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Postoperative day one serum alanine aminotransferase does not predict patient morbidity and mortality after elective liver resection in non-cirrhotic patients

Postoperative day one serum alanine aminotransferase does not predict patient morbidity and mortality after elective liver resection in non-cirrhotic patients
Postoperative day one serum alanine aminotransferase does not predict patient morbidity and mortality after elective liver resection in non-cirrhotic patients

Serum aminotransferases have been used as surrogate markers for liver ischemia-reperfusion injury that follows liver surgery. Some studies have suggested that rises in serum alanine aminotransferase (ALT) correlate with patient outcome after liver resection. We assessed whether postoperative day 1 (POD 1) ALT could be used to predict patient morbidity and mortality following liver resection. We reviewed our prospectively held database and included consecutive adult patients undergoing elective liver resection in our institution between January 2013 and December 2014. Primary outcome assessed was correlation of POD 1 ALT with patient's morbidity and mortality. We also assessed whether concurrent radiofrequency ablation, neoadjuvant chemotherapy and use of the Pringle maneuver significantly affected the level of POD 1 ALT. A total of 110 liver resections were included in the study. The overall in-hospital patient morbidity and mortality were 31.8% and 0.9%, respectively. The median level of POD 1 ALT was 275 IU/L. No correlation was found between POD 1 serum ALT levels and patient morbidity after elective liver resection, whilst correlation with mortality was not possible because of the low number of mortalities. Patients undergoing concurrent radiofrequency ablation were noted to have an increased level of POD 1 serum ALT but not those given neoadjuvant chemotherapy and those in whom the Pringle maneuver was used. Our study demonstrates POD 1 serum ALT does not correlate with patient morbidity after elective liver resection.

Adult, Aged, Alanine Transaminase/blood, Biomarkers/blood, Catheter Ablation/adverse effects, Colorectal Neoplasms/mortality, Databases, Factual, Elective Surgical Procedures, England, Female, Hepatectomy/adverse effects, Humans, Liver Neoplasms/mortality, Male, Middle Aged, Neoadjuvant Therapy/adverse effects, Postoperative Complications/blood, Predictive Value of Tests, Retrospective Studies, Risk Factors, Time Factors, Treatment Outcome, Up-Regulation
1499-3872
655-659
Bhogal, Ricky Harminder
0e670132-dbd5-49ae-99ec-8c4985d7febb
Nair, Amit
fd381498-2b83-428d-81cb-d15a5069ec29
Papis, Davide
466c8947-15cb-455a-a0ed-16e6d72dea95
Hamady, Zaed
545a1c81-276e-4341-a420-aa10aa5d8ca8
Ahmad, Jawad
2378fd75-73a9-4589-b88c-1bcbd91d24a5
Lam, For Tai
239f1f16-33f7-40b0-8313-f82cd98021fa
Khan, Saboor
226e1dd2-af39-40e6-9cb1-d65545e6ffd7
Marangoni, Gabriele
b876a178-8129-4455-adcf-1f8b04428c2a
Bhogal, Ricky Harminder
0e670132-dbd5-49ae-99ec-8c4985d7febb
Nair, Amit
fd381498-2b83-428d-81cb-d15a5069ec29
Papis, Davide
466c8947-15cb-455a-a0ed-16e6d72dea95
Hamady, Zaed
545a1c81-276e-4341-a420-aa10aa5d8ca8
Ahmad, Jawad
2378fd75-73a9-4589-b88c-1bcbd91d24a5
Lam, For Tai
239f1f16-33f7-40b0-8313-f82cd98021fa
Khan, Saboor
226e1dd2-af39-40e6-9cb1-d65545e6ffd7
Marangoni, Gabriele
b876a178-8129-4455-adcf-1f8b04428c2a

Bhogal, Ricky Harminder, Nair, Amit, Papis, Davide, Hamady, Zaed, Ahmad, Jawad, Lam, For Tai, Khan, Saboor and Marangoni, Gabriele (2016) Postoperative day one serum alanine aminotransferase does not predict patient morbidity and mortality after elective liver resection in non-cirrhotic patients. Hepatobiliary & pancreatic diseases international : HBPD INT, 15 (6), 655-659. (doi:10.1016/s1499-3872(16)60090-5).

Record type: Article

Abstract

Serum aminotransferases have been used as surrogate markers for liver ischemia-reperfusion injury that follows liver surgery. Some studies have suggested that rises in serum alanine aminotransferase (ALT) correlate with patient outcome after liver resection. We assessed whether postoperative day 1 (POD 1) ALT could be used to predict patient morbidity and mortality following liver resection. We reviewed our prospectively held database and included consecutive adult patients undergoing elective liver resection in our institution between January 2013 and December 2014. Primary outcome assessed was correlation of POD 1 ALT with patient's morbidity and mortality. We also assessed whether concurrent radiofrequency ablation, neoadjuvant chemotherapy and use of the Pringle maneuver significantly affected the level of POD 1 ALT. A total of 110 liver resections were included in the study. The overall in-hospital patient morbidity and mortality were 31.8% and 0.9%, respectively. The median level of POD 1 ALT was 275 IU/L. No correlation was found between POD 1 serum ALT levels and patient morbidity after elective liver resection, whilst correlation with mortality was not possible because of the low number of mortalities. Patients undergoing concurrent radiofrequency ablation were noted to have an increased level of POD 1 serum ALT but not those given neoadjuvant chemotherapy and those in whom the Pringle maneuver was used. Our study demonstrates POD 1 serum ALT does not correlate with patient morbidity after elective liver resection.

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More information

Published date: December 2016
Keywords: Adult, Aged, Alanine Transaminase/blood, Biomarkers/blood, Catheter Ablation/adverse effects, Colorectal Neoplasms/mortality, Databases, Factual, Elective Surgical Procedures, England, Female, Hepatectomy/adverse effects, Humans, Liver Neoplasms/mortality, Male, Middle Aged, Neoadjuvant Therapy/adverse effects, Postoperative Complications/blood, Predictive Value of Tests, Retrospective Studies, Risk Factors, Time Factors, Treatment Outcome, Up-Regulation

Identifiers

Local EPrints ID: 455655
URI: http://eprints.soton.ac.uk/id/eprint/455655
ISSN: 1499-3872
PURE UUID: 910de012-cc5d-4dec-890e-f307efb587b7
ORCID for Zaed Hamady: ORCID iD orcid.org/0000-0002-4591-5226

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Date deposited: 30 Mar 2022 16:35
Last modified: 17 Mar 2024 04:12

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Contributors

Author: Ricky Harminder Bhogal
Author: Amit Nair
Author: Davide Papis
Author: Zaed Hamady ORCID iD
Author: Jawad Ahmad
Author: For Tai Lam
Author: Saboor Khan
Author: Gabriele Marangoni

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