Effect of cold ischemia time on early graft function and acute rejection after liver transplantation / 器官移植

Objective To evaluate the effect of different cold ischemia time (CIT) on early graft function and acute rejection (AR) after liver transplantation. Methods Clinical data of 218 donors and recipients undergoing liver transplantation were collected and analyzed. All patients were divided into three groups according to the CIT of donor liver: group A (CIT≤6 h, n=60), group B (6 h < CIT≤10 h, n=89) and group C (CIT > 10 h, n=69). Blood samples were collected on the 1, 7 and 14 d after liver transplantation. The changes of alanine aminotransferase (ALT), aspartate aminotransferase (AST), lactate dehydrogenase (LDH) and adenosine triphosphate (ATP) in CD4+T cells were detected. The incidence of AR and the positive rate of C4d deposition were analyzed. Results The ALT, AST and LDH levels in each group reached the peak on the 1 d after operation, and then gradually decreased. The indexes in each group were almost equivalent on the 14 d. An interaction effect existed between postoperative time and group. After liver transplantation, ATP levels in CD4+T cells were gradually increased in each group, peaked at postoperative 7 d, and then decreased gradually. An interaction effect was noted between postoperative time and group. The incidence of AR in groups A, B and C was 10%, 12% and 28%. Compared with group C, the incidence of AR in groups A and B was decreased significantly (both P < 0.05/3). The positive rate of C4d deposition in AR recipients of groups A, B and C was 1/3, 45% and 89% respectively. Compared with group C, the positive rate of C4d deposition in group A was decreased significantly (P=0.015). Conclusions The prolongation of CIT may lead to aggravation of early-stage liver function injury after liver transplantation, which is more easily to induce humoral AR.

Study of Liver Function Test in Perinatal Asphyxia at a Tertiary Care Center in Haryana

Background: Perinatal asphyxia is an insult to the fetus or newborn due to lack of oxygen (hypoxia) and /or a lack of perfusion (ischemia) to various organs. The diagnosis of perinatal asphyxia is mostly established retrospectively. But it is difficult to diagnose perinatal asphyxia retrospectively in the absence of perinatal records. As because of hypoxaemia, different organ systems of the body are affected in perinatal asphyxia, this study was done to assess the hepatic function in the cases of perinatal asphyxia which could prove useful in diagnosing perinatal asphyxia. Methods: The study included 25 asphyxiated neonates as cases and 25 healthy neonates as control group. Venous blood was analyzed between 2nd and 5th day of life to estimate serum alanine aminotransferase (ALT), aspartate aminotransferase (AST) and alkaline phosphatase (ALP), serum total bilirubin (STB), direct bilirubin (DSB) and prothrombin time (PT). Unpaired student’s ‘t’ test was used for data analysis and P value of <0.05 were considered significant. Results: Serum ALT and AST were found significantly higher in asphyxiated babies compared to reference  groups (p<0.001). The mean ALT and AST of asphyxiated babies were 100.17±35.50 and 84.13±44.49 U/L, respectively and those of normal babies were 30.25±9.49 U/L and 41.97±11.49 U/L respectively. Conclusions: Estimation of liver enzymes can prove helpful in diagnosing perinatal asphyxia in absence of birth details especially in developing country like India.

Effect of cigarette smoking on liver functions: a comparative study conducted among smokers and non-smokers male in El-beida City, Libya.

Tobacco use is widely spread throughout the world. The effect of smoking on human health are serious and in many cases, deadly. The present study was done to investigate the effect of cigarette smoking on some liver functions in male population in El-beida city, Libya. The study was carried out on thirty Libyan male smokers, who smoked at least 10 cigarettes per day for at least15 years. The group includes smokers with age range between 30-60 years. Non-smokers, (control, n= 30) group were collected with the same range of age for statistical comparison. The whole blood samples were drawn by venipuncture from each member and liver functions test were estimated by a kit method on automatic analyzer (Beckman BUN analyzer, USA). The results of the study revealed a significant increase of malondialdehyde (MDA), which is an indicator of lipid peroxidation and oxidative stress significantly increased in cigarette smokers in groups when compared with control group. While the plasma level of total protein, albumin and total bilirubin decreased during smoking. Cigarette smoking raised alkaline phosphatase (ALP), alanine aminotrans-ferase (ALT), aspartate aminotransferase (AST), plasma total cholesterol and triglycerides in smoker group when compared with non-smoker group. To conclude, cigarette smoking leads to oxidative stress by free radical generation by the mechanism of lipid peroxidation. Smoking exerts negative influence on liver functions test should be carefully interpreted, and further study on the mechanism of the effects is warranted.

Effect of cigarette smoking on liver functions: a comparative study conducted among smokers and non-smokers male in El-beida City, Libya.

Tobacco use is widely spread throughout the world. The effect of smoking on human health are serious and in many cases, deadly. The present study was done to investigate the effect of cigarette smoking on some liver functions in male population in El-beida city, Libya. The study was carried out on thirty Libyan male smokers, who smoked at least 10 cigarettes per day for at least15 years. The group includes smokers with age range between 30-60 years. Non-smokers, (control, n= 30) group were collected with the same range of age for statistical comparison. The whole blood samples were drawn by venipuncture from each member and liver functions test were estimated by a kit method on automatic analyzer (Beckman BUN analyzer, USA). The results of the study revealed a significant increase of malondialdehyde (MDA), which is an indicator of lipid peroxidation and oxidative stress significantly increased in cigarette smokers in groups when compared with control group. While the plasma level of total protein, albumin and total bilirubin decreased during smoking. Cigarette smoking raised alkaline phosphatase (ALP), alanine aminotrans-ferase (ALT), aspartate aminotransferase (AST), plasma total cholesterol and triglycerides in smoker group when compared with non-smoker group. To conclude, cigarette smoking leads to oxidative stress by free radical generation by the mechanism of lipid peroxidation. Smoking exerts negative influence on liver functions test should be carefully interpreted, and further study on the mechanism of the effects is warranted.

Adolescent obesity and the elevation of aminotransferase levels / 소아과

PURPOSE: The prevalence of obesity and nonalcoholic steatohepatitis(NASH) was increased in adolescents. This study was performed to observe the prevalence of elevated aminotransferase levels in adolescents and to assess the correlations between aminotransferase levels and obesity related parameters(body mass index, waist circumference, hip circumference, waist to hip ratio and insulin level). METHODS: We obtained weight, height, waist circumference and hip circumference from 2,417 male and 1,219 female adolescents. Mean age was 15.7+/-0.7 years old. We measured fasting insulin, aspartate aminotransferase(AST) and alanine aminotransferase(ALT). Obese and overweight were defined as body mass indices(BMI) of more than the 95th, and 85th-94th percentiles, respectively, for age and sex. RESULTS: The number of adolescents with obesity is 324(8.9 percent). 414(11.4 percent) subjects belonged to the overweight group. The average ALT level of obese, overweight and control groups were significantly different(obese : 32.1+/-34.3 U/L, overweight : 19.6+/-13.6 U/L, control : 12.7+/-6.7 U/L, P<0.001). The average AST level was also different according to group(obese : 27.8+/-16.5 U/L, overweight : 22.8+/-8.6 U/L, control : 20.8+/-8.5 U/L, P<0.001). AST and ALT were correlated with anthropometric parameters and insulin level. After multiple regression analysis, waist circumference was the significant predictive value for AST(r=0.234, P<0.001). Waist circumference, BMI and insulin levels were significant predictive values for ALT(r=0.435, P<0.001). CONCLUSION: The prevalence of abnormal aminotransferase was higher in the obese and overweight groups than control group. Waist circumference was useful to predict abnormal aminotransferase le

Therapeutic effect of Swertia Mussotii Franch on immunological liver injury in mice / 西安交通大学学报(医学版)

Objective To observe the therapeutic effect of Swertia mussotii Franch is extracted by alcohol on immunological liver injury in mice,and further evaluate its immun-regulating effect in decreasing aminotransferase and protecting heptocytes. Methods BCG vaccine and lipopolysaccharide were intravenously injected to establish liver injury model.The effects of Swertia mussotii Franch on liver injury were contrasted. Results The high-,medium-and low-dose Swertia mussotii Franch groups which had been administered for 10 consecutive days,had significantly inhibited serum ALT and AST acticities of immunological liver injury;Swertia mussotii Franch could effectively prevent immunological liver injury by BCG+LPS. Conclusion Swertia mussotii Franch can protect mice from immunological liver injury and protect the function of liver.

Cerebrospinal Fluid Aspartate Aminotransferase in Alzheimer Disease and Vascular Dementia

BACKGROUND: To evaluate usefulness of cerebrospinal aspartate aminotransferase(AST) as a biologic marker for differentiation of Alzheimer's disease(AD) and Vascular dementia(VD) METHODS: A consecutive series of patients who met either the criteria of the National Institute of Neurological Disorders and Stroke and the Alzheimer's Disease and Related Disorders Association(NINCDSADRDA) for probable AD or National Institute of Neurological Disorders and Stroke and the Association Internationale pour la Recherche et l'Enseignement en Neurosciences(NINDS-AIREN) criteria for porbable VD were included in the study. Enzymatic determinations in cere brospinal fluid of aspartate aminotransferase in cerebrospinal fluid of aspartate aminotransferase and serologic analysis of apolipoprotein E were performed in 17 patients with AD and in 15 patients with VD. And we compared CSF AST of AD with that of VD. RESULTS: We found no difference of CSF AST concentration between patients with Alzheimer's disease and vascular dementia. Cerebrospinal AST activity also did not correlate with K-MMSE score, serum AST activity, Functional inde-pence measure(FIM) as a ADL(Activity of daily living), and presence of Apolipoprotein E4 allele in AD. Only serum AST of VD shows correlation with CSF AST. CONCLUSION: These findings suggest that cerebrospinal AST concentration is not useful maker for differentiation between AD and VD.

An Isolated AST Elevation due to Macroenzyme Formation / 대한간학회지

Serum aspartate aminotransferase (AST) is a common enzyme for the evaluation of the hepatic, muscular and cardiac diseases and is produced also at kidney, brain, pancreas, lung, leukocytes, erythrocytes, etc. The elevation of its activity is usually caused by the necrosis of hepatocytes when there are not muscular injuries or myopathies. Recently, it is found that AST can exist as a macroenzyme by forming a complex with an immunoglobulin and this complex is erroneously considered to indicate the presence of liver disease as a result of elevation of AST activity on routine blood chemistry analysis. We experienced the patient with isolated AST elevation due to the formation of AST-mmunoglobulin complex confirmed by AST isoenzyme electrophoresis (EP).