scholarly journals Evaluation of Liver Function Tests to Predict Operative Risk in Liver Surgery

HPB Surgery ◽  
1995 ◽  
Vol 9 (1) ◽  
pp. 13-18 ◽  
Author(s):  
Thomas Zoedler ◽  
Christoph Ebener ◽  
Heinz Becker ◽  
Hans D. Roeher
Keyword(s):  
Liver Function ◽  
Liver Failure ◽  
Liver Tissue ◽  
Elimination Rate ◽  
Liver Function Tests ◽  
Operative Risk ◽  
Postoperative Liver Failure ◽  
Resection Rate ◽  
Function Tests ◽  
Galactose Elimination Capacity

Despite numerous studies in the past it is not possible yet to predict postoperative liver failure and safe limits for hepatectomy. In this study the following liver function tests ICG-ER (indocyaninegreen elimination rate), GEC (galactose elimination capacity) and MEGX-F (monoethylglycinexylidid formation) are examined with regard to loss of liver tissue and prediction of operative risk. Liver function tests were assessed in 20 patients prior to liver resection and on the 10th. postoperative day. Liver and tumor volume were measured by ultrasound and pathologic specimen and the parenchymal resection rate was calculated. In patients without cirrhosis (n = 10) ICG-ER and MEGX-F remained unchanged after resection, GEC was reduced but did not correspond to the resection rate. Patients with cirrhosis (n = 10) had a significantly lower ICG-ER and GEC before resection than patients without cirrhosis. After resection these tests were unchanged. Patients with liver related complications and cirrhosis (n = 5) had lower ICG-ER and GEC than patients with cirrhosis and no complications. In the postoperative course all liver function tests in these patients were significantly lower compared to preoperative results. Comparing liver function tests ICG serves best to indicate postoperative liver failure. Liver function tests do not correspond with loss of liver tissue.

Liver Function Tests and Physiological Features of Liver Failure

2020 ◽  
pp. 241-242
Author(s):  
Peter Kam ◽  
Ian Power ◽  
Michael J. Cousins ◽  
Philip J. Siddal
Keyword(s):  
Liver Function ◽  
Liver Failure ◽  
Liver Function Tests ◽  
Function Tests

scholarly journals Pharmacokinetics of Caspofungin in Critically Ill Patients in Relation to Liver Dysfunction: Differential Impact of Plasma Albumin and Bilirubin Levels

2019 ◽  
Vol 63 (6) ◽  
Author(s):  
S. Kurland ◽  
M. Furebring ◽  
E. Löwdin ◽  
E. Eliasson ◽  
E. I. Nielsen ◽  
...  
Keyword(s):  
Liver Function ◽  
Critically Ill ◽  
Rate Constant ◽  
Negative Correlation ◽  
Critically Ill Patients ◽  
Elimination Rate ◽  
Liver Function Tests ◽  
Elimination Rate Constant ◽  
Minimal Inhibitory Concentrations ◽  
Function Tests

ABSTRACT Caspofungin has a liver-dependent metabolism. Reduction of the dose is recommended based on Child-Pugh (C-P) score. In critically ill patients, drug pharmacokinetics (PK) may be altered. The aim of this study was to investigate the prevalence of abnormal liver function tests, increased C-P scores, their effects on caspofungin PK, and whether pharmacokinetic-pharmacodynamic (PK/PD) targets were attained in patients with suspected candidiasis. Intensive care unit patients receiving caspofungin were prospectively included. PK parameters were determined on days 2, 5, and 10, and their correlations to the individual liver function tests and the C-P score were analyzed. Forty-six patients were included with C-P class A (n = 5), B (n = 40), and C (n = 1). On day 5 (steady state), the median and interquartile range for area under the curve from 0 to 24 h (AUC0–24), clearance (CL), and central volume of distribution (V1) were 57.8 (51.6 to 69.8) mg·h/liter, 0.88 (0.78 to 1.04) liters/h, and 11.9 (9.6 to 13.1) liters, respectively. The C-P score did not correlate with AUC0–24 (r = 0.03; P = 0.84), CL (r = −0.07; P = 0.68), or V1 (r = 0.19; P = 0.26), but there was a bilirubin-driven negative correlation with the elimination rate constant (r = −0.46; P = 0.004). Hypoalbuminemia correlated with low AUC0–24 (r = 0.45; P = 0.005) and was associated with higher clearance (r = −0.31; P = 0.062) and somewhat higher V1 (r = −0.15; P = 0.37), resulting in a negative correlation with the elimination rate constant (r = −0.34; P = 0.042). For Candida strains with minimal inhibitory concentrations of ≥0.064 μg/ml, PK/PD targets were not attained in all patients. The caspofungin dose should not be reduced in critically ill patients in the absence of cirrhosis, and we advise against the use of the C-P score in patients with trauma- or sepsis-induced liver injury.

Alpha-1-Antitrypsin in Liver Disease

1989 ◽  
Vol 26 (2) ◽  
pp. 122-124 ◽  
Author(s):  
David Deam ◽  
Keith Byron ◽  
Sujiva Ratnaike
Keyword(s):  
Liver Disease ◽  
Liver Function ◽  
Liver Failure ◽  
Liver Diseases ◽  
Liver Function Tests ◽  
Function Tests ◽  
Low Levels ◽  
Alpha 1 Antitrypsin

Low alpha-1 -antitrypsin (AAT) levels are known to be associated with liver disease. As AAT is also synthesised in the liver, we investigated whether liver disease itself may result in low AAT levels. AAT was measured in plasma from 100 patients with various liver diseases including hepatitis, cirrhosis, jaundice and liver failure. Twenty-eight patients had increased AAT values (greater than 3·;1 g/L), 70 had normal AAT values (between 1·;5 and 3·;1 g/L) and 2 had decreased AAT levels (< 1·;5 g/L). The 2 patients with low AAT levels were found to be of the PiMZ phenotype. There was no significant correlation between any of the standard ‘liver function tests' and the AAT level. Our findings suggest that in liver disease AAT levels are usually normal or increased. Low levels are uncommon and the possibility of an abnormal AAT phenotype being associated with the liver disease should be examined.

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