Analysis of the changes pattern of serum apolipoprotein A-1 after hepatectomy

Previously, we reported that apolipoprotein A-1 (apoA) is a good indicator of hepatic protein synthesis after hepatectomy. In this study, we analyzed whether the recovery patterns of apoA after hepatectomy were different with the operation procedure or the coexistence of liver disease.

From 1997-2003, we measured the serum levels of albumin, apoA, prealbumin (prealb), and retinol binding protein (RBP) in 100 patients who underwent hepatectomy. All patients tolerated hepatectomy without severe complications such as liver failure. The type of operation was partial resection in 62 cases, segmentectomy (Hr1) in 9 cases, and bisegmentectomy (Hr2) in 29 cases. Coexistent liver conditions were normal liver (NL) in 43 cases, chronic hepatitis (CH) in 29 cases, and liver cirrhosis (LC) in 28 cases.

Postoperative changes of apoA showed the same patterns and no significant difference between operative procedures. Although apoA on preoperation had almost the same value in NL, CH, and LC cases, apoA at POD 14 was the lowest in LC (70.4+ 24.8 mg/dL) compared with NL (79.4+/-23.4 mg/dL) and CH (81.4-19.7 mg/dL). Thirty-five cases showed low recovery of apoA (1.09), and their apoA level was under 70 mg/dL at POD 14. Thirty cases showed a high recovery rate of apoA (1.27), and their apoA at POD 14 was over 90 mg/dL. The percentages of low recovery cases were 28.6% in NL, 31.0% in CH, and 41.9% in LC. For low recovery, there was no significant difference with coexistent liver disease.

The recovery pattern of apoA differed by individual. ApoA synthesis potential depends on individual protein synthesis ability, and not on the operative procedure or coexistent liver disease.