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Plasma bilirubin correlations in non-obstructive cholestasis after partial hepatectomy

  • Carlo Chiarla , Ivo Giovannini , Felice Giuliante , Maria Vellone , Francesco Ardito , Antonio Masi and Gennaro Nuzzo
Published/Copyright: November 1, 2008
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Clinical Chemistry and Laboratory Medicine
From the journal Clinical Chemistry and Laboratory Medicine Volume 46 Issue 11

Abstract

Background: The aim of this study was to provide an improved outline of the patterns and correlates of changes in plasma bilirubin after partial hepatectomy.

Methods: A large series of blood measurements and complementary variables were prospectively collected from 85 patients undergoing liver resection, and bilirubin correlations were assessed by regression analysis.

Results: Early postoperatively, the best simultaneous correlates of increasing bilirubin were the preoperative value, the duration of surgery, and the number of blood transfusions (r2=0.74, p<0.001). Subsequently, increasing bilirubin became related to the number of resected liver segments, the duration of intraoperative liver ischemia, the use of continuous vs. intermittent ischemia, and the presence of sepsis (r2=0.82, p<0.001); these were also the best simultaneous correlates of peak bilirubin. This pattern was characterized by prominently conjugated hyperbilirubinemia, hypocholesterolemia, and moderately increased alkaline phosphatase, and occurred in the absence of obstructive cholestasis.

Conclusions: Major hepatectomy, parenchymal ischemia, and sepsis have similar and synergistic impacts as determinants of prominently conjugated hyperbilirubinemia after liver resection. This is likely related to impaired hepatocellular bilirubin transport and occurs in the absence of obstructive components.

Clin Chem Lab Med 2008;46:1598–601.

Keywords: liver dysfunction; liver ischemia; liver resection; plasma bilirubin; sepsis
Corresponding author: Ivo Giovannini, Department of Surgery, Hepatobiliary Unit, Catholic University, Largo Agostino Gemelli 8, 00168 Rome, Italy Phone: +39-06-3015-4082/+39-06-3015-4967, Fax: +39-06-305-1343
Received: 2008-5-31
Accepted: 2008-8-1
Published Online: 2008-11-01
Published in Print: 2008-11-01

©2008 by Walter de Gruyter Berlin New York

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https://doi.org/10.1515/CCLM.2008.321
Keywords for this article
liver dysfunction; liver ischemia; liver resection; plasma bilirubin; sepsis

Articles in the same Issue

  1. Editorial
  2. Biochemical markers in clinical cardiology: perspectives from present to future. 1st IFCC-Ortho Clinical Diagnostics Conference on Clinical Diagnosis and the Clinical Laboratory
  3. Highlight: Cardiovascular Biomarkers
  4. Reviews
  5. The clinical impact of the universal diagnosis of myocardial infarction
  6. Troponin revisited 2008: assay performance
  7. Standardization of troponin I measurements: an update
  8. Biochemistry of B-type natriuretic peptide – where are we now?
  9. Clinical relevance of non-cardiac determinants of natriuretic peptide levels
  10. What is the value of B-type natriuretic peptide testing for diagnosis, prognosis or monitoring of critically ill adult patients in intensive care?
  11. Natriuretic peptide testing in primary care patients
  12. Natriuretic peptide testing in emergency settings
  13. Minireviews
  14. Oxidative stress, free radicals and bone remodeling
  15. Plasma homocysteine and vascular disease in elderly patients with mental illness
  16. Opinion Papers
  17. Fate of abstracts presented at the 2002 IFCC meeting
  18. Transition from congress abstract to full paper: the case of a national Argentinean congress in clinical laboratory
  19. Genetics and Molecular Diagnostics
  20. Association of endothelin-1 gene polymorphisms with variant angina in Korean patients
  21. Single nucleotide polymorphisms in ABCG5 and ABCG8 genes in Chilean subjects with polygenic hypercholesterolemia and controls
  22. Paternal exclusion: allele sharing in microsatellite testing
  23. General Clinical Chemistry
  24. Rapid sample preparation and simultaneous quantitation of prostaglandins and lipoxygenase derived fatty acid metabolites by liquid chromatography-mass spectrometry from small sample volumes
  25. Plasma bilirubin correlations in non-obstructive cholestasis after partial hepatectomy
  26. Aggregation of lipoprotein and inflammatory parameters in families with a history of premature myocardial infarction: the Tallinn Myocardial Infarction Study
  27. Significant elevation of a Th2 cytokine, interleukin-10, in pelvic inflammatory disease
  28. Hemoglobin A1c determination in the A1C-Derived Average Glucose (ADAG) study
  29. The effect of the mode of delivery on maternal-neonatal interleukin-6, biogenic amine and their precursor amino acid concentrations
  30. A rapid liquid chromatography-tandem mass spectrometry analysis of whole blood sirolimus using turbulent flow technology for online extraction
  31. Validation and Outcome Studies
  32. Benefits of the iQ200 automated urine microscopy analyser in routine urinalysis
  33. Electrochemical detection of blood alcohol concentration using a disposable biosensor based on screen-printed electrode modified with Nafion and gold nanoparticles
  34. About the z-multiplier in total error calculations
  35. Letters to the Editor
  36. A hypothyroid patient with increased free thyroid hormones
  37. Evaluation of blood collection tubes specific for homocysteine measurement
  38. Influence of assay-dependent variability of serum insulin levels on insulin sensitivity indices
  39. Frequency and type of preanalytical errors in a laboratory medicine department in India
  40. Sample dilution causes a positive bias on C-reactive protein using VITROS reagents, diluents and instruments – clinical implications?
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