Changes Of ALT,AST,?-GT,ALP And TBA Level In Bile And AST,?-GT Predictive Value For Ead After Liver Transplantation

ObjectiveTo analyze the changes of alanine aminotransferase?ALT?,aspartate aminotransferase?AST?,?-glutamyltransferase??-GT?,alkaline phosphatase?ALP?and total bile acid?TBA?levels in the bile of patients after liver transplantation and discuss AST and?-GT predictive value in early graft dysfunction?EAD?.Methods32 patients after liver transplantation were enrolled in this study.Compare the levels of ALT,AST,?-GT,ALP and TBA between in serum and that in the bile.The patients were divided into two groups,EAD?EAD group,n=6?and non-EAD?N-EAD group,n=26?,according to the onset of EAD after surgery.Patients'bile from day 1 to day 7 after surgery was collected and the changes of?-GT and AST in bile were detected and compared.The ROC curve was used to evaluate the predictive value of bile?-GT and AST at different times for postoperative EAD.ResultsRepeated measures analysis of variance shows time point comparison,group comparison and interaction between time and group have a significant effect on the bile AST level(F_group=49.708,F_time=49.332,F_time*group=10.093,P<0.01),and also had a significant effect on the bile?-GT level(F_group=12.827,F_time=17.421,F_time*group=2.918,P<0.05).The bile AST level of EAD group was higher than that of N-EAD group from day 1to day 6 after surgery?F=8.175-40.527,P<0.01?,and the bile?-GT level of EAD group was higher than that of N-EAD group from day 1 to day 5?F=4.396-13.199,P<0.05?.There was a significant positive correlation between the level of ALT and AST in serum and that in the bile(r_ALT=0.893,r_AST=0.855,P<0.01).Bile?-GT and AST levels from day 1 to day 4 after surgery have certain diagnostic value for EAD.ConclusionThe changes of?-GT,ALT and AST levels in bile from day 1 to day 7 after transplantation indicated the destruction degree of hepatocyte to some extent.The levels of?-GT and AST in bile of liver transplant patients from day 1 to day 4 had early predictive value for EAD.In clinical practice,the bile?-GT and AST levels can be used to evaluate the possibility of EAD after transplantation and guide the early treatment.