Abstract
The development of liver dysfunction or liver failure must be prevented after liver injury, including liver surgery. We describe the usefulness of apolipoprotein A-1 (ApoA-1) for assessment of the liver function after treatment of liver injury. Our previous studies showed that the serum ApoA-1 level decreased on postoperative day (POD) 7 and then recovered on POD 14 after hepatectomy. This change in ApoA-1 seems to reflect the hepatic protein synthetic ability. When patients developed liver failure, ApoA-1 dramatically decreased, and the serum level was usually under 5mg/dL. This decrease of ApoA-1 was recognized in the relatively early phase of liver failure. Recent studies have shown that ApoA-1 has the ability to bind with and protect against lipopolysaccharides and that it is the major contributor to anti-endotoxin function. When ApoA-1 decreases to an extremely low level, the patient will be at high risk to infection or sepsis. ApoA-1 must be measured for the prevention of postoperative infection in patients with liver injury. In the liver failure patients, we experienced improvement of liver function following oral intake of Valine, an amino acid. This selective amino acid therapy may be effective in the treatment of liver failure.
