{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T13:24:26Z","timestamp":1788355466672,"version":"build-2803163510"},"reference-count":39,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,11,25]],"date-time":"2025-11-25T00:00:00Z","timestamp":1764028800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100007380","name":"Fondation de l'Avenir pour la Recherche M\u00e9dicale Appliqu\u00e9e","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100007380","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Transplant."],"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Ischemia\u2013reperfusion injury causes endothelial damage, partly through degradation of the glycocalyx. This study aimed to evaluate glycocalyx degradation from graft procurement to reperfusion and assess its potential as a biomarker of early graft function (early allograft dysfunction, EAD).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This single-center observational prospective study was conducted at Paul Brousse Hospital from April 2022 to April 2023. All primary liver transplantation (LT) recipients were included. Glycocalyx degradation was assessed at procurement, at the end of cold ischemia, and during LT in liver graft caval effluent and correlated with liver histological injury. The primary endpoint was EAD, defined as a Model for Early Allograft Function score \u22659. We quantified glycocalyx components [Syndecan-1 (Synd-1), heparan sulfate, angiopoietin-1, and angiopoietin-2], inflammation (TNF-alpha), and cell death markers.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Thirty-one patients were included; 12 (39%) developed EAD. Synd-1 plasma levels at procurement (donor Synd-1 level\u2009=\u2009d-Synd-1) were significantly higher in patients with EAD [12,173\u2005pg\/mL (10,538\u201317,570) vs. 6,282\u2005pg\/mL (4,604\u201310,002),\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.004]. A plasma d-Synd-1 cutoff of 9,419.7\u2005pg\/mL predicted EAD [AUC\u2009=\u20090.81, 95% confidence interval (95% CI) (0.65\u20130.97); sensitivity 83%; specificity 74%, positive predictive value\u2009=\u200967%, negative predictive value\u2009=\u200988%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&amp;lt;\u20090.05]. d-Synd-1 \u22659,419.7\u2005pg\/mL was associated with severe post-LT complications (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.007).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>d-Synd-1 levels in graft effluent during procurement may serve as a predictor of early allograft dysfunction. Strategies aimed at protecting the endothelial during procurement could improve graft outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/frtra.2025.1662187","type":"journal-article","created":{"date-parts":[[2025,11,25]],"date-time":"2025-11-25T13:52:11Z","timestamp":1764078731000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Glycocalyx kinetics and injury during liver procurement and transplantation as predictors of early graft dysfunction"],"prefix":"10.3389","volume":"4","author":[{"given":"Nassiba","family":"Beghdadi","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexis","family":"Texier","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marc Antoine","family":"Allard","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mylene","family":"Sebagh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nour","family":"Bousaleh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haitham","family":"Triki","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Pietrasz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicolas","family":"Cabrit","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicolas","family":"Golse","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ren\u00e9","family":"Adam","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cyrille","family":"Feray","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter J.","family":"Lenting","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"St\u00e9phanie","family":"Roullet","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Azoulay","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,11,25]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"38","DOI":"10.1002\/lt.23990","article-title":"A score model for the continuous grading of early allograft dysfunction severity","volume":"21","author":"Pareja","year":"2015","journal-title":"Liver Transpl"},{"key":"B2","doi-asserted-by":"publisher","first-page":"198","DOI":"10.1093\/cvr\/cvq062","article-title":"Microvascular fluid exchange and the revised starling principle","volume":"87","author":"Levick","year":"2010","journal-title":"Cardiovasc Res"},{"key":"B3","doi-asserted-by":"crossref","DOI":"10.4199\/C00025ED1V01Y201101ISP013","volume-title":"Regulation of Endothelial Barrier Function","author":"Yuan","year":"2011"},{"key":"B4","doi-asserted-by":"publisher","first-page":"559","DOI":"10.1093\/cvr\/cvx044","article-title":"Layer upon layer: the functional consequences of disrupting the glycocalyx-endothelial barrier in vivo and in vitro","volume":"113","author":"Curry","year":"2017","journal-title":"Cardiovasc Res"},{"key":"B5","doi-asserted-by":"publisher","first-page":"500","DOI":"10.1016\/0167-5699(93)90265-M","article-title":"Role of heparan sulfate in immune system-blood vessel interactions","volume":"14","author":"Ihrcke","year":"1993","journal-title":"Immunol Today"},{"key":"B6","doi-asserted-by":"publisher","first-page":"653","DOI":"10.1007\/s004240000307","article-title":"The endothelial surface layer","volume":"440","author":"Pries","year":"2000","journal-title":"Pflugers Arch"},{"key":"B7","doi-asserted-by":"publisher","first-page":"H2287","DOI":"10.1152\/ajpheart.00808.2003","article-title":"Effect of glycocalyx on shear-dependent albumin uptake in endothelial cells","volume":"287","author":"Ueda","year":"2004","journal-title":"Am J Physiol Heart Circ Physiol"},{"key":"B8","doi-asserted-by":"publisher","first-page":"31","DOI":"10.1016\/j.molmed.2012.10.010","article-title":"Orchestral actions of angiopoietin-1 in vascular regeneration","volume":"19","author":"Koh","year":"2013","journal-title":"Trends Mol Med"},{"key":"B9","doi-asserted-by":"publisher","first-page":"838","DOI":"10.3389\/fimmu.2018.00838","article-title":"Endothelial activation: the Ang\/Tie axis in sepsis","volume":"9","author":"Leligdowicz","year":"2018","journal-title":"Front Immunol"},{"key":"B10","doi-asserted-by":"publisher","first-page":"387","DOI":"10.14670\/HH-25.387","article-title":"Angiopoietin-1\/Tie2 receptor signaling in vascular quiescence and angiogenesis","volume":"25","author":"Fukuhara","year":"2010","journal-title":"Histol Histopathol"},{"key":"B11","doi-asserted-by":"publisher","first-page":"1096","DOI":"10.1111\/ajt.12672","article-title":"Angiopoietin-2 inhibition prevents transplant ischemia-reperfusion injury and chronic rejection in rat cardiac allografts","volume":"14","author":"Syrjala","year":"2014","journal-title":"Am J Transplant"},{"key":"B12","doi-asserted-by":"publisher","first-page":"432","DOI":"10.1097\/MOH.0000000000000361","article-title":"Angiopoietins and Tie2 in vascular inflammation","volume":"24","author":"Parikh","year":"2017","journal-title":"Curr Opin Hematol"},{"key":"B13","doi-asserted-by":"publisher","first-page":"1217","DOI":"10.1038\/nm.2843","article-title":"The pulmonary endothelial glycocalyx regulates neutrophil adhesion and lung injury during experimental sepsis","volume":"18","author":"Schmidt","year":"2012","journal-title":"Nat Med"},{"key":"B14","doi-asserted-by":"publisher","first-page":"H1672","DOI":"10.1152\/ajpheart.00832.2003","article-title":"Inflammation-and ischemia-induced shedding of venular glycocalyx","volume":"286","author":"Mulivor","year":"2004","journal-title":"Am J Physiol Heart Circ Physiol"},{"key":"B15","doi-asserted-by":"publisher","first-page":"1896","DOI":"10.1161\/CIRCULATIONAHA.106.684852","article-title":"Shedding of the endothelial glycocalyx in patients undergoing major vascular surgery with global and regional ischemia","volume":"116","author":"Rehm","year":"2007","journal-title":"Circulation"},{"key":"B16","doi-asserted-by":"publisher","first-page":"1445","DOI":"10.1016\/j.jtcvs.2008.07.063","article-title":"Shedding of the endothelial glycocalyx during cardiac surgery: on-pump versus off-pump coronary artery bypass graft surgery","volume":"138","author":"Bruegger","year":"2009","journal-title":"J Thorac Cardiovasc Surg"},{"key":"B17","doi-asserted-by":"publisher","first-page":"e96477","DOI":"10.1371\/journal.pone.0096477","article-title":"Deeper penetration of erythrocytes into the endothelial glycocalyx is associated with impaired microvascular perfusion","volume":"9","author":"Lee","year":"2014","journal-title":"PLoS One"},{"key":"B18","doi-asserted-by":"publisher","first-page":"1289","DOI":"10.1213\/ANE.0b013e318210385c","article-title":"Plasma restoration of endothelial glycocalyx in a rodent model of hemorrhagic shock","volume":"112","author":"Kozar","year":"2011","journal-title":"Anesth Analg"},{"key":"B19","doi-asserted-by":"publisher","first-page":"759","DOI":"10.1097\/TA.0b013e3182a92514","article-title":"Evaluation of resuscitation fluids on endothelial glycocalyx, venular blood flow, and coagulation function after hemorrhagic shock in rats","volume":"75","author":"Torres","year":"2013","journal-title":"J Trauma Acute Care Surg"},{"key":"B20","doi-asserted-by":"publisher","first-page":"745","DOI":"10.1097\/SLA.0b013e3182365081","article-title":"Are there better guidelines for allocation in liver transplantation? A novel score targeting justice and utility in the model for end-stage liver disease era","volume":"254","author":"Dutkowski","year":"2011","journal-title":"Ann Surg"},{"key":"B21","doi-asserted-by":"publisher","first-page":"e2039","DOI":"10.1590\/0100-6991e-20192039","article-title":"Primary liver graft dysfunction and non-function: integrative literature review","volume":"46","author":"Salviano","year":"2019","journal-title":"Rev Col Bras Cir"},{"key":"B22","doi-asserted-by":"publisher","first-page":"205","DOI":"10.1097\/01.sla.0000133083.54934.ae","article-title":"Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey","volume":"240","author":"Dindo","year":"2004","journal-title":"Ann Surg"},{"key":"B23","doi-asserted-by":"publisher","first-page":"72","DOI":"10.1097\/TP.0000000000002838","article-title":"Glycocalyx damage within human liver grafts correlates with graft injury and postoperative graft function after orthotopic liver transplantation","volume":"104","author":"Schiefer","year":"2020","journal-title":"Transplantation"},{"key":"B24","doi-asserted-by":"publisher","first-page":"348","DOI":"10.3390\/ijms19020348","article-title":"Cytoprotective mechanisms in fatty liver preservation against cold ischemia injury: a comparison between IGL-1 and HTK","volume":"19","author":"Panisello-Rosello","year":"2018","journal-title":"Int J Mol Sci"},{"key":"B25","doi-asserted-by":"publisher","first-page":"2118","DOI":"10.1097\/TP.0000000000000680","article-title":"Alterations of endothelial glycocalyx during orthotopic liver transplantation in patients with End-stage liver disease","volume":"99","author":"Schiefer","year":"2015","journal-title":"Transplantation"},{"key":"B26","doi-asserted-by":"publisher","first-page":"e0221010","DOI":"10.1371\/journal.pone.0221010","article-title":"Graft glycocalyx degradation in human liver transplantation","volume":"14","author":"Passov","year":"2019","journal-title":"PLoS One"},{"key":"B27","doi-asserted-by":"publisher","first-page":"F1134","DOI":"10.1152\/ajprenal.00158.2010","article-title":"Acute ischemic injury to the renal microvasculature in human kidney transplantation","volume":"299","author":"Snoeijs","year":"2010","journal-title":"Am J Physiol Renal Physiol"},{"key":"B28","doi-asserted-by":"publisher","first-page":"1541","DOI":"10.1161\/01.ATV.0000085630.24353.3D","article-title":"Endothelial cell glycocalyx modulates immobilization of leukocytes at the endothelial surface","volume":"23","author":"Constantinescu","year":"2003","journal-title":"Arterioscler Thromb Vasc Biol"},{"key":"B29","doi-asserted-by":"publisher","first-page":"e0186116","DOI":"10.1371\/journal.pone.0186116","article-title":"Regeneration of glycocalyx by heparan sulfate and sphingosine 1-phosphate restores inter-endothelial communication","volume":"12","author":"Mensah","year":"2017","journal-title":"PLoS One"},{"key":"B30","doi-asserted-by":"publisher","first-page":"590","DOI":"10.1111\/aas.13797","article-title":"Human glycocalyx shedding: systematic review and critical appraisal","volume":"65","author":"Hahn","year":"2021","journal-title":"Acta Anaesthesiol Scand"},{"key":"B31","doi-asserted-by":"publisher","first-page":"H2815","DOI":"10.1152\/ajpheart.2000.279.6.H2815","article-title":"TNF-alpha increases entry of macromolecules into luminal endothelial cell glycocalyx","volume":"279","author":"Henry","year":"2000","journal-title":"Am J Physiol Heart Circ Physiol"},{"key":"B32","doi-asserted-by":"publisher","first-page":"296","DOI":"10.1016\/j.atherosclerosis.2008.03.024","article-title":"Tumor necrosis factor-alpha inhibition protects against endotoxin-induced endothelial glycocalyx perturbation","volume":"202","author":"Nieuwdorp","year":"2009","journal-title":"Atherosclerosis"},{"key":"B33","doi-asserted-by":"publisher","first-page":"3019","DOI":"10.1016\/j.transproceed.2003.10.006","article-title":"Perioperative cytokines during orthotopic liver transplantation without venovenous bypass","volume":"35","author":"Faybik","year":"2003","journal-title":"Transplant Proc"},{"key":"B34","doi-asserted-by":"publisher","first-page":"281","DOI":"10.1016\/j.cytogfr.2014.10.013","article-title":"The angiopoietin\/TIE receptor system: focusing its role for ischemia-reperfusion injury","volume":"26","author":"Hilbert","year":"2015","journal-title":"Cytokine Growth Factor Rev"},{"key":"B35","doi-asserted-by":"publisher","first-page":"586","DOI":"10.1161\/01.RES.0000066881.04116.45","article-title":"Tie-ing the antiinflammatory effect of angiopoietin-1 to inhibition of NF-kappaB","volume":"92","author":"Jeon","year":"2003","journal-title":"Circ Res"},{"key":"B36","doi-asserted-by":"publisher","first-page":"115","DOI":"10.1016\/j.cardiores.2004.05.013","article-title":"Reciprocal regulation of angiopoietin-1 and angiopoietin-2 following myocardial infarction in the rat","volume":"64","author":"Sandhu","year":"2004","journal-title":"Cardiovasc Res"},{"key":"B37","doi-asserted-by":"publisher","first-page":"F901","DOI":"10.1152\/ajprenal.00542.2012","article-title":"Renal ischemia-reperfusion induces a dysbalance of angiopoietins, accompanied by proliferation of pericytes and fibrosis","volume":"305","author":"Khairoun","year":"2013","journal-title":"Am J Physiol Renal Physiol"},{"key":"B38","doi-asserted-by":"publisher","first-page":"309","DOI":"10.14744\/AnatolJCardiol.2017.8003","article-title":"The effects of steroids on endothelial function","volume":"18","author":"Gokalp","year":"2017","journal-title":"Anatol J Cardiol"},{"key":"B39","doi-asserted-by":"publisher","first-page":"694312","DOI":"10.1155\/2014\/694312","article-title":"Modulation of endothelial glycocalyx structure under inflammatory conditions","volume":"2014","author":"Kolarova","year":"2014","journal-title":"Mediators Inflamm"}],"container-title":["Frontiers in Transplantation"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/frtra.2025.1662187\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,11,25]],"date-time":"2025-11-25T13:52:12Z","timestamp":1764078732000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/frtra.2025.1662187\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,11,25]]},"references-count":39,"alternative-id":["10.3389\/frtra.2025.1662187"],"URL":"https:\/\/doi.org\/10.3389\/frtra.2025.1662187","relation":{},"ISSN":["2813-2440"],"issn-type":[{"value":"2813-2440","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,11,25]]},"article-number":"1662187"}}