title: Analysis of the components of hypertransaminasemia after liver resection.
abstract: BACKGROUND
  The increase in plasma aspartate (AST) and alanine (ALT) aminotransferase after liver resection is multifactorial, and a major problem is the difficult quantification of the impact of each factor involved.
  
  
  METHODS
  Regression analysis of a large series of measurements for 92 hepatectomy patients was carried out to assess in detail the postoperative evolution of AST and ALT, together with related components.
  
  
  RESULTS
  The best correlate of increased AST and ALT on postoperative day 1 was the duration of surgery (T-surg) (r(2)=0.31 and 0.29), with a lower correlation for intraoperative liver ischemia (T-isch) (r(2)=0.22 and 0.17, respectively; p<0.001 for all). Subsequently AST decreased more quickly than ALT and both followed an inverse exponential pattern. T-surg, T-isch, time after surgery and plasma bilirubin explained 77% and 51% of the variability of AST and ALT, respectively, for all postoperative measurements (p<0.001 for both). The best correlate of T-isch was a delayed increase in bilirubin, detected on postoperative day 7, attenuated by the use of intermittent liver ischemia.
  
  
  CONCLUSIONS
  These data show that T-isch may not be the main determinant of increased transaminases after hepatectomy, and provide a quantitative analysis of the main impact of the trauma of liver resection, liver ischemia, and other factors on the postoperative evolution of transaminases.
authors: Department of Surgical Sciences, Hepatobiliary Unit, Catholic University School of Medicine, Rome, Italy. ivo.giovannini@rm.unicatt.it
authors: Ivo
authors: I
authors: Giovannini
authors: Carlo
authors: C
authors: Chiarla
authors: Felice
authors: F
authors: Giuliante
authors: Maria
authors: M
authors: Vellone
authors: Francesco
authors: F
authors: Ardito
authors: Gerardo
authors: G
authors: Sarno
authors: Gennaro
authors: G
authors: Nuzzo
mesh_terms: D000368:Aged; D000410:Alanine Transaminase / Q000097:blood*; D001219:Aspartate Aminotransferases / Q000097:blood*; D005260:Female; D006801:Humans; D008099:Liver / Q000601:surgery*; D008107:Liver Diseases / Q000601:surgery*; D008113:Liver Neoplasms / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011184:Postoperative Period; D011300:Preoperative Care; D012044:Regression Analysis
chemical_list: D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase