An Early Increase in Gamma Glutamyltranspeptidase And Low Aspartate Aminotransferase Peak Values Are Associated With Superior Outcomes After Orthotopic Liver Transplantation

Abstract

Background Prediction of prognosis after liver transplantation (OLT) remains difficult. The present study determines if standard laboratory parameters measured within the first week after OLT correlate with outcome. Patients and Methods Laboratory parameters measured within the first weak after OLT of 328 patients were grouped either graft loss or death within 90 days after (group 1: graft loss; group 2: death; group 3: neither graft loss nor death within 90 days). Results Peak AST and ALT were significantly lower in group 3 (1867 and 1252 U/L) than in group 1 (4474 and 2077 U/L) or 2 (3121 and 1865 U/L). Bilirubin was significantly lower and γ-GT significantly higher in group 3 compared to groups 1 and 2. In multivariate analysis, high AST peaks were independently associated with death or graft loss within 90 days. An increase in γ-GT and low bilirubin early after transplantation were found to be independently associated with superior outcome. Discussion Unexpectedly, a disproportionate rise in γ-GT was associated with graft and patient survival of more than 90 days. This might be explained by regeneration phenomena in the liver indicative of a well functioning graft.