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An abattoir-based cohort study using liver and serum specimens from Holstein dairy cows (452 healthy and 54 fatty liver cases) was conducted. Serum fructosamine and other biochemical parameters and fat content of liver specimens w...
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An abattoir-based cohort study using liver and serum specimens from Holstein dairy cows (452 healthy and 54 fatty liver cases) was conducted. Serum fructosamine and other biochemical parameters and fat content of liver specimens were measured. There were significant negative correlations of fructosamine with hepatic lipid content (P = 0.001), and serum total bilirubin (P = 003) and significant positive correlation with glucose (P < 0.02), albumin (P < 0.0001) and cholesterol (P < 0.0001) within normal cows. In fatty liver-affected cows significant positive correlations were seen between fructosamine and cholesterol (P < 0.0001) and albumin (P < 0.0001). In addition fructosamine had a significant negative correlation with the ratio of non-esterified fatty acids to cholesterol in both normal (P < 0.0001) and fatty liver-affected cows (P = 0.006). We found that serum fructosamine concentration was lower (P < 0.001) in cows suffering from fatty liver. The area under the receiver operating characteristic curve of fructosamine for diagnosis of fatty liver was 67.6. Optimum fructosamine cut-point based on the maximum total of sensitivity (SE) and specificity (SP) was < 213 mmol/L (SE = 71%; SP = 65). Cows with serum fructosamine concentrations below 213 mmol/L were 4.5 times more likely to have hepatic lipidosis (odds ratio = 4.5; 95% CI = 2.4-8.6; P < 0.0001). We found that fructosamine showed a combination of high SE, SP, which was greater than aspartate aminotransferase, non-esterified fatty acids, beta-hydroxybutyrate, total cholesterol, bile acids and bilirubin. In addition, fructosamine showed a positive likelihood ratio of 2.0, and negative likelihood ratio of 0.45. In conclusion, the present results indicate that fructosamine measurement could improve the diagnosis of fatty liver in dairy cows.
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Laboratory tests of liver function are among most commonly ordered blood tests. However, interpretation of parameters should be based not only on measuring the metabolic and synthetic function of the liver, but also parameters whi...
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Laboratory tests of liver function are among most commonly ordered blood tests. However, interpretation of parameters should be based not only on measuring the metabolic and synthetic function of the liver, but also parameters which reflect liver injury. Clinical and laboratory assessment of liver function help to identify causes of liver failure, monitor clinical deterioration and prognosis, and determine treatment options including liver transplantation.
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Approximately 24,000 liver transplants are performed annually worldwide, almost 7000 of which are performed in the USA. Survival is excellent and continues to improve, with 1-year survival currently exceeding 85 %, but effective m...
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Approximately 24,000 liver transplants are performed annually worldwide, almost 7000 of which are performed in the USA. Survival is excellent and continues to improve, with 1-year survival currently exceeding 85 %, but effective management of patients after liver transplantation is critical to achieve optimal results. A plethora of diseases can affect the transplanted allograft, ranging from recurrence of the original disease to de novo liver pathology, and diagnosis can be complicated by nonclassical presentation, de novo disease, or inconclusive histology. Patients can remain asymptomatic despite significant damage to the transplanted liver, so prompt identification and treatment of liver disease after transplantation is crucial to preserve allograft function. Liver function tests are routinely taken throughout the postoperative period to monitor the graft. Although nonspecific, they are inexpensive, noninvasive, and sensitive for allograft disease and can quickly alert physicians to the presence of asymptomatic pathology. This review will outline possible causes of liver function test abnormalities in the late posttransplant period and provide guidance for investigation, diagnosis, and management.
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Objective: To assess the association of preeclampsia with deranged liver enzymes of patients presenting in a tertiary care hospital. Methods: It was case a control study including 100 females who fulfilled the inclusion criteria. ...
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Objective: To assess the association of preeclampsia with deranged liver enzymes of patients presenting in a tertiary care hospital. Methods: It was case a control study including 100 females who fulfilled the inclusion criteria. They were enrolled in the study from OPD of Department of Obstetrics and Gynecology, Ghurki Trust Teaching Hospital, Lahore. Informed consent was obtained. Then two groups were formed i.e. cases with preeclampsia and controls without preeclampsia. Then blood sample was obtained in 3cc BD syringe. All samples were sent to the laboratory of the hospital for assessment of ALT and AST. Data was entered and analyzed by SPSS version 21.0. Odds ratio was calculated to find association between preeclampsia and deranged ALT and AST. Results: The mean age of the patients was 33.30 (±4.45) years in cases and 32.96 (±4.72) in the control group. Mean gestational age was 33.88 (±4.07) weeks while 33.6 (±4.29) weeks in the control group. It was observed that body mass index was 28.90 (±2.32) in cases and 31.45 (±3.76). Parity was also almost similar in the both groups. It was observed that among cases 14 (28%) of the participants had deranged. ALT and AST value while 3 (6%) in the control group which was significant with Odds ratio >1. Conclusions: Significantly deranged liver enzymes were observed in the eclampsia patients. There is a need to conduct further study to know its relationship with disease.
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Portovascular anomalies are most commonly seen as congenital communications in dogs and cats. Fixation, whether surgical or interventional, should be considered in all cases for which it is possible to improve perfusion to the liv...
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Portovascular anomalies are most commonly seen as congenital communications in dogs and cats. Fixation, whether surgical or interventional, should be considered in all cases for which it is possible to improve perfusion to the liver, and ultimately liver function. Medical management before fixation is always recommended. If surgery is not recommended or not possible, long-term medical management can be successful in approximately 30% of cases. New modalities, such as percutaneous transjugular coil embolization or glue embolization, facilitate treatment of more complicated conditions, such as intrahepatic portosystemic shunts and hepatic arteriovenous malformations.
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Incidentally detected abnormality in liver function tests is a common situation encountered by physicians across all disciplines. Many of these patients do not have primary liver disease as most of the commonly performed markers a...
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Incidentally detected abnormality in liver function tests is a common situation encountered by physicians across all disciplines. Many of these patients do not have primary liver disease as most of the commonly performed markers are not specific for the liver and are affected by myriad factors unrelated to liver disease. Also, many of these tests like liver enzyme levels do not measure the function of the liver, but are markers of liver injury, which is broadly of two types: hepatocellular and cholestatic. A combination of a careful history and clinical examination along with interpretation of pattern of liver test abnormalities can often identify type and aetiology of liver disease, allowing for a targeted investigation approach. Severity of liver injury is best assessed by composite scores like the Model for End Stage Liver Disease rather than any single parameter. In this review, we discuss the interpretation of the routinely performed liver tests along with the indications and utility of quantitative tests.
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Objective: The aim of this study was to investigate the influence of herbal medicine (HM) prescribed by doctors of Korean medicine (KMD) on liver function in Korea.
Design and interventions: For this multicenter, prospective, obs...
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Objective: The aim of this study was to investigate the influence of herbal medicine (HM) prescribed by doctors of Korean medicine (KMD) on liver function in Korea.
Design and interventions: For this multicenter, prospective, observational study, we enrolled patients who wished to take HM prescribed by KMD for various medical purposes in Korea. One hundred and twenty-two (122) patients took HM for an average of 20.6 ± 8.4 (mean ± standard deviation) days, and completed questionnaires.
Outcome measures: Liver function tests (LFTs) were performed before (first test) and after each HM treatment (second test). For LFT, aspartate aminotransferase, alanine aminotransferase, total bilirubin (t-Bil), direct bilirubin, alkaline phosphatase, and γ-glutamyl transferase were measured.
Results: There were no significant changes in LFT data between the first and second tests, except in the t-Bil level. However, all data of total bilirubin level in second test were within normal range, except only one patient. Multivariate analysis did not identify any herb that significantly increased t-Bil; hence no hepatotoxic herb was found. Twenty-one (21) of the 122 patients were abnormal on first testing, and 10 at the second testing. Of the patients taking herbs, 4 changed from normal to abnormal and 15 from abnormal to normal (p = 0.019).
Conclusion: The current study showed that ingestion of HM prescribed by KMD did not increase the frequency of abnormal LFTs, at least in the short term.
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LiMAx has been recently proposed as a new quantitative liver function test. Thus, we aimed to evaluate the diagnostic ability of LiMAx to assess short-term survival in liver transplant candidates and compare its performance to the...
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LiMAx has been recently proposed as a new quantitative liver function test. Thus, we aimed to evaluate the diagnostic ability of LiMAx to assess short-term survival in liver transplant candidates and compare its performance to the model for end-stage liver disease (MELD) and indocyanine green plasma disappearance rate (ICG-PDR). Liver function of 167 chronic liver failure patients without hepatocellular carcinoma was prospectively investigated when they were evaluated for liver transplantation. Primary study endpoints were liver-related death within 6months of follow-up. Within 6months of follow-up, 18 patients died and 36 underwent liver transplantation. Median LiMAx results on evaluation day were significantly lower in patients who died (99g/kg/h vs. 55g/kg/h; P=0.024), while median ICG-PDR results did not differ within both groups (4.4%/min vs. 3.5%/min; P=0.159). LiMAx showed a higher negative predictive value (NPV: 0.93) as compared with ICG-PDR (NPV: 0.90) and the MELD (NPV: 0.91) in predicting risk of death within 6months. In conclusion, LiMAx provides good prognostic information of liver transplant candidates. In particular, patients who are not at risk of death can be identified reliably by measuring actual enzymatic liver function capacity.
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LiMAx has been recently proposed as a new quantitative liver function test. Thus, we aimed to evaluate the diagnostic ability of LiMAx to assess short-term survival in liver transplant candidates and compare its performance to the...
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LiMAx has been recently proposed as a new quantitative liver function test. Thus, we aimed to evaluate the diagnostic ability of LiMAx to assess short-term survival in liver transplant candidates and compare its performance to the model for end-stage liver disease (MELD) and indocyanine green plasma disappearance rate (ICG-PDR). Liver function of 167 chronic liver failure patients without hepatocellular carcinoma was prospectively investigated when they were evaluated for liver transplantation. Primary study endpoints were liver-related death within 6?months of follow-up. Within 6?months of follow-up, 18 patients died and 36 underwent liver transplantation. Median LiMAx results on evaluation day were significantly lower in patients who died (99?μg/kg/h vs. 55?μg/kg/h; P?=?0.024), while median ICG-PDR results did not differ within both groups (4.4%/min vs. 3.5%/min; P?=?0.159). LiMAx showed a higher negative predictive value (NPV: 0.93) as compared with ICG-PDR (NPV: 0.90) and the MELD (NPV: 0.91) in predicting risk of death within 6?months. In conclusion, LiMAx provides good prognostic information of liver transplant candidates. In particular, patients who are not at risk of death can be identified reliably by measuring actual enzymatic liver function capacity. ? 2014 Steunstichting ESOT.
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Background/Aims: Liver resection is the gold standard in managing patients with metastatic or primary liver cancer. The aim of our study was to compare the traditional clamp-crushing technique to the radiofrequency-assisted liver ...
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Background/Aims: Liver resection is the gold standard in managing patients with metastatic or primary liver cancer. The aim of our study was to compare the traditional clamp-crushing technique to the radiofrequency-assisted liver resection technique in terms of postoperative liver function. Methodology: Liver function was evaluated preoperatively and on postoperative days 3 and 7. Liver synthetic function parameters (serum albumin level, prothrombin time and international normalized ratio), markers of hepatic injury and necrosis (serum alanine aminotransferase, aspartate aminotransferase and total bilirubin level) and microsomal activity (quantitative lidocaine test) were compared. Results: Forty three patients completed the study (14 had clamp-crushing and 29 had radiofrequency assisted liver resection). The groups did not differ in demographic characteristics, pre-operative liver function, operative time and perioperative transfusion rate. In postoperative period, there were similar changes in monitored parameters in both groups except albumin levels, that were higher in radiofrequency-assisted liver resection group (p=0.047). Conclusions: Both, traditional clamp-crushing technique and radiofrequency assisted liver resection technique, result in similar postoperative changes of most monitored liver function parameters.
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