ALKALINE-PHOSPHATASE ISOFORMS IN SERUM AFTER LIVER ALLOGRAFT SURGERY

Orthotopic liver transplantation (OLT) is now the only available treat ment for end-stage liver disease; the major postoperative complication s of OLT are rejection and infection. Fractionation of alkaline phosph atase (ALP) isoforms in serum by isoelectric focusing can be used to i dentify patients with complications. Reference ranges for liver-functi on tests (LFT) and liver ALP isoforms were established for post-OLT pa tients with stable postoperative courses and compared with those of pa tients with complications. We found canalicular, hepatocyte, and high- molecular-mass ALP to be statistically higher in nearly all patients w ith complications as compared with patients who had a stable postopera tive course; these tests may identify patients requiring a liver biops y. When used in conjunction with LFT and other clinical findings, ALP isoforms could aid in the monitoring of complications and treatment an d in the adjustment of immunosuppressive therapy in stable OLT cases.