Aspartate transaminase, a liver specific enzyme released into serum following acute liver injury is used in experimental organ preservation studies as a measure of liver IR injury. Whether post-operative serum transaminases are a good indicator of IR injury and subsequent graft and patient survival in human liver transplantation remains controversial.
METHODS: A single centre prospectively collected liver transplant database was analysed for the period 1988-2012. All patients were followed up for 5 years or until graft failure. Transaminase levels on the 1(st) , 3(rd) and 7(th) post-operative days were correlated with the patient demographics, operative outcomes, post-operative complications and both graft and patient survival via a binary logistic regression analysis.
RESULTS: Graft and patient survival at 3 months was 80.3% and 87.5%. AST levels on the 3(rd) (p=0.005) and 7(th) (p=0.001) post-operative days correlated with early graft loss. Patients were grouped by their AST level (day 3): <107iU, 107-1213iU, 1213-2744iU and >2744iU. The incidence of graft loss at 3 months was 10%, 12%. 27% and 59% and 1 year patient mortality was 12%, 14%, 27% and 62%.
CONCLUSIONS: Day 3 AST levels correlate with patient and graft outcome post liver transplantation and would be a suitable surrogate end-point for clinical trials in liver transplantation. This article is protected by copyright. All rights reserved.