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 c holesterol to total cholesterol as markers of hepatic synthetic capaci ty after orthotopic liver transplantation, serial measurements of thes e variables were performed on posttransplant days 1, 3, 5, 7, 10 and 1 4 in 70 patients. Liver function was assessed by a quantitative dynami c test based on the hepatic conversion of lidocaine to monoethylglycin exylidide (MEGX). Patients were divided into two groups on the basis o f clinical and laboratory findings, those with evidence (n = 46) and t hose without evidence (n = 24) of hepatic dysfunction. Apo AI levels f ell in both groups to day 5, but then began to increase in the group w ith good hepatic function, a highly significant (P < 0.001) positive c orrelation being found with the results of the MEGX test on post-trans plant days 7, 10 and 14. The ratio of unesterified cholesterol to tota l cholesterol rose in both groups from days 1 to 7 and then began to f all in the group without hepatic dysfunction; a highly significant (P < 0.001) negative correlation was observed with the results of the MEG X 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 cor relation was observed with the results of the MEGX test on any study d ay. 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 result s 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 unest erified cholesterol to total cholesterol are of value in monitoring th e restoration of hepatic synthetic capacity in patients after orthotop ic liver transplantation.