Ivo Giovannini, Carlo Chiarla, Felice Giuliante, Maria Vellone, Francesco Ardito, Gerardo Sarno, Gennaro Nuzzo
Analysis of the components of hypertransaminasemia after liver resection
Background: The increase in plasma aspartate (AST) and alanine (ALT) aminotransferase after liver resection is multifactorial, and a major problem is the difficult quantification of the impact of each factor involved.
Methods: Regression analysis of a large series of measurements for 92 hepatectomy patients was carried out to assess in detail the postoperative evolution of AST and ALT, together with related components.
Results: The best correlate of increased AST and ALT on postoperative day 1 was the duration of surgery (T-surg) (r2=0.31 and 0.29), with a lower correlation for intraoperative liver ischemia (T-isch) (r2=0.22 and 0.17, respectively; p<0.001 for all). Subsequently AST decreased more quickly than ALT and both followed an inverse exponential pattern. T-surg, T-isch, time after surgery and plasma bilirubin explained 77% and 51% of the variability of AST and ALT, respectively, for all postoperative measurements (p<0.001 for both). The best correlate of T-isch was a delayed increase in bilirubin, detected on postoperative day 7, attenuated by the use of intermittent liver ischemia.
Conclusions: These data show that T-isch may not be the main determinant of increased transaminases after hepatectomy, and provide a quantitative analysis of the main impact of the trauma of liver resection, liver ischemia, and other factors on the postoperative evolution of transaminases.
Clin Chem Lab Med 2007;45:357–60.
Clinical Chemical Laboratory Medicine, Walter de Gruyter
Print ISSN: 1434-6621
Volume: 45, 03/2007
Pages: 357 - 360
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