Plasma fatty acid lipidome is associated with cirrhosis prognosis and graft damage in liver transplantation

Background: Knowledge regarding the plasma fatty acid (FA) pattern in patients with liver cirrhosis is fragmentary. Objective: We evaluated plasma FA lipidome and its association with the prognosis of cirrhosis and severity of liver graft damage after transplantation. Design: In this observational study, plasma FA lipidome was investigated in 51 cirrhotic patients before liver transplantation and in 90 age- and sex-matched healthy control subjects. In addition, we studied ischemia-reperfusion damage in the liver of 38 patients for whom a graft biopsy was available at transplantation. With the use of logistic regression, we modeled the presence of cirrhosis, the dichotomized model for end-stage liver disease score below and above the median, and the presence of severe liver graft ischemiareperfusion damage. Results: The FA pattern was markedly altered in cirrhotic patients, who showed, compared with healthy controls, higher monounsaturated FAs, lower n2 6a nd n23 polyunsaturated FAs, and undetectable cerotic acid. Plasma di-homo-g-linolenic acid was independently associated with the presence of cirrhosis (OR: 0.026; 95% CI: 0.004, 0.196; P , 0.0001), severity of its prognosis (OR: 0.041; 95% CI:0.005, 0.376; P = 0.006), postreperfusion graft hepatocellular necrosis (OR: 0.921; 95% CI: 0.851, 0.997; P = 0.043), and sinusoidal congestion (OR: 0.954; 95% CI: 0.912, 0.998; P = 0.039). Associations of di-homo-g-linolenic acid with the presence of cirrhosis and severity of its prognosis were confirmed also after false discovery rate correction. Conclusions: Cerotic and di-homo-g-linolenic acids may serve as markers of disease and prognosis in liver cirrhosis. Dietary supplementation with di-homo-g-linolenic acid could be a reasonable interventional strategy to delay disease progression in liver cirrhosis. This trial was registered at clinicaltrials.gov as NCT01389115. Am J Clin Nutr doi: 10.3945/ajcn.113.074427.