CARBOHYDRATE-DEFICIENT TRANSFERRIN - DIAGNOSTIC EFFICIENCY AMONG PATIENTS WITH END-STAGE LIVER-DISEASE BEFORE AND AFTER LIVER-TRANSPLANTATION

We tested the diagnostic validity of carbohydrate-deficient transferri n (CDT) as an indicator for relapse into elevated alcohol consumption among patients who were examined under follow-up treatment before (n = 147) and after (n = 102) orthotopic liver transplantation (OLT) in th e outpatient;department of the University Hospital Department of Surge ry in Hamburg-Eppendorf. CDT measurements were performed with two comm ercial kits in parallel (CDTect-RIA and CDT%-RIA). Short-term paramete rs of alcohol consumption (ethanol, methanol) indicated relapses into elevated alcohol consumption in 11.4% of the evaluated patients with a lcoholic liver disease (ALD) before transplantation. Before OLT, media n CDT values were determined to be elevated among patients with alcoho lic as well as nonalcoholic end-stage liver diseases (NALD). Among pat ients with ALD, we found elevated CDT medians even in those who were s uccessfully scheduled for OLT after long-term evidence or abstinence p roved by biochemical short-term parameters end psychological tests. Bo th CDTect acid CDT% assays had comparable law specificities in selecte d patient groups before transplantation. CDT% and CDTect were negative ly correlated with the albumin level. Before the study ended, CDT was no longer implemented in the evaluation of whether an OLT should be ad ministered. This was due to inconsistent results of CDT in ALD as well as NALD. After OLT, patients with ALD, as well as NALD, had statistic ally significant lower CDT medians than before OLT, which ranged withi n reference levels. We determined, according to CDT, elevated alcohol consumption subsequent to OLT in 4 of 13 patients with ALD who underwe nt transplantation during the study (median observation period: 10 mon ths). CDT does not appear to be useful in evaluating patients before O LT. With regained specificity and high sensitivity in patients after O LT, CDT could be recommended as a standard instrument for quality cont rol in patients with ALD after liver transplantation.