Liver Function Tests and Physiological Features of Liver Failure

Despite numerous studies in the past it is not possible yet to predict postoperative liver failure and safe limits for hepatectomy. In this study the following liver function tests ICG-ER (indocyaninegreen elimination rate), GEC (galactose elimination capacity) and MEGX-F (monoethylglycinexylidid formation) are examined with regard to loss of liver tissue and prediction of operative risk. Liver function tests were assessed in 20 patients prior to liver resection and on the 10th. postoperative day. Liver and tumor volume were measured by ultrasound and pathologic specimen and the parenchymal resection rate was calculated. In patients without cirrhosis (n = 10) ICG-ER and MEGX-F remained unchanged after resection, GEC was reduced but did not correspond to the resection rate. Patients with cirrhosis (n = 10) had a significantly lower ICG-ER and GEC before resection than patients without cirrhosis. After resection these tests were unchanged. Patients with liver related complications and cirrhosis (n = 5) had lower ICG-ER and GEC than patients with cirrhosis and no complications. In the postoperative course all liver function tests in these patients were significantly lower compared to preoperative results. Comparing liver function tests ICG serves best to indicate postoperative liver failure. Liver function tests do not correspond with loss of liver tissue.

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Alpha-1-Antitrypsin in Liver Disease

Annals of Clinical Biochemistry International Journal of Laboratory Medicine ◽

10.1177/000456328902600205 ◽

1989 ◽

Vol 26 (2) ◽

pp. 122-124 ◽

Cited By ~ 1

Author(s):

David Deam ◽

Keith Byron ◽

Sujiva Ratnaike

Keyword(s):

Liver Disease ◽

Liver Function ◽

Liver Failure ◽

Liver Diseases ◽

Liver Function Tests ◽

Function Tests ◽

Low Levels ◽

Alpha 1 Antitrypsin

Low alpha-1 -antitrypsin (AAT) levels are known to be associated with liver disease. As AAT is also synthesised in the liver, we investigated whether liver disease itself may result in low AAT levels. AAT was measured in plasma from 100 patients with various liver diseases including hepatitis, cirrhosis, jaundice and liver failure. Twenty-eight patients had increased AAT values (greater than 3·;1 g/L), 70 had normal AAT values (between 1·;5 and 3·;1 g/L) and 2 had decreased AAT levels (< 1·;5 g/L). The 2 patients with low AAT levels were found to be of the PiMZ phenotype. There was no significant correlation between any of the standard ‘liver function tests' and the AAT level. Our findings suggest that in liver disease AAT levels are usually normal or increased. Low levels are uncommon and the possibility of an abnormal AAT phenotype being associated with the liver disease should be examined.

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