[FUNCTIONAL LIVER INSUFFICIENCY AND MACROCYTOSIS OF ERYTHROCYTES IN HYPERTENSION].
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Anemia, Macrocytic↗
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Results for “Liver function”
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Optimal initial treatment for early hepatocellular carcinoma in patients with preserved liver function: transplantation or resection?
Partial hepatic resection has been the mainstay of curative treatment for hepatocellular carcinoma (HCC) in cirrhotic patients with preserved liver function. Liver transplantation for HCC was initially developed as a treatment option for patients with unresectable tumors associated with Child B or C cirrhosis. However, in recent years, some authors have advocated liver transplantation even for resectable early HCC associated with Child A cirrhosis. Whether transplantation or liver resection is the optimal initial treatment for early HCC in compensated cirrhosis depends on the survival results and also the availability of liver grafts. Recent studies comparing liver resection and transplantation for early HCC in Child A cirrhotic patients demonstrated similar long-term survival. While liver transplantation is associated with a lower tumor recurrence rate, this benefit is counteracted by long-term complications such as immunosuppression related infections and neoplasms. Patients put on transplantation waiting list run a significant risk of tumor progression and dropout, while liver resection is immediately applicable to all. A premature liver transplantation may expose patients to the side effects of immunosuppression earlier than necessary. With the current shortage of liver grafts, advocating primary liver transplantation for patients with early HCC associated with compensated cirrhosis will increase waiting time of transplantation and further increases the chance of dropout. Resection first and salvage transplantation for recurrent tumors or liver failure has been shown to be a feasible strategy in the majority of patients, and this appears to be the optimal strategy with the best use of organs.
Carcinoma, Hepatocellular↗
Liver function in Edinburgh haemophiliacs: a five-year follow-up.
Liver function was assessed in 38 Edinburgh haemophiliacs. Results before the introduction of NHS intermediate factor VIII concentrate from 1974 onwards were compared with values in 1979. Measurements of serum bile salts in 16 patients as well as conventional liver function tests gave useful evidence of deranged liver function. Deterioration over the five-year follow-up period was seen only in patients on home treatment using large amounts of factor VIII concentrate, and there was no association between cryoprecipitate usage and derangement of liver function.
Adolescent↗
Effects of transjugular intrahepatic portosystemic shunt (TIPS) on quantitative liver function tests.
BACKGROUND/AIMS: The transjugular intrahepatic portosystemic stent-shunt (TIPS) has been established as a new effective treatment for portal hypertension in advanced liver disease. Impairment of liver function due to reduced portal venous perfusion is considered to be a major risk of TIPS, and the shunt leads to an increase in the incidence of hepatic encephalopathy (HE). Known complications, like the increase in the incidence of HE or TIPS stenosis, are diagnosed either clinically or by doppler ultrasound. It is not practicable to use quantitative liver function tests in the diagnostic work-up of HE, and medical or interventional therapy can be established after clinical diagnosis. Still, information is limited about the influence of TIPS on quantitative liver function tests in patients with liver cirrhosis. Therefore, the aim of this prospective study was to assess the effects of TIPS on various liver function tests. METHODOLOGY: Fifteen patients with liver cirrhosis, a hepatopetal portal flow before TIPS, and an uncomplicated course without stenosis after elective TIPS were analysed. Liver function was quantitatively measured using the [14C]aminopyrine breath test (ABT), considered to be independent of hepatic blood flow, the monoethylglycinexylidide test (MEGX), believed to be largely dependent on hepatic blood flow, serum bilirubin, serum albumin, and prothrombin time. Measurements were performed before, 1, 3 and 6 months after TIPS. RESULTS: TIPS decreased the portal venous pressure gradient from 31.0+/-2.0 cm (SEM) H2O to 16.9+/-1.8 cm H2O (p<0.01). One, 3 and 6 months after TIPS there was no significant deterioration of liver function as assessed by ABT, MEGX or serum bilirubin, serum albumin, and prothrombin time compared to baseline values before TIPS. ABT and MEGX were significantly correlated before TIPS (r=0.72; p<0.01) and after TIPS (r=0.76; p<0.05). CONCLUSIONS: These data show no significant deterioration of microsomal liver function as measured by the quantitative liver function tests ABT and MEGX over a period of 6 months after elective TIPS. In particular, there was no significant reduction of the MEGX-test considered to depend predominantly on hepatic blood flow. Thus, there is no need for the quantitative liver function tests ABT and MEGX in the routine management of patients following the TIPS procedure.
Adult↗
Recovery patterns of liver function after complete and partial surgical biliary decompression.
BACKGROUND: Recovery patterns of liver function after surgical drainage of obstructing biliary system have not been studied properly, particularly after a single-lobe biliary decompression where atrophic-hypertrophic changes of the liver may affect the recovery of liver functions. PATIENTS AND METHODS: Thirty patients with malignant obstructive jaundice had their liver functions evaluated biochemically both 1 week and 1 day preoperatively, and at 4 points postoperatively: 3 days, 1 week, 3 weeks, and 6 weeks. Half of them underwent complete biliary drainage procedures, whereas the remaining half had partial drainage (decompression of the left lobe only by means of segment III duct-enteric bypass). RESULTS: For those with complete drainage, serum alkaline phosphatase (AP) and gamma glutamyl transpeptidase (GGT) were 40% to 50% of preoperative levels 3 days after surgery (P<0.005), and were about twice the norm at 6 weeks. Their serum total and direct bilirubins (TB, DB) were approximately 60% reduced 1 week after the drainage (P<0.05). For partial drainage, serum AP and GGT decreased by 50% at 1 week (P<0.05), but were still very high 6 weeks after the drainage. The TB and DB decreased significantly 1 week postoperatively, and were three times the norm at 6 weeks. Serum albumin decreased sharply at 3 days and returned to normal levels 3 weeks after either complete or partial biliary drainage. Aminotransferase enzymes responded differently between the two groups. The levels dramatically declined one week after complete drainage and were slightly higher than normal thereafter. Following partial drainage, the enzyme levels were unchanged throughout the study period. CONCLUSION: Complete biliary drainage can nearly normalize the liver functions by 6 weeks, and biliary drainage of one lobe of the liver can effectively recover the liver functions.
Adult↗
Evaluating asymptomatic patients with abnormal liver function test results.
Asymptomatic patients with abnormal results on liver function test pose a diagnostic challenge. In general, determinations of routinely ordered tests of liver function are neither sensitive nor specific for liver disease. Fatty liver, alcohol-related liver damage and chronic viral hepatitis are the most common causes of abnormal liver function test results in asymptomatic patients. Causes of asymptomatic liver disease include hemochromatosis, Wilson's disease, drug toxicity, chronic autoimmune hepatitis, biliary cirrhosis, sclerosing cholangitis, alpha1-antitrypsin deficiency and sarcoidosis. The most efficient screening tests for liver damage are alanine transaminase, alkaline phosphatase and bilirubin. Repeat testing when results are abnormal, and use of ancillary tests, such as creatine phosphokinase or gamma-glutamyl-transferase, may confirm liver damage. Imaging studies help exclude biliary obstruction or neoplasm. Treatable illnesses should be ruled out. Three to six months of observation for progressive symptoms and liver dysfunction may follow. After the period of observation, further laboratory tests, a diagnostic liver biopsy and/or referral to gastroenterologist may be needed.
Aftercare↗
[Effects of grayanotoxin III on liver function and renal function in rats].
The grayanotoxin III (GTX III) was given intraperitoneally to rats at a dose of 0.8 or 2.8 mg/kg. To study the effects of GTX III on rats, biological tests in serum for functions of liver and kidney and their pathological observation were performed 1 h after the administration. Using analysis of variance, multiple comparison and correlation on biological parameters, activities of glutamic-pyruvic transaminase (GPT), guanase and leucine aminopeptidase and concentrations of total protein, albumin, creatinine, uric acid and K increased significantly. These parameters showed dose-effect relations with GTX III. Though GPT and free fatty acid increased significantly, dose-effect relations were not shown. The activity of choline esterase and the concentrations of bilirubin, urea-N, lipoperoxide, cholesterol, triglycerides, Na and Cl were not significantly different. Pathological changes were not observed in the liver and kidney of rats. These results show that GTX III may affect the functions of liver and kidney in rats.
Alanine Transaminase↗
Studies on changes of thyroid hormones in various liver diseases: usefulness of free thyroid hormones as liver function test.
Various thyroid parameters in liver disease which were morphologically diagnosed were measured, and their relationship to liver function was mainly studied. Serum T4 levels were elevated in acute hepatitis (AH), chronic persistent hepatitis (CPH) and chronic aggressive hepatitis (CAH) compared with in normal controls (C). Serum T3 levels were elevated in CAH and reduced in liver cirrhosis (LC). Serum reverse T3 (rT3) levels were elevated in AH and chronic liver diseases (CLD). T3/T4 ratios decreased in AH, CPH and CAH. RT3/T3 ratios increased in AH and CLD. Serum Free T3 (FT3) levels reduced in CLD in order of CPH, CAH and LC, and were low levels in AH with the same degree as LC. Moreover, serum FT3 levels revealed negative correlation with ICG-R15 and positive correlation with prothrombin time (PT) and serum albumin levels (Alb). Therefore serum FT3 level was considered to become a sensitive index of liver damage. Serum free T4 (FT4) levels did not change significantly in AH with high levels of transaminases and reduced in only LC. Therefore serum FT4 may become an index of severity of liver dysfunction. On the other hand, T3/T4 ratios and rT3/T3 ratios showed less correlation with liver function tests compared with free thyroid hormones.
Adult↗
Routine testing of liver function after biliary-enteric anastomosis has no clinical relevance.
BACKGROUND/AIMS: Patients who had a biliary-enteric anastomosis often have elevated liver function tests. The aim of this study was to investigate whether elevated liver function tests are associated with recurrent episodes of cholangitis. METHODOLOGY: Thirty-two patients, who received a biliary-enteric anatomosis for benign biliary disease were evaluated. Follow-up consisted of the patient's history, physical examination, determination of liver function tests, ultrasonography and hepatobiliary scintigraphy using 99mTc-HIDA. RESULTS: Median duration of follow-up was 45 months (range: 1-192) and liver function tests were elevated in 22 patients (69%) at some time during follow-up. Dilated intrahepatic ducts were found in 3 of 30 patients (10%), all of whom had elevated liver function tests at follow-up. Delayed passage from the liver was observed using scintigraphy in 10 (31%) of the patients. Seven patients (22%) experienced one episode of cholangitis and none experienced more than one episode. Multivariate analysis showed that male sex was an independent risk factor for elevated liver function tests (odds ratio: 10.9; P < 0.05). For cholangitis, no risk factors could be identified. CONCLUSIONS: It is concluded that elevated liver function tests are relatively common after a biliary-enteric anastomosis for benign biliary tract disease and are not predictive of the occurrence of cholangitis. We, therefore, recommend omitting routine laboratory screening for elevated liver function tests in the follow-up of a biliary-enteric anastomosis.
Adult↗
[Functional liver sequelae in late toxemias].
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Female↗
[APROPOS OF FUNCTIONAL LIVER CHANGES IN CHRONIC ANGIOCHOLECYSTITIS].
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Cholangitis↗
Changes in liver function after different types of surgery.
Liver function tests carried out after minor surgical procedures, under anaesthesia lasting for 1 hr, showed no abnormalities. Tests after body surface operations under the same anaesthetic techniques showed transient derangements. After intra-abdominal procedures, liver dysfunction was more marked, although no patients with evidence of preoperative liver dysfunction or postoperative surgical complications were studied and none received blood transfusions. Measurements of the serum bilirubin concentration showed the most frequent abnormalities, but the pseudocholinesterase concentration decreased progressively after intra-abdominal surgery and b.s.p. retention increased significantly. Serum concentration of intracellular enzymes (LDH, s.g.o.t. and s.g.p.t.) increased within an hour of starting surgery, changes which were probably not related to liver function.
Adult↗
Evaluation of abnormal liver function tests.
Interpretation of abnormalities in liver function tests is a common problem faced by clinicians. This has become more common with the introduction of automated routine laboratory testing. Not all persons with one or more abnormalities in these tests actually have liver disease. The various biochemical tests, their pathophysiology, and an approach to the interpretation of abnormal liver function tests are discussed in this review.
Alkaline Phosphatase↗
Assessment of monoethylglycinexylidide as measure of liver function for patients with chronic viral hepatitis.
The liver metabolizes lidocaine by oxidative deethylation to form monoethylglycinexylidide (MEGX), an analyte proposed as an index of liver function. We determined MEGX and lidocaine serum concentrations with the TDx (Abbott Laboratories) at baseline and 15, 30, 60, and 90 min after the intravenous administration of lidocaine (1 mg/kg), analyzing specimens from 12 apparently healthy volunteers and 40 patients with chronic viral hepatitis diagnosed by liver biopsy and serum tests. The patients were grouped on the basis of the histology activity index. The following laboratory tests were performed on serum specimens from all subjects: albumin (ALB), alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase, total bilirubin, and prothrombin time. The results showed no significant difference among the four groups for the concentrations of MEGX, lidocaine, and lidocaine/MEGX at the four time points. However, the concentrations of ALB, ALT, AST, AST/ALT, and prothrombin time were substantially different among the four groups. Thus, we conclude that assay of MEGX in our patients with chronic viral hepatitis did not contribute to the assessment of liver function when compared with apparently healthy volunteers and traditional tests of liver function.
Adult↗
[The impact of antituberculosis drugs upon liver function in patients with positive HBVM].
Through the liver function analysis of 100 tuberculosis cases in the course of antituberculosis chemotherapy the authors found that the abnormal liver function rate turned to be 50% in the positive HBVM Group but only 2.4% in the negative, HBVM Group. There is a significant statistical difference between the two groups of cases (P less than 0.01). For this reason, the authors suggested the HBVM should be determined one by one before taking the antituberculosis chemotherapy in the area with high incidence of B-type hepatitis, the data indicated clearly that, the abnormal phenomena of liver function after the antituberculosis treatment for those patients, mainly caused by the drugs.
Adult↗
The bromsulfalein liver function test and biopsy of the liver in the diagnosis of senecio poisoning in cattle.
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Animals↗
Peritoneoscopic liver biopsy findings in asymptomatic chronic HBsAg carriers with normal liver function tests and no hepatomegaly.
Asymptomatic chronic HBsAg carriers with normal liver function tests are, in general regarded as having no liver pathology. Most of the histologic findings in asymptomatic chronic carriers have been reported from areas with low incidence of Hepatitis B virus (HBV) infection, such as North America and Western Europe. It is well known that there are many differences in HBV infection between low and high endemic areas, but there have been few reports on the histologic findings of asymptomatic chronic HBsAg carriers from endemic areas. The present study was undertaken in Korea which is one of the endemic areas for HBV infection and was designed to assess the prevalence of chronic liver disease by peritoneoscopic liver biopsy among asymptomatic chronic HBsAg carriers and to make a basis for the follow-up of asymptomatic chronic HBsAg carriers according to the results obtained. One hundred and ten asymptomatic HBsAg-positive carriers with normal liver function tests and no hepatomegaly were included in the study. Final diagnosis by peritoneoscopic liver biopsy revealed that of the 110 asymptomatic carriers only 27 (24.5%) had a histologically normal liver, while 51 (46.4%) had chronic liver diseases, and the remaining 32 (29.1%) had nonspecific histologic abnormalities (nonspecific reactive changes in 18 cases, cholestasis in 6 cases, and fatty change in 8 cases). Of the 51 patients with chronic liver diseases, 3 had liver cirrhosis, 4 chronic active hepatitis with cirrhosis, 11 chronic active hepatitis and 33 chronic persistent hepatitis. The frequency of liver cirrhosis and chronic active hepatitis with cirrhosis was significantly high in the over 30 years of age group (12.1%) than in the under 30 years of age group (0%; p = 0.011 by Fisher's exact test). In conclusion, 46.4% of the Korean asymptomatic chronic HBsAg carriers with normal liver function tests and no hepatomegaly had chronic liver disease. This finding contrasted with reports from low incidence areas of HBV infection. Our results suggest that in endemic areas, a liver biopsy should be considered to assess the status of liver disease in asymptomatic chronic HBsAg carriers even if liver function tests are normal and hepatomegaly is absent, and the result can be used as a basis for the follow-up of each asymptomatic chronic HBsAg carriers.
Adolescent↗
Liver function during treatment with cefuroxime.
The liver function was studied in 15 patients before and during treatment with cefuroxime. Four elderly patients had a prolonged half-life of galactose at admission but they all showed declining values during the cefuroxime treatment. Only in one patient did the galactose half-life increase during treatment (from 14 to 25 min.). This patient was an old diabetic who also had prostatic cancer. Cefuroxime treatment seems to be well tolerated also in patients with signs of impaired metabolic liver function at start of treatment.
Adult↗