engleski

Biochemical monitoring after liver transplantation

In the early post-liver transplantation period laboratory tests form an essential part of the routine monitoring protocol.The purpose of this study is to present our experience in the biochemical monitoring using particularly those tests that are of diagnostic value in assessing graft function, for 23 liver-transplant patients in the Surgical Clinic, Department for Organ Transplantation, University Hospital "Merkur", Zagreb, Croatia, for the period from 1998. to 2001. The patients were intensively laboratory monitored to detect the early development of possible complications by serial measurement of alanin aminotransferase (ALT), aspartat aminotransferase (AST), gamma-glutamyltransferase (GGT), alkaline phosphatase (ALP), pseudocholinesterase (ChE), C-reactive protein, total bilirubin, total cholesterol, albumin concentrations and prothrombin time (PT) on 1, 3, 5, 10, 15, 20, 25, 30 post-transplant days. Patients were devided into two groups according to the post operative clinical and laboratory findings: those with evidence and those without evidence of hepatic dysfunction. Early produced health associated reference values for liver function tests for the Croatian population together with reference ranges established for post-orthotopic liver transplantation patients without evidence of liver graft dysfunction were compared with test results of patients with complications.Our results showed that the pathological concentrations of total bilirubin, CHS and PT were associated with primary non- function, high ALT activities with acute rejection and high enzyme activities of GGT and ALP, as a biliary markers, with cholestasis and diagnosis of developing rejection.According to those results, the optimal choice and judicious use of cost- effective and routinely performed biochemical liver function tests could support clinical decisionmaking and be efficient marker of hepatocellular damage associated with acute liver graft dysfunction or rejection.

post-liver transplantation; hepatocellular damage; biochemical monitoring

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