Conventional and quantitative liver function tests after hepatic transplantation: a prospective long-term follow-up

Area of Science:

• Hepatology
• Transplantation Medicine
• Immunology

Background:

• Hepatic function is critical for long-term survival after liver transplantation.
• Assessing liver function in long-term survivors is essential to understand graft performance and patient outcomes.
• Previous studies have focused on early post-transplant periods, with less data on stability over several years.

Purpose of the Study:

• To prospectively evaluate conventional and quantitative liver function tests in long-term liver transplant survivors.
• To determine the stability of hepatic function at least 4 years after a first liver transplantation.
• To correlate liver function parameters with cyclosporin A blood levels.

Main Methods:

• Prospective study involving patients surviving at least 4 years post-liver transplantation.
• Conventional liver function tests including serum bilirubin, gamma GT, AP, AST, ALT, GLDH, total protein, and coagulation profiles.
• Quantitative liver function tests such as indocyanine green clearance, galactose elimination capacity, lidocaine metabolism (MEGX formation), and half-life measurements.

Main Results:

• Serum bilirubin and gamma GT levels were significantly lower at 3, 4, and 5 years compared to 6 months post-transplant.
• Cyclosporin A blood levels were also significantly lower at these later time points.
• Other liver function and integrity parameters, as well as serial quantitative tests, remained stable over the observed period.

Conclusions:

• Hepatic function remains stable in long-term liver transplant survivors for at least several years.
• The observed decrease in bilirubin and gamma GT may reflect improved graft adaptation and reduced immunosuppression over time.
• These findings support the long-term viability and functional capacity of transplanted livers.