TIMP-2: A Predictor of Early Allograft Dysfunction in Liver Transplantation

According to a new article in the European Journal of Medical Research, TIMP-2 measured in liver graft perfusate strongly predicts early allograft dysfunction (EAD) after transplantation — a finding with potential to change immediate postoperative monitoring and intervention thresholds.

In a targeted perfusate-based cohort of extended-criteria donor livers subjected to 90 minutes of ex vivo machine perfusion, the researchers used ROC analysis to evaluate performance for the primary endpoint of early allograft dysfunction (EAD). At a cutoff of 2,106 pg/ml, sensitivity was 1.00 and specificity 0.94, yielding an AUC consistent with strong discrimination in this cohort.

Measuring TIMP-2 intraoperatively or at end-of-perfusion could serve as a practical trigger to escalate graft surveillance. Flagged grafts could be routed to intensified monitoring, earlier imaging, or proactive hemodynamic and coagulopathy management by surgical and ICU teams. A point-of-care assay with rapid turnaround would make perioperative decision-making feasible; in similar settings this may enable earlier detection and intervention with short-term clinical benefit.