PMID: 8445227Feb 1, 1993Paper

Serum bile acids and esterified bilirubin in early detection and differential diagnosis of hepatic dysfunction following orthotopic liver transplantation

Journal of Hepatology
M MuracaR Pichlmayr

Abstract

Routine laboratory tests are of little help for early detection and differential diagnosis of hepatic dysfunction following orthotopic liver transplantation (OLT). In the present study, serum levels of esterified bilirubin, total bilirubin and bile acids were investigated in 20 patients after OLT. Twenty episodes of liver dysfunction were observed: 10 rejection episodes, 3 cases of thrombosis of the hepatic artery, 3 cases of septic shock, and 4 episodes of cyclosporin toxicity. During rejection, the median increase in esterified bilirubin was 3.2-fold (range 1.6-24.9), while total bilirubin increased 1.5-fold (range 0.7-3.4). Bile acids increased 3.6-fold (range 2.5-6.6; peak levels 25-87 microM). Both bile acids and esterified bilirubin increased 1-3 days earlier than serum transaminases and decreased only after successful anti-rejection treatment. The response of bile acids to successful treatment was usually more rapid than the response of esterified bilirubin. Hepatic artery thrombosis and septic shock were associated with a sharp increase in esterified bilirubin and very high bile acid levels (peak levels 80-185 microM). During cyclosporin toxicity, a characteristic pattern of progressively increasing bilirubin with no ch...Continue Reading

References

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Citations

Jul 1, 1983·World Journal of Surgery·H BismuthG Mazmanian
Jun 27, 2003·Transplantation Proceedings·M MabuchiS Mutoh
Jan 22, 2003·Journal of Chromatography. B, Analytical Technologies in the Biomedical and Life Sciences·V P TripodiC N Carducci
Sep 21, 2000·Journal of Pediatric Gastroenterology and Nutrition·P VajroM Muraca
Jun 13, 1998·Transplantation·H Vilca MelendezN Heaton
Dec 1, 1994·Hepatology : Official Journal of the American Association for the Study of Liver Diseases·S A AzerN H Stacey
May 5, 2011·Liver Transplantation : Official Publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society·Ken ShirabeYoshihiko Maehara
Jun 9, 2020·Liver Transplantation : Official Publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society·Taisa J KohutBrendan J Keating
Feb 23, 2021·Biochemical and Biophysical Research Communications·Chengyu ZhangZhimin He

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