The Use of Circulating Fibronectin and Blood Biomarkers for Non-invasive Assessment of Liver Status Before and After Liver Transplantation

Radi, Hisham A.; Abdelmageed, Asmaa M.; Abd El-Wahab, Mohamed; Ismail, Hisham

doi:10.21608/eajbsc.2025.445643

The Use of Circulating Fibronectin and Blood Biomarkers for Non-invasive Assessment of Liver Status Before and After Liver Transplantation

Document Type : Original Article

Authors

¹ Biochemistry Division, Chemistry Department, Faculty of Science, Minia University, Minia 61519, Egypt.

² Gastrointestinal Surgery Center, Faculty of Medicine, Mansoura University, Mansoura 35516, Egypt.

10.21608/eajbsc.2025.445643

Abstract

Liver transplantation (LT) remains the treatment of choice for liver cirrhosis (LC) and early-stage hepatocellular carcinoma (HCC). However, HCC recurrence rates remain high, and recurrence is a key predictor of survival post-transplant. This study aimed to investigate the use of circulating Fibronectin (FN) and other blood biomarkers for non-invasive monitoring of liver status pre- and post-transplant. A total of 80 Egyptian patients with chronic hepatitis C (56 males and 24 females, aged 18 - 66 years) and 16 age-matched healthy individuals were included. The patients were 50 with LC and 30 with HCC. Of these patients, 36 patients (22 with LC and 14 with HCC) underwent successful LT and were followed one-year after transplantation to evaluate liver status. Traditional biomarkers and circulating FN levels were assessed and the data were analysed using SPSS. The HCC patients showed significantly higher mean levels of FN in comparison with LC patients and healthy individuals. FN demonstrated an AUROC of 0.878 at a cut-off level of 1.85 mg/L for discriminating HCC from all non-HCC individuals, yielding 92.7% efficiency. One-year after transplantation, a significant decline (p < 0.05) was observed in levels of all investigated blood biomarkers and FN compared to pre-transplantation levels. However, patients with pre-HCC exhibited significantly (p < 0.0001) higher mean levels of FN (1.865 mg/L) compared to those with pre LC (1.601 mg/L) after transplantation. In conclusion, FN is a highly accurate biomarker for non-invasive monitoring liver status post-transplant. It offers potential for improving LT outcomes and reducing recurrence.

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