Conclusions:
UPLC-MS lipid profiling proved to be an efficient and
convenient tool for diagnosis and screening of LC in an at-risk
population.
Disclosures:
João Renato R. Pinho - Employment: Hospital Israelita Albert Einstein
The following authors have nothing to disclose: Ana Maria Passos-Castilho,
Maria Lucia Ferraz, Valdemir M. Carvalho, Karina H. Cardozo, Luciana Kikuchi,
Aline Chagas, Michele S. Gomes-Gouvêa, Fernanda Malta, Flair J. Carrilho,
Celso Granato
49
Comparison of Liver Transplant-related Survival Benefit
in Patients With vs Without Hepatocellular Carcinoma in
the United States.
George N. Ioannou 1,2 , Kristin Berry 1 ; 1 Veterans Affairs Puget
Sound Healthcare System, Seattle, WA; 2 University of Washington,
Seattle, WA
Background and Aims Patients with T2 hepatocellular carcinoma
(HCC) can obtain an exception allowing them to undergo
liver transplantation at much lower actual Model for End Stage
Liver Disease (MELD) scores than patients without HCC. We
aimed to compare patients transplanted with and without HCC
with regards to transplantation-related survival benefit. Methods
We modeled the post-transplant survival of adult, first-time
liver transplant recipients with (n=9135) or without (n=25,890)
HCC from 2002-2013 using Cox proportional hazards regression.
We modeled waitlist survival of patients listed for transplantation
with (n=15,605) or without (n=85,229) HCC using
competing risks analysis and a combined outcome of death
or liver failure, defined as MELD score ≥30. We used these
survival models to calculate monthly transition probabilities and
5-year life expectancies. Survival benefit was calculated as the
difference between post-transplant and waitlist life expectancy.
Results Five-year survival benefit increased with actual MELD
score for both patients with and without HCC from just a few
months in patients with low MELD scores (6-8) to 4 years in
patients with the highest MELD scores (36-40). The survival
benefit of patients with HCC was similar to that of patients
without HCC who had the same actual MELD score, irrespective
of tumor burden or serum alpha fetoprotein level. Because
patients with HCC were transplanted at a lower mean MELD
score (13.3±6.2) than patients without HCC (21.8±8.0), a
dramatically lower mean 5-year survival benefit was achieved
by transplanting patients with HCC (0.12 years/patient) than
patients without HCC (1.47 years/patient). Conclusions The
HCC MELD exception policy unintentionally resulted in a dramatic
reduction in transplant-related survival benefit.