SERUM DELTA-BILIRUBIN CONJUGATED BILIRUBINS RATIO MEASUREMENT AS A LIVER-FUNCTION MARKER AFTER LIVER-TRANSPLANTATION

Serum delta-bilirubin measured in relationship to total bilirubin coul d be a liver function test in hepatobiliary diseases and even a marker of early rejection after liver transplantation. Delta-bilirubin bound to albumin constitutes with mono and diglucuroconjugates, conjugated bilirubins. We determined the delta-bilirubin / conjugated bilirubins ratio and studied its value in various complications in 16 liver recip ients. The results were compared with alanine aminotransferase activit y and prothrombin index. Hyperbilirubinemia and a delta-bilirubin / co njugated bilirubins ratio lower than 40 % were observed initially. Aft er 15 days, the delta-bilirubin / conjugated bilirubins ratio evolved differently according to the funtional state of the graft, which allow ed to distinguish three patient groups: in patients with good graft fu nction, the ratio increased regularly to reach 65 % or more on the 30t h day; in patients with disfunctional episodes, the ratio was always l ess than or equal to 40 % and did not increase after the 15th day; in other patients, the ratio was lower than 40 % and dropped suddenly bef ore death. After liver transplantation, the delta-bilirubin / conjugat ed bilirubins ratio may be a simple liver function marker. Alone, howe ver, it cannot be used to assess acute rejection.