Role of Iron Metabolic Disturbances and Inflammatory Iron Biomarkers in Liver Transplant Prognosis

Abstract

Iron metabolism plays a pivotal role in liver transplantation, significantly impacting outcomes for both donors and recipients. The liver, central to iron homeostasis, is often impaired in chronic liver diseases leading to metabolic disorders that exacerbate liver damage. Liver transplantation (LT) is a critical treatment for end-stage liver diseases, with iron status in both donors and recipients influencing post-transplant outcomes. Studies indicate that pre-transplant iron overload in recipients is associated with poor liver function recovery, increased graft rejection risk, and reduced patient survival. The iron metabolic state of donors also affects the functionality of the transplanted liver, impacting transplant success and patient prognosis. Biomarkers such as hepcidin, serum ferritin, and total iron-binding capacity are significant predictors of LT prognosis, yet their specific roles and impacts remain inconclusive. This review systematically assesses how variations in iron metabolic levels of donors and recipients affect patient outcomes following LT, aiming to optimize iron metabolism regulation in clinical management to enhance transplant success, reduce postoperative complications, and improve long-term patient quality of life. Future research should focus on developing personalized iron metabolism management protocols to refine these approaches and enhance transplant care.

Keywords: Biomarkers; Clinical management; Iron Metabolism; Ischemia-reperfusion injury; Liver Transplantation; Oxidative stress.

Figure 1

The relationship between iron metabolism indicators and the mechanism of ischemia-reperfusion injury. Abbreviations: TSAT - transferrin saturation; TF - transferrin; ROS - reactive oxygen species.