Measurement of serum hyaluronic acid level during the perioperative period of liver resection for evaluation of functional liver reserve.
OBJECTIVE
The serum hyaluronic acid (HA) concentrations reflect the degree of hepatic fibrosis and sinusoidal endothelial cell damage. The HA concentrations were examined to evaluate liver damage during the perioperative period of hepatectomy.


METHODS
The HA level of serum samples from 79 patients who underwent a hepatectomy was measured, and the results were compared to conventional liver function tests, the degree of fibrosis, liver regeneration and complications.


RESULTS
Hyaluronic acid concentrations correlated with the severe fibrosis or histological activity index, and also correlated with liver function tests including transaminase level, platelet counts, prothrombin time activity, indocyanine green retention rate at 15 min (ICG R15), liver activity at 15 min by technetium-99m galactosyl human serum albumin scintigraphy (LHL 15), and portal pressure. The HA level postoperatively correlated with liver function, especially with total bilirubin. Hyaluronic acid levels at day 28 postoperatively correlated with ICG R15 and LHL 15. The hyaluronic acid level before surgery and at day 28 postoperatively correlated with the regeneration of remnant liver in major hepatectomy. The HA levels were significantly higher in patients with hepatic failure or prolonged ascites.


CONCLUSIONS
Our results indicate that the measurement of the HA level is useful for monitoring liver damage or predicting complications associated with liver surgery.
Nanashima
A
A
The First Department of Surgery, Nagasaki University School of Medicine, Nagasaki, Japan. a-nanasm@alpha.med.nagasaki-u.ac.jp
Yamaguchi
H
H
Shibasaki
S
S
Sawai
T
T
Yamaguchi
E
E
Yasutake
T
T
Tsuji
T
T
Jibiki
M
M
Nakagoe
T
T
Ayabe
H
H
D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D005260:Female; D006498:Hepatectomy; D006801:Humans; D006820:Hyaluronic Acid / Q000097:blood*; D008107:Liver Diseases / Q000097:blood* / Q000601:surgery*; D008111:Liver Function Tests; D008115:Liver Regeneration / Q000502:physiology; D008297:Male; D008875:Middle Aged; D019990:Perioperative Care; D011183:Postoperative Complications / Q000097:blood; D011237:Predictive Value of Tests; D012306:Risk
D006820:Hyaluronic Acid