Use of quantitative liver function tests--caffeine clearance and galactose elimination capacity--after orthotopic liver transplantation.
To establish the potential value of quantitative tests of liver function following orthotopic liver transplantation (OLT), a total of 100 determinations of caffeine clearance (CafCl) and galactose elimination capacity (GEC) were made in ten OLT recipients early in the post-operative course (days 2, 4, 6, 8 and 12) and later when clinically stable (3-12 months). Values were compared with a reference range in six normal volunteers in whom it was shown that the standard doses of caffeine (125 mg) and galactose (0.5 g per kg body weight) could be given together without interference. In orthotopic liver transplantation recipients initial GEC and CafCl measurements showed no correlation with peri-operative blood loss, donor ischaemia time, initial bile flow or survival. Throughout the early post-operative period, there were wide inter- and intra-individual variations in both CafCl (17-fold range from 0.16 to 2.7 ml.min-1.kg-1) and GEC (2.4-fold range from 5.1 to 12 mg.min-1.kg-1), but the only correlation of test values with standard liver function tests results was between GEC and gamma-glutamyltranspeptidase. However, GEC values fell by 19% during periods of acute rejection and there was an inverse correlation of GEC with white cell count probably related to sepsis.(ABSTRACT TRUNCATED AT 250 WORDS)
Nagel
R A
RA
Liver Unit, King's College Hospital, Denmark Hill, London, U.K.
Dirix
L Y
LY
Hayllar
K M
KM
Preisig
R
R
Tredger
J M
JM
Williams
R
R
D000328:Adult; D002110:Caffeine; D005260:Female; D005500:Follow-Up Studies; D005690:Galactose; D006801:Humans; D008111:Liver Function Tests / Q000379:methods; D016031:Liver Transplantation / Q000502:physiology*; D008297:Male; D008657:Metabolic Clearance Rate / Q000502:physiology; D008875:Middle Aged; D011184:Postoperative Period; D011237:Predictive Value of Tests; D012016:Reference Values
D002110:Caffeine; D005690:Galactose