Laboratory test results after living liver donation in the adult-to-adult living donor liver transplantation cohort study

James F Trotter, Brenda W Gillespie, Norah A Terrault, Michael M Abecassis, Robert M Merion, Robert S Brown Jr, Kim M Olthoff, Paul H Hayashi, Carl L Berg, Robert A Fisher, James E Everhart, Adult-to-Adult Living Donor Liver Transplantation Cohort Study Group, Jean C Emond, Robert S Brown Jr, Scott Heese, Jonah S Zaretsky, Michael M I Abecassis, Laura M Kulik, Patrice Al-Saden, Abraham Shaked, Kim M Olthoff, Brian Conboy, Mary Shaw, Gregory T Everson, Igal Kam, Carlos Garcia, Anastasia Krajec, Johnny C Hong, Ronald W Busuttil, Janet Mooney, Chris E Freise, Norah A Terrault, Dulce MacLeod, Robert M Merion, Anna S F Lok, Akinlolu O Ojo, Brenda W Gillespie, Margaret Hill-Callahan, Terese Howell, Lisa Holloway, Mary Akagi, Monique Lowe, Abby Smith, Abby Brithinee, Paul H Hayashi, Tracy Russell, Carl L Berg, Jaye Davis, Robert A Fisher, R Todd Stravitz, April Ashworth, Andrea Lassiter, James E Everhart, Leonard B Seeff, Patricia R Robuck, Jay H Hoofnagle, James F Trotter, Brenda W Gillespie, Norah A Terrault, Michael M Abecassis, Robert M Merion, Robert S Brown Jr, Kim M Olthoff, Paul H Hayashi, Carl L Berg, Robert A Fisher, James E Everhart, Adult-to-Adult Living Donor Liver Transplantation Cohort Study Group, Jean C Emond, Robert S Brown Jr, Scott Heese, Jonah S Zaretsky, Michael M I Abecassis, Laura M Kulik, Patrice Al-Saden, Abraham Shaked, Kim M Olthoff, Brian Conboy, Mary Shaw, Gregory T Everson, Igal Kam, Carlos Garcia, Anastasia Krajec, Johnny C Hong, Ronald W Busuttil, Janet Mooney, Chris E Freise, Norah A Terrault, Dulce MacLeod, Robert M Merion, Anna S F Lok, Akinlolu O Ojo, Brenda W Gillespie, Margaret Hill-Callahan, Terese Howell, Lisa Holloway, Mary Akagi, Monique Lowe, Abby Smith, Abby Brithinee, Paul H Hayashi, Tracy Russell, Carl L Berg, Jaye Davis, Robert A Fisher, R Todd Stravitz, April Ashworth, Andrea Lassiter, James E Everhart, Leonard B Seeff, Patricia R Robuck, Jay H Hoofnagle

Abstract

Information on the long-term health of living liver donors is incomplete. Because changes in standard laboratory tests may reflect the underlying health of donors, results before and after donation were examined in the Adult-to-Adult Living Donor Liver Transplantation Cohort Study (A2ALL). A2ALL followed 487 living liver donors who donated at 9 US transplant centers between 1998 and 2009. The aminotransferase [aspartate aminotransferase (AST) and alanine aminotransferase (ALT)] and alkaline phosphatase (AP) activities, bilirubin, international normalized ratio (INR), albumin, white blood cell count (WBC), hemoglobin (HGB), platelet count, ferritin, serum creatinine (SCR), and blood urea nitrogen (BUN) were measured at the evaluation and after donation (1 week, 1 month, 3 months, 1 year, and yearly thereafter). Repeated measures models were used to estimate median laboratory values at each time point and to test for differences between values at the evaluation (baseline) and postdonation time points. Platelet counts were significantly decreased at every time point in comparison with the baseline, and at 3 years, they were 19% lower. Approximately 10% of donors had a platelet count < 150 × 1000/mm(3) 2 to 3 years post-donation. Donors with a platelet count ≤ 150 × 1000/mm(3) at 1 year had significantly lower mean platelet counts (189 ± 32 × 1000/mm(3) ) versus the remainder of the cohort (267 ± 56 × 1000/mm(3) , P < 0.0001) at the evaluation. Statistically significant differences compared to the evaluation values were noted for AST, AP, INR, and albumin through the first year, although most measurements were in the normal range. The median values for WBC, HGB, ferritin, albumin, SCR, BUN, and INR were not substantially outside the normal range at any time point. In conclusion, after 3 months, most laboratory values return to normal among right hepatic lobe liver donors, with a slower return to baseline levels for AST, AP, INR, and albumin. Persistently decreased platelet counts warrant further investigation.

Copyright © 2010 American Association for the Study of Liver Diseases.

Figures

Figure 1
Figure 1
a-d. Laboratory tests at evaluation (Eval) and 7 time points post-donation. Asterisks just above x-axis indicate time points where the median is significantly different from Eval (p<0.05). Boxes include the 25th to 75th percentiles, with indentation indicating median and “+” indicating mean values (connected by grey line). Whiskers extend to the 5th and 95th percentiles.
Figure 1
Figure 1
a-d. Laboratory tests at evaluation (Eval) and 7 time points post-donation. Asterisks just above x-axis indicate time points where the median is significantly different from Eval (p<0.05). Boxes include the 25th to 75th percentiles, with indentation indicating median and “+” indicating mean values (connected by grey line). Whiskers extend to the 5th and 95th percentiles.
Figure 1
Figure 1
a-d. Laboratory tests at evaluation (Eval) and 7 time points post-donation. Asterisks just above x-axis indicate time points where the median is significantly different from Eval (p<0.05). Boxes include the 25th to 75th percentiles, with indentation indicating median and “+” indicating mean values (connected by grey line). Whiskers extend to the 5th and 95th percentiles.
Figure 1
Figure 1
a-d. Laboratory tests at evaluation (Eval) and 7 time points post-donation. Asterisks just above x-axis indicate time points where the median is significantly different from Eval (p<0.05). Boxes include the 25th to 75th percentiles, with indentation indicating median and “+” indicating mean values (connected by grey line). Whiskers extend to the 5th and 95th percentiles.
Figure 2
Figure 2
a-c. Laboratory tests at evaluation (Eval) and 7 time points post-donation. Asterisks just above x-axis indicate time points where the median is significantly different from Eval (p<0.05). Boxes include the 25th to 75th percentiles, with indentation indicating median and “+” indicating mean values (connected by grey line). Whiskers extend to the 5th and 95th percentiles.
Figure 2
Figure 2
a-c. Laboratory tests at evaluation (Eval) and 7 time points post-donation. Asterisks just above x-axis indicate time points where the median is significantly different from Eval (p<0.05). Boxes include the 25th to 75th percentiles, with indentation indicating median and “+” indicating mean values (connected by grey line). Whiskers extend to the 5th and 95th percentiles.
Figure 2
Figure 2
a-c. Laboratory tests at evaluation (Eval) and 7 time points post-donation. Asterisks just above x-axis indicate time points where the median is significantly different from Eval (p<0.05). Boxes include the 25th to 75th percentiles, with indentation indicating median and “+” indicating mean values (connected by grey line). Whiskers extend to the 5th and 95th percentiles.
Figure 3
Figure 3
a-d. Laboratory values at year 1 versus baseline. Diagonal line indicates the line of equality; points below the diagonal indicate larger values at baseline; points above the diagonal indicate larger values at year 1.
Figure 3
Figure 3
a-d. Laboratory values at year 1 versus baseline. Diagonal line indicates the line of equality; points below the diagonal indicate larger values at baseline; points above the diagonal indicate larger values at year 1.
Figure 3
Figure 3
a-d. Laboratory values at year 1 versus baseline. Diagonal line indicates the line of equality; points below the diagonal indicate larger values at baseline; points above the diagonal indicate larger values at year 1.
Figure 3
Figure 3
a-d. Laboratory values at year 1 versus baseline. Diagonal line indicates the line of equality; points below the diagonal indicate larger values at baseline; points above the diagonal indicate larger values at year 1.
Figure 4
Figure 4
a-c. Laboratory values at year 1 versus baseline. Diagonal line indicates the line of equality; points below the diagonal indicate larger values at baseline; points above the diagonal indicate larger values at year 1.
Figure 4
Figure 4
a-c. Laboratory values at year 1 versus baseline. Diagonal line indicates the line of equality; points below the diagonal indicate larger values at baseline; points above the diagonal indicate larger values at year 1.
Figure 4
Figure 4
a-c. Laboratory values at year 1 versus baseline. Diagonal line indicates the line of equality; points below the diagonal indicate larger values at baseline; points above the diagonal indicate larger values at year 1.
Figure 5
Figure 5
a-d. Laboratory values at week 1 (a and c) or month 1 (b and d) versus baseline. Diagonal line indicates the line of equality; points below the diagonal indicate larger values at baseline; points above the diagonal indicate larger values at year 1.
Figure 5
Figure 5
a-d. Laboratory values at week 1 (a and c) or month 1 (b and d) versus baseline. Diagonal line indicates the line of equality; points below the diagonal indicate larger values at baseline; points above the diagonal indicate larger values at year 1.
Figure 5
Figure 5
a-d. Laboratory values at week 1 (a and c) or month 1 (b and d) versus baseline. Diagonal line indicates the line of equality; points below the diagonal indicate larger values at baseline; points above the diagonal indicate larger values at year 1.
Figure 5
Figure 5
a-d. Laboratory values at week 1 (a and c) or month 1 (b and d) versus baseline. Diagonal line indicates the line of equality; points below the diagonal indicate larger values at baseline; points above the diagonal indicate larger values at year 1.

Source: PubMed

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