title: Serum hyaluronate level for predicting subclinical liver dysfunction after hepatectomy.
abstract: The serum hyaluronate (HA) level reflects sinusoidal endothelial cell function correlated with liver function. We have reviewed multiple liver function indicators from 37 patients who underwent hepatectomy for various liver diseases. The serum HA level was well correlated with the indocyanine green retention rate at 15 minutes (ICGR15), lectin-cholesterol (LCAT), hepatocyte growth factor (HGF), liver uptake ratio of technetium-99m galactosyl human serum albumin (99mTc-GSA) at 15 minutes (HH15), prealbumin, and hepatic uptake ratio of 99mTc-GSA at 15 minutes (LHL15). In addition, the model for end-stage liver disease (MELD) score at 7 days after operation was well correlated with serum HA, ICGR15, HH15, and LHL15. In patients who showed serum an HA level of = 100 ng/ml before hepatectomy, the MELD score had significantly deteriorated by 7 days after hepatectomy. Of the 20 patients who showed a serum HA level < 100 ng/ml before hepatectomy, 11 had high serum HA after hepatectomy. The bilirubin level 7 days after operation in this group was much higher than that for patients who maintained a serum HA level < 100 ng/ml after hepatectomy. In addition, the serum HGF level before hepatectomy in this group was significantly lower. We concluded that the serum HA level is a reliable indicator when evaluating liver function and predicting liver dysfunction after hepatectomy. Furthermore, patients with a significantly low HGF level who have a normal HA level are susceptible to liver dysfunction after hepatectomy.
authors.affiliation: Department of Surgery I, Sapporo Medical University Hospital, Sapporo Medical University School of Medicine, S-1, W-16, Chuo-Ku, 060-8543, Sapporo, Hokkaido, Japan. tmizu@sapmed.ac.jp
authors.forename: Toru
authors.initials: T
authors.lastname: Mizuguchi
authors.forename: Tadashi
authors.initials: T
authors.lastname: Katsuramaki
authors.forename: Takayuki
authors.initials: T
authors.lastname: Nobuoka
authors.forename: Masaki
authors.initials: M
authors.lastname: Kawamoto
authors.forename: Hideki
authors.initials: H
authors.lastname: Oshima
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Kawasaki
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Kikuchi
authors.forename: Chihiro
authors.initials: C
authors.lastname: Shibata
authors.forename: Koichi
authors.initials: K
authors.lastname: Hirata
mesh_terms: D000368:Aged; D001663:Bilirubin / Q000097:blood; D006528:Carcinoma, Hepatocellular / Q000097:blood / Q000601:surgery; D005260:Female; D006498:Hepatectomy; D017228:Hepatocyte Growth Factor / Q000097:blood; D006801:Humans; D006820:Hyaluronic Acid / Q000097:blood*; D008103:Liver Cirrhosis / Q000097:blood / Q000601:surgery; D008107:Liver Diseases / Q000097:blood* / Q000601:surgery*; D008111:Liver Function Tests; D008113:Liver Neoplasms / Q000097:blood / Q000601:surgery; D008297:Male; D008875:Middle Aged; D011184:Postoperative Period
chemical_list: D017228:Hepatocyte Growth Factor; D006820:Hyaluronic Acid; D001663:Bilirubin