Apolipoprotein A-1 as a Factor to Assess Recovery of the Liver Function after Hepatectomy and Liver Transplantation

ABSTRACT

PURPOSE: The aim of this study is to determine whether the serum apolipoprotein A1(apoA1) level, as measured at different time points after hepatectomy and liver transplantation, can predict the synthesis ability of the liver and the nutritional status. We also investigated the usefulness of regions of interest(ROIs) as an indicator of the recovery status of the liver after liver transplantation. METHODS: 93 patients (21 laparoscopic cholecystectomy, 53 partial hepatectomy, 19 liver transplantation) were operated on under general anesthesia. The serum levels of apoA1, prealbumin, albumin, aspartate aminotransferase and alanine aminotransferase and the prothrombin time were measured at pre- and post-operation. The liver conditions were a normal liver (50 cases), hepatitis (16 cases) and liver cirrhosis (28 cases). The mean hepatic attenuation was calculated by averaging the ROI values that were obtained at different hepatic segments. RESULTS: The serum apoA1 level was minimally changed during the perioperative period in the laparoscopic cholecystectomy group. Yet in most cases, the serum apoA1 level after partial hepatectomy and liver transplantation was decreased on postoperative days (PODs) 1 and 7, but it nearly recovered to the preoperative level on POD 30. There were significant differences in the values of apoA1 between the normal liver and co-existent liver disease at the various time points. The ROI value after transplantation gradually increased and it reached a normal level by POD 30. CONCLUSION: The serum apoA1 level can be an indicator of liver's ability to synthesize protein and the nutritional status after partial hepatectomy. In addition, ROIs of the unenhanced CT image can reflect the recovery status of the liver after transplantation.