Change in alpha glutathione s-transferase levels during liver resection.
OBJECTIVE
Alpha-glutathione s-transferase (GST) is a 50,000-kDa cytosol protein of the hepatocytes. It comprises 5% of the soluble protein of hepatocytes and is readily released in response to injury. Its half-life time is 60 minutes (AST: 47 hrs, ALT: 22 hrs). The aim of this study is to clarify the usefulness of GST measurement during liver resection. We obtained data from 26 patients undergoing liver resection and compared GST levels with AST and ALT levels.


METHODS
Patients included 15 hepatocellular carcinoma, 5 cholangiocellular carcinoma and 6 metastatic cancers (4: colon, 2: stomach). We performed lobectomy for 11, segmentectomy for 5 and partial resection for 10 patients. From these patients, blood samples were collected before surgery, beginning of resection, end of resection, 15, 30, 60 min after resection, end of surgery, 1, 3, 6, 12, 24 hr after operation and 2, 3, 4, 5, 6, 7, 10, 14 postoperative days (POD). GST (Biotrin, Ireland) levels in the serum samples were determined by an ELISA. We also measured AST, ALT levels from the same set of samples.


RESULTS
At the end of resection, GST showed highest level and quickly decreased at 1 hr after operation. On the other hand, AST and ALT showed peak levels at 12 hr after operation.


CONCLUSIONS
Our findings suggest that perioperative GST measurement may be a sensitive and useful marker to evaluate liver function after liver resection.
Suehiro
Taketoshi
T
Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka 812-8582, Japan. tsuehiro@med.gunma-u.ac.jp
Matsumata
Takashi
T
Shikada
Yasunori
Y
Shimada
Mitsuo
M
Shirabe
Ken
K
Sugimachi
Keizo
K
D000328:Adult; D000368:Aged; D014408:Biomarkers, Tumor / Q000378:metabolism*; D006528:Carcinoma, Hepatocellular / Q000201:enzymology / Q000601:surgery; D018281:Cholangiocarcinoma / Q000201:enzymology / Q000601:surgery; D005260:Female; D005982:Glutathione Transferase / Q000032:analysis / Q000378:metabolism*; D006498:Hepatectomy / Q000379:methods*; D006801:Humans; D008103:Liver Cirrhosis / Q000201:enzymology / Q000601:surgery; D008111:Liver Function Tests; D008113:Liver Neoplasms / Q000201:enzymology* / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D016343:Monitoring, Intraoperative; D019990:Perioperative Care; D011379:Prognosis; D011446:Prospective Studies; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D016896:Treatment Outcome
D014408:Biomarkers, Tumor; D005982:Glutathione Transferase