Post-operative serum transaminase levels (TRL) is more related to the weight of resected liver rather than the injury of the remnant liver

Background. Post-operative increase of transaminase levels (TRL) is usually used as the main marker of hepatocyte injury of remnant liver after hepatectomy with vascular clamping. Aims. In this prospective study we evaluated the level of transaminase during the peri-operative period of liver resection procedure in patients with and without vascular clamping according to the resected liver volume. Methods. Between June and November 2005, fifty patients, aged 53±13 years, who underwent hepatectomy on normal liver were included in a prospective study. Major resection (>3 segments) was realised in 40 (80%) patients. Liver transection was performed in 25 (50%) patients under intermittent clamping for a mean duration of 38 min (range 15–64 min). All patients underwent serial blood samples assessing transaminase levels (ALT) during surgical procedure, respectively before incision, before liver transection and before abdominal closure and post-operatively, respectively on days 1, 2, 5 and 7. Results. As shows in the table TRL which increase early, at the end of resection, remain stable on postoperative day (POD) 1, decrease thereafter and was not affected by the presence of clamping. Major hepatectomy had significant higher TRL than minor hepatectomy at the end (342±216 vs 219±102) and on day 1 (364±204 vs 231±160). TRL at the end of surgery and on POD 1 has a significant correlation with the weight of resected liver according to Sperman/rho. Conclusions. Our results suggest that the early TRL should be considered as reflect of the damaged resected liver rather than the damage of remnant liver.