Digoxin-like immunoreactive substance in liver failure: effect of liver transplantation and relationship to presence of hepatic encephalopathy

Abstract

Objectives: To determine the contribution of liver dysfunction to the presence of digoxin-like immunoreactive substances (DLIS) in patients with liver failure on the intensive care unit (ICU); to examine the relationship between plasma DLIS levels and grade of hepatic encephalopathy (HE); and to study the effect of normalisation of liver function following successful liver transplantation (LT) on plasma DLIS levels. Design: Measurement of plasma DLIS levels, indices of liver function, and assessment of grade of HE on admission to hospital or to the ICU, and at 48 and 96 hours following LT. Setting: A teaching hospital ICU servicing the Australian National Liver Transplant Unit. Subjects: Eleven patients with stable chronic liver disease admitted for elective LT, seven patients with fulminant hepatic failure (FHF) and five patients with miscellaneous causes of liver failure with encephalopathy. Interventions: Sixteen patients underwent LT. Measurements and main results: All 23 patients had measurable level...