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. 2022 Feb;46(2):433-440.
doi: 10.1007/s00268-021-06280-4. Epub 2021 Nov 19.

Post-operative Day 1 Serum Transaminase Levels in Relation to Morbidity After Liver Resection

G W de Klein  1 , R M Brohet  2 , M S L Liem  1 , J M Klaase  3
Affiliations

Post-operative Day 1 Serum Transaminase Levels in Relation to Morbidity After Liver Resection

G W de Klein et al. World J Surg. 2022 Feb.

Abstract

Background: Post-operative serum transaminases have been proposed as possible early predictors of morbidity after liver resection. This study aimed to verify the clinical value of post-operative serum transaminases.

Methods: Clinical data from 2001 to 2016 in a single non-academic referral HPB center were collected from a prospectively held database. Post-operative day 1 serum aspartate transaminase (AST) and alanine transaminase (ALT) were tested for their relationship with post-operative major morbidity, defined by a Clavien-Dindo score 3 or higher, and mortality.

Results: For this analysis, 371 patients were included, including 149 (40%) undergoing major liver resections. In total, 17% of the patients developed major morbidity. Stepwise logistic regression demonstrated that AST, and not ALT, is an independent predictor for major morbidity (p = 0.017). The probability of major morbidity significantly increased with increasing AST values. A threshold value of 242 U/L was found to be predictive for one or more major complications.

Conclusions: In this study, post-operative serum AST on day 1 was a predictive factor for major morbidity after liver resection. For patients with low AST value, early discharge could be considered. However, because of the substantial inter-individual variability of AST values, more studies are needed to translate these results into clinical practice.

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