The changes and significance of clinical routine laboratory test results in hepatitis B patients before and after undergoing liver transplantation

Objective To analyze the changes of clinical routine laboratory test results in patients with hepatitis B before and after undergoing liver transplantation,and investigate the regularity and characteristics before and after undergoing liver transplantation and in the period of recovery.Methods A retrospective study was performed in 44 patients with preoperative antiviral therapy undergoing liver transplantation.Alanine aminotransferase(ALT),aspartate aminotransferase(AST),total bilirubin(TBil),direct bilirubin(DBil),total bile acid(TBA),alkaline phosphatase(ALP),gamma-glutamyltransferase(GGT),total protein(TP),albumin(Alb),prealbumin(PAlb),glucose(GLU),prothrombin time(PT),activated partial thromboplastin time(APTT),platelet(PLT) and hepatitis B virus(HBV) DNA load and other clinical routine laboratory tests were determined before and 1,10,20,30 d after undergoing liver transplantation.The results were expressed as median(range).Results Before the operation,AST and ALT were 70.2(15.5-539.6) IU/L and 44.1(5.8-255.5) IU/L,and they increased sharply to 1 506.4(172.4-5 195.3) IU/L and 749.1(142.2-2 874.2)IU/L after 1d,and then quickly dropped to 117.3(17.2-900.4) IU/L and 135.3(27.5-1 237.1) IU/L after 10 d,and ended up with the normal levels after 20 d.GGT and ALP decreased slightly after 1 d,and they increased after 10 d,and then remained high after 30 d.TBil and DBil mostly continued to decline,and came back to normal after 30 d.TP and Alb slightly decreased after 1 d,and returned to be normal after 10 d.PAlb continued to increase after the operation.TBA decreased after the operation.PT and APTT were prolonged after the operation,and returned to be normal after 10 d.PLT declined after the operation,and returned to be normal after 10 d.Except for 2 patients who had no change in serum hepatitis B markers and HBV DNA loads between preoperation and postoperation,the remaining 42 patients became negative in serum hepatitis B surface antigen(HBsAb) and turned positive in serum anti-hepatitis B surface antigen antibody(anti-HBs antibody),and their HBV DNA loads became lower than the limit of detection.Conclusions Liver transplantation combined with comprehensive antiviral and immunological treatments can induce the seroconversion of HBsAg and hepatitis B e antigen(HBeAg),and has significant reduction of HBV DNA detection rate and hepatitis B recurrence rate.The variations and characteristics of perioperative routine laboratory test results in patients undergoing liver transplantation may perform as a basis for clinical condition judgments.