Publication Name	World Journal of Gastrointestinal Surgery
Manuscript ID	114662
Country	Italy

Category	Transplantation
Manuscript Type	Minireviews
Article Title	Graft bile analysis for predicting post-transplant outcomes: A literature review and a protocol for a novel biomarker
Manuscript Source	Invited Manuscript
All Author List	Marco Maria Pascale, Jacopo Gervasoni, Giuseppe Bianco, Silvia Persichilli, Lorenzo Ferri, Aniello Primiano, Salvatore Agnes and Andrea Urbani
Funding Agency and Grant Number
Corresponding Author	Marco Maria Pascale, MD, General Surgery and Organ Transplant Unit, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 8 Largo A Gemelli, Rome 00168, Lazio, Italy. marcomaria.pascale@policlinicogemelli.it
Key Words	Bile; Biomarkers; Early allograft dysfunction; Tacrolimus; Protocol
Core Tip	Early detection of graft dysfunction and rejection after liver transplantation remains challenging. This minireview highlights bile as an organ-specific biofluid directly reflecting hepatocellular and cholangiocyte function. We summarize the biochemical, metabolic, and molecular components of bile as predictive markers of graft viability during machine perfusion and in the perioperative period. Building on these insights, we present a prospective protocol assessing biliary tacrolimus concentration and introducing the blood-bile ratio of tacrolimus as a novel index for early, non-invasive detection of rejection. Integrating bile biomarkers into transplant workflows may enable real-time, graft-specific monitoring and improve post-transplant outcomes.
Citation	Pascale MM, Gervasoni J, Bianco G, Persichilli S, Ferri L, Primiano A, Agnes S, Urbani A. Graft bile analysis for predicting post-transplant outcomes: A literature review and a protocol for a novel biomarker. World J Gastrointest Surg 2025; In press

Received	2025-09-25 02:57
Peer-Review Started	2025-09-25 02:57
First Decision by Editorial Office Director	2025-10-29 09:30
Return for Revision	2025-10-31 13:53
Revised	2025-11-15 16:24
Publication Fee Transferred
Second Decision by Editor	2025-12-24 02:34
Second Decision by Editor-in-Chief
Final Decision by Editorial Office Director	2025-12-24 09:41
Articles in Press	2025-12-24 09:41
Edit the Manuscript by Language Editor
Typeset the Manuscript

ISSN	1948-9366 (online)
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