Early profile and clinical significance of serum delta bilirubin after orthotopic liver transplantation / 中国微创外科杂志

ABSTRACT

Objective To investigate the early variations and clinical value of serum delta bilirubin after orthotopic liver transplantation. Methods Orthotopic liver transplantation was performed in 27 cases.Of them,10 cases were uneventful;8 patients suffered from acute rejection.According to the outcome,18 patients (including 10 uneventful cases and 8 cases with acute rejection) survived while other 9 died.Daily determination of serum delta bilirubin was examined in all patients. Results The changing patterns of serum delta bilirubin were different between uneventful patients and those with acute rejection.For those uneventful patients,?B% tended to increase after operation.On the 21st day after transplantation,it reached(37.5?11.2)%.To the contrary,after acute rejection occurred,?B% decreased from basal level(26.4?9.8)% to(20.2?12.7)%(n=8,t=2.12,P=0.07).Serum concentration of total bilirubin (TB) and conjugated bilirubin (CB) significantly increased after acute rejection arose.The difference between peak and basal level of TB and CB was (150.3?113.2)?mol/L(n=8)and(118.5?93.4)?mol/L(n=8)respectively(t=3.75,P=0.007;t=3.59,P=0.009).On the 14th day after operation,?B% in patients with good outcome(n=18) significantly higher than that in patients who died(n=9)(33.4%?12.2% vs 22.0%?10.0%,t=2.42,P=0.02).Conclusions Two weeks after operations,?B% is correlative to the outcome of the patients.But as for the diagnosis of the acute rejection,?B% shows no advantages over serum TB or CB.