Analysis of the components of hypertransaminasemia after liver resection
-
Ivo Giovannini
Abstract
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.
References
1. 1983 Metropolitan Height and Weight Tables. Statist Bull Metrop Life Insur Co 1984;64:2–8.Search in Google Scholar
2. Du Bois D, Du Bois EF. A formula to estimate the approximate surface area if height and weight be known. Arch Intern Med1916;17:863–71.10.1001/archinte.1916.00080130010002Search in Google Scholar
3. Djokovic JL, Hedley-White J. Prediction of outcome of surgery and anesthesia in patients over 80. J Am Med Assoc1979;242:2301–6.10.1001/jama.242.21.2301Search in Google Scholar
4. Nuzzo G, Giuliante F, Giovannini I, Vellone M, De Cosmo G, Capelli G. Liver resection with or without pedicle clamping. Am J Surg2001;181:238–46.10.1016/S0002-9610(01)00555-4Search in Google Scholar
5. Giovannini I, Chiarla C, Boldrini G, Castiglioni GC, Castagneto M. Calorimetric response to amino acid infusion in sepsis and critical illness. Crit Care Med1988;16:667–70.10.1097/00003246-198807000-00004Search in Google Scholar PubMed
6. Knaus WA, Draper EA, Wagner DP, Zimmerman JE. APACHE II: a severity of disease classification system. Crit Care Med1985;13:818–29.10.1097/00003246-198510000-00009Search in Google Scholar
7. Seber GA. Linear regression analysis. New York: Wiley, 1977.Search in Google Scholar
8. Clavien PA, Yadav S, Sindram D, Bentley RC. Protective effects of ischemic preconditioning for liver resection performed under inflow occlusion in humans. Ann Surg2000;232:155–62.10.1097/00000658-200008000-00001Search in Google Scholar PubMed PubMed Central
9. Nuzzo G, Giuliante F, Vellone M, De Cosmo G, Ardito F, Murazio M, et al. Pedicle clamping with ischemic preconditioning in liver resection. Liver Transplant2004;10 (Suppl 1):S53–7.10.1002/lt.20045Search in Google Scholar PubMed
©2007 by Walter de Gruyter Berlin New York
Articles in the same Issue
- From human genetic variations to prediction of risks and responses to drugs and the environment
- Nutrigenomics – 2006 update
- How to comprehensively analyse proteins and how this influences nutritional research
- Genotypes, obesity and type 2 diabetes – can genetic information motivate weight loss? A review
- The Gene-Diet Attica Investigation on childhood obesity (GENDAI): overview of the study design
- Polymorphisms in the APOA1/C3/A4/A5 gene cluster and cholesterol responsiveness to dietary change
- Nutri-epigenomics: lifelong remodelling of our epigenomes by nutritional and metabolic factors and beyond
- Emerging role of cathepsin S in obesity and its associated diseases
- Association analysis of hepatitis virus B infection with haplotypes of the TBX21 gene promoter region in the Chinese population
- Multiplex polymerase chain reaction on FTA cards vs. flow cytometry for B-lymphocyte clonality
- Real-time multiplex PCR assay for genotyping of three apolipoprotein E alleles and two choline acetyltransferase alleles with three hybridization probes
- Immunomagnetic CD45 depletion does not improve cytokeratin 20 RT-PCR in colorectal cancer
- Analysis of the components of hypertransaminasemia after liver resection
- Fine characterization of mitral valve glycosaminoglycans and their modification with degenerative disease
- Oxidative stress evaluated using an automated method for hydroperoxide estimation in patients with coronary artery disease
- Secretory phospholipase A2 activity and release kinetics of vascular tissue remodelling biomarkers after coronary artery bypass grafting with and without cardiopulmonary bypass
- Clustered components of the metabolic syndrome and platelet counts in Japanese females
- International Standard for serum vitamin B12 and serum folate: international collaborative study to evaluate a batch of lyophilised serum for B12 and folate content
- Multicentre physiological reference intervals for serum concentrations of immunoglobulins A, G and M, complement C3c and C4 measured with Tina-Quant® reagents systems
- In vivo and in vitro allergy diagnostics: it's time to reappraise the costs
- Experience with post-market surveillance of in-vitro diagnostic medical devices for lay use in Germany
- Evaluation of the high-sensitivity, full-range Olympus CRP OSR6199 application on the Olympus AU640®
- How to improve the teaching of urine microscopy
- In vitro determination of allergen-specific serum IgE. Comparative analysis of three methods
- Efficacy of a new blocker against anti-ruthenium antibody interference in the Elecsys free triiodothyronine assay
- Clinical indications for plasma protein assays: transthyretin (prealbumin) in inflammation and malnutrition: International Federation of Clinical Chemistry and Laboratory Medicine (IFCC): IFCC Scientific Division Committee on Plasma Proteins (C-PP)
- Meeting Report: From human genetic variations to prediction of risks and responses to drugs and the environment
Articles in the same Issue
- From human genetic variations to prediction of risks and responses to drugs and the environment
- Nutrigenomics – 2006 update
- How to comprehensively analyse proteins and how this influences nutritional research
- Genotypes, obesity and type 2 diabetes – can genetic information motivate weight loss? A review
- The Gene-Diet Attica Investigation on childhood obesity (GENDAI): overview of the study design
- Polymorphisms in the APOA1/C3/A4/A5 gene cluster and cholesterol responsiveness to dietary change
- Nutri-epigenomics: lifelong remodelling of our epigenomes by nutritional and metabolic factors and beyond
- Emerging role of cathepsin S in obesity and its associated diseases
- Association analysis of hepatitis virus B infection with haplotypes of the TBX21 gene promoter region in the Chinese population
- Multiplex polymerase chain reaction on FTA cards vs. flow cytometry for B-lymphocyte clonality
- Real-time multiplex PCR assay for genotyping of three apolipoprotein E alleles and two choline acetyltransferase alleles with three hybridization probes
- Immunomagnetic CD45 depletion does not improve cytokeratin 20 RT-PCR in colorectal cancer
- Analysis of the components of hypertransaminasemia after liver resection
- Fine characterization of mitral valve glycosaminoglycans and their modification with degenerative disease
- Oxidative stress evaluated using an automated method for hydroperoxide estimation in patients with coronary artery disease
- Secretory phospholipase A2 activity and release kinetics of vascular tissue remodelling biomarkers after coronary artery bypass grafting with and without cardiopulmonary bypass
- Clustered components of the metabolic syndrome and platelet counts in Japanese females
- International Standard for serum vitamin B12 and serum folate: international collaborative study to evaluate a batch of lyophilised serum for B12 and folate content
- Multicentre physiological reference intervals for serum concentrations of immunoglobulins A, G and M, complement C3c and C4 measured with Tina-Quant® reagents systems
- In vivo and in vitro allergy diagnostics: it's time to reappraise the costs
- Experience with post-market surveillance of in-vitro diagnostic medical devices for lay use in Germany
- Evaluation of the high-sensitivity, full-range Olympus CRP OSR6199 application on the Olympus AU640®
- How to improve the teaching of urine microscopy
- In vitro determination of allergen-specific serum IgE. Comparative analysis of three methods
- Efficacy of a new blocker against anti-ruthenium antibody interference in the Elecsys free triiodothyronine assay
- Clinical indications for plasma protein assays: transthyretin (prealbumin) in inflammation and malnutrition: International Federation of Clinical Chemistry and Laboratory Medicine (IFCC): IFCC Scientific Division Committee on Plasma Proteins (C-PP)
- Meeting Report: From human genetic variations to prediction of risks and responses to drugs and the environment
