Z Gastroenterol 2014; 52 - KG149
DOI: 10.1055/s-0034-1386171

The role of miR-34a as a prognostic biomarker for cirrhotic patients with portal hypertension receiving TIPS

C Jansen 1, H Eischeid 2, J Goertzen 1, R Schierwagen 1, E Anadol 1, CP Strassburg 1, T Sauerbruch 1, M Odenthal 2, J Trebicka 1
  • 1Universität Bonn, Medizinische Klinik und Poliklinik I, Bonn, Germany
  • 2Department of Pathology, University of Cologne, Cologne, Germany

Background: Circulating miR-34a is increased in blood of patients with different liver diseases when compared to healthy controls. However, the origin of miR-34a and its possible relationship with hemodynamics and outcome in cirrhotic patients with portal hypertension is unknown. We analyzed the levels of miR-34a in the portal and hepatic vein of cirrhotic patients with severe portal hypertension.

Methods: We included 60 cirrhotic patients receiving TIPS for prevention of rebleeding and/or therapy-refractory ascites. miR-34a levels were measured using qPCR and normalized by spike-in SV-40 RNA in the portal and hepatic venous blood of these patients taken at TIPS procedure. Hemodynamic and clinical parameters were assessed before TIPS and during follow-up.

Results: Levels of miR-34a were higher in the hepatic vein than in the portal vein (p = 0.019). Circulating miR-34a in the hepatic vein correlated with parameters of hepatic function (ALT and CHE) and sodium excretion after TIPS. There was no correlation with portal pressure, but miR-34a levels in the portal vein correlated inversely with the congestion index. Interestingly, the levels of miR-34a in the portal and hepatic vein showed inverse correlation with arterial pressure. Furthermore, higher levels of miR-34a in the hepatic vein had a predictive value for survival.

Conclusion: This study demonstrates for the first time, that miR-34a originates to a large extent from the liver. Furthermore, circulating levels of miR-34a are associated with hepatic function. Hence, higher levels of miR-34a are possibly associated with better survival at long-term follow-up in cirrhotic patients with severe portal hypertension receiving TIPS.