Perioperative changes in hepatic function as assessed by asialoglycoprotein receptor indices by technetium 99m galactosyl human serum albumin.
OBJECTIVE
Perioperative changes in intrinsic hepatocyte function and functional volume were investigated.


METHODS
52 cases of liver cancer, including hepatocellular carcinoma, cholangiocellular carcinoma and metastatic carcinoma were studied. There were diagnoses of liver cirrhosis, liver fibrosis and normal liver in 20, 23 and 9 cases, respectively. Hepatic resection of subsegment, one segment, two segments and three segments were performed in 11, 6, 23 and 4 cases, respectively, while 8 cases were diagnosed as inoperable. Assessments were performed before and 4 weeks after hepatectomy with asialoglycoprotein (ASGP) receptor indices, i.e., technetium-99m-galactosyl human serum albumin (TcGSA) uptake by the liver, TcGSA retention in the blood and functional volume as measured by single emission computed tomography (SPECT) with TcGSA as a probe.


RESULTS
The hyperbolic relationship between galactosyl human serum albumin (GSA) uptake by the liver and GSA retention in the blood, both of which were independent of functional volume, shifted to the right after hepatectomy. The number of conventional liver function tests correlating to the GSA uptake increased after hepatectomy. By contrast, none of the pre-operative and post-operative tests were correlated with functional volume. Post-operative decrease in intrinsic hepatocyte function can be minimized by selection of mode of hepatic resection.


CONCLUSIONS
These results indicate that GSA uptake by the liver can reveal information regarding intrinsic liver function which deteriorates and becomes a decisive factor after hepatectomy.
Tanaka
A
A
Department of Surgery, Kyoto City Hospital, Japan.
Shinohara
H
H
Hatano
E
E
Sato
S
S
Kanazawa
A
A
Yamaoka
Y
Y
Torizuka
T
T
Konishi
J
J
Tamaki
N
N
D000328:Adult; D000368:Aged; D037263:Asialoglycoprotein Receptor; D001212:Asialoglycoproteins / Q000378:metabolism*; D006528:Carcinoma, Hepatocellular / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery; D018281:Cholangiocarcinoma / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery; D005260:Female; D006498:Hepatectomy; D006801:Humans; D008099:Liver / Q000166:cytology / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D008103:Liver Cirrhosis / Q000000981:diagnostic imaging / Q000209:etiology; D008111:Liver Function Tests / Q000379:methods; D008113:Liver Neoplasms / Q000000981:diagnostic imaging* / Q000503:physiopathology* / Q000556:secondary / Q000601:surgery; D008297:Male; D008875:Middle Aged; D011956:Receptors, Cell Surface / Q000378:metabolism*; D013668:Technetium Tc 99m Aggregated Albumin; D016284:Technetium Tc 99m Pentetate; D015899:Tomography, Emission-Computed, Single-Photon
D037263:Asialoglycoprotein Receptor; D001212:Asialoglycoproteins; D011956:Receptors, Cell Surface; D013668:Technetium Tc 99m Aggregated Albumin; C070561:technetium Tc 99m DTPA-galactosyl-human serum albumin; D016284:Technetium Tc 99m Pentetate