RELATIONSHIP OF APOLIPOPROTEIN-AI, APOLIPOPROTEIN-B AND LIPOPROTEIN LP(A) TO HEPATIC-FUNCTION OF LIVER RECIPIENTS DURING THE EARLY POSTTRANSPLANT PERIOD

To evaluate serum apo AI, apo B, Lp(a) and the ratio of unesterified cholesterol to total cholesterol as markers of hepatic synthetic capacity after orthotopic liver transplantation, serial measurements of these variables were performed on posttransplant days 1, 3, 5, 7, 10 and 14 in 70 patients. Liver function was assessed by a quantitative dynamic test based on the hepatic conversion of lidocaine to monoethylglycinexylidide (MEGX). Patients were divided into two groups on the basis of clinical and laboratory findings, those with evidence (n = 46) and those without evidence (n = 24) of hepatic dysfunction. Apo AI levels fell in both groups to day 5, but then began to increase in the group with good hepatic function, a highly significant (P < 0.001) positive correlation being found with the results of the MEGX test on post-transplant days 7, 10 and 14. The ratio of unesterified cholesterol to total cholesterol rose in both groups from days 1 to 7 and then began to fall in the group without hepatic dysfunction; a highly significant (P < 0.001) negative correlation was observed with the results of the MEGX test on days 10 and 14. Apo B levels rose in both groups from days 1 to 10, with no significant differences between the two groups; no correlation was observed with the results of the MEGX test on any study day. In contrast, serum Lp(a) concentrations fell in both groups to day 5, but then began to increase in patients with good hepatic function; a highly significant (P < 0.001) positive correlation with the results of the MEGX test was recorded on posttransplant day 14. We conclude that serial measurements of serum apo AI, Lp(a) and the ratio of unesterified cholesterol to total cholesterol are of value in monitoring the restoration of hepatic synthetic capacity in patients after orthotopic liver transplantation.