Serum S100 as a marker of cerebral injury in acute liver failure (ALF) and during orthotopic liver transplantation (OLT)

Introduction

Encephalopathy and irreversible cerebral injury may occur in ALF. S100 is a CNS-specific protein that is a marker of cerebral injury [1,2]. We investigated S100 protein in patients with ALF who underwent OLT.

Methods

After IRB approval blood samples were taken in 10 patients age 20-51 years with ALF. Blood was taken before OLT (A), during the anhepatic phase (B), 30 min after reperfusion (C), and on days 1 (D) and 4 (E) post-OLT. The blood was centrifuged and serum stored at -70°C. S100 was analysed using an immunoluminometric assay.

Results

Serum S100 (X ± SEM) was elevated prior to OLT (normal < 0.12 µg/l). By day 4 post-OLT S100 had fallen in all patients except one. This patient subsequently died.

Conclusion

Serum S100 is elevated in ALF and encephalopathy. We observed a rise in S100 during OLT in these patients. The role of S100 as a marker of neuronal injury in ALF and OLT warrants further investigation.