Early dynamic changes of liver function and its prognostic implications after hepatic transplantation

OBJECTIVE: To detect the rule of hepatocyte-function change with 1 week following liver transplantation and to select useful parameter to forecast prognosis, we investigated the function of hepatocytes dynamically of patients within 1 week following surgery. METHODS: A retrospective study was undertaken. Data was collected form 149 patients in our hospital from December 1994 to August 2003. AST, ALT, total bilirubin (TB), direct bilirubin (DB), prothrombin time (PT), activated partial thromboplastin time (APTT) and fibrinogen (FIB) were examined in the day before operation, 1, 3 and 7 d following surgery. RESULTS: Single peak of all values occurred with 1 week in patients who lived more than 1 month following surgery. The level of FIB, PT and APTT, AST and ALT descended to normal level in 1, 3 and 7 d after liver transplantation respectively. However, double peaks of bilirubin and altered peak of APTT and PT were observed in patients lived less than 1 month after surgery. Furthermore, descents of these values were delayed. Compared with the reversion of patients received classic liver transplantation, that of patients who received piggy back-on liver transplantation showed a slow recovery trend in earlier period after surgery. However, at 7 d following surgery, both can went near to normal level. The level of AST 7 d, DB 1 d and 3 d, PT 1 d following surgery and TB were related closely to the prognosis of patients who underwent liver transplantation. CONCLUSIONS: The levels of ALT, AST, TB, DB, PT, APTT and FIB become normal on the whole within 1 week after liver transplantation. During this period, Single peak of all values occur. Alteration of the hump indicated the occurrence of complications. The shape of hepatic function hump and the level of AST, DB and PT and TB postoperation were useful value to forecast prognosis.