Assessment of the functional state of the remnant left liver lobe in living related donors
DOI:
https://doi.org/10.15574/PS.2025.3(88).7175Keywords:
living related donor, liver transplantation, right hemihepatectomy, liver resection, remnant liver, liver functional state, postoperative period, liver regenerationAbstract
Aim - to comprehensively evaluate the functional adaptation and state of the remnant left liver lobe in living related donors following right hemihepatectomy for transplantation by assessing the dynamics of key blood laboratory parameters in the early postoperative period.
Materials and methods. The study included 30 somatically healthy living related liver donors aged 22-52 years who underwent standard right hemihepatectomy for transplantation. The following laboratory parameters were assessed: alanine aminotransferase (ALT), aspartate aminotransferase (AST), total and direct bilirubin, albumin, international normalized ratio (INR), interleukin-6 (IL-6), and C-reactive protein (CRP). Biochemical analyses were performed preoperatively and on days 1, 2, 3, 5, and 7 of the postoperative period, respectively.
Results. In the early postoperative period, a significant but transient increase in transaminases, total and direct bilirubin, IL-6, CRP, and INR levels was recorded, with gradual normalization by days 5-7. The highest increase in AST was observed on the first day after resection (more than an 18-fold increase compared to the preoperative level). Albumin levels decreased until day 3, after which a trend towards normalization was maintained. Peak values of IL-6 and CRP were observed on days 1-2 of the postoperative period; such dynamics correspond to the transient functional load on the remnant liver lobe and the initiation of active parenchymal regeneration processes. No clinical signs of acute liver failure were recorded in the examined patients.
Conclusions. In living liver donors after right hemihepatectomy, a pronounced short-term impairment of the functional state of the remnant left liver lobe is observed, which shows a clear tendency towards spontaneous normalization within the first week. The obtained results can be used to improve clinical monitoring of donors, predict the recovery of liver function, and optimize patient management tactics in the early postoperative period.
The study was conducted in accordance with the principles of the Declaration of Helsinki. The study protocol was approved by the local ethics committee of the mentioned institution. Informed consent was obtained from the patients.
The authors declare no conflict of interest.
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