Liver enzymes cannot be used to predict liver damage after global hypoxia-ischemia in a neonatal pig model.
BACKGROUND
The term newborn pig is an established model for studying both brain and organ pathology after hypoxia-ischemia (HI). Serial liver enzyme activity is often used to predict liver injury but little is known about the relation between consecutive values of different liver enzymes and histologically verified liver injury.


OBJECTIVE
To determine whether plasma values of aspartate aminotransferase (AST), alanine aminotransferase (ALT) and lactate dehydrogenase (LDH) differed between newborn pigs with liver injures and pigs with normal livers after a severe global HI insult.


METHODS
Nineteen < or =36-hour-old pigs underwent a 45-min global HI insult followed by 72-hour survival. Four histological sections from standardized areas within each liver were examined. Areas under the curve (AUC) for the enzymes were calculated and compared between pigs with pathological changes in the liver (n = 12) and pigs with normal liver histology (n = 7).


RESULTS
No differences in AUC for the enzyme values were seen between the groups. However, in pigs with liver injuries a transient significant increase in LDH at the end of the HI insult (928 U/l (567-1,031)) was seen compared to the baseline value (679 U/l (548-866), p = 0.010). Significantly more liver injury was seen in animals with the umbilical vein catheter (UVC) tip inserted into the liver (p = 0.040) compared to animals with the UVC tip located outside the liver.


CONCLUSIONS
In newborn pigs subjected to global HI, only LDH increases alongside pathological changes in the liver. Normal values of ALT and AST do not exclude hepatic injury.
Karlsson
Mathias
M
Department of Clinical Science at South Bristol (Child Health), St Michael's Hospital, University of Bristol, Bristol, UK.
Satas
Saulius
S
Stone
Janet
J
Porter
Helen
H
Thoresen
Marianne
M
D000410:Alanine Transaminase / Q000097:blood*; D000818:Animals; D000831:Animals, Newborn; D019540:Area Under Curve; D001219:Aspartate Aminotransferases / Q000097:blood*; D004796:Clinical Enzyme Tests; D004195:Disease Models, Animal; D007770:L-Lactate Dehydrogenase / Q000097:blood*; D008107:Liver Diseases / Q000201:enzymology* / Q000473:pathology; D015427:Reperfusion Injury / Q000201:enzymology* / Q000473:pathology; D013552:Swine
D007770:L-Lactate Dehydrogenase; D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase