Clinical Chemistry
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Clinical Chemistry 43: 1546-1554, 1997;
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(Clinical Chemistry. 1997;43:1546-1554.)
© 1997 American Association for Clinical Chemistry, Inc.

Articles

Clinical chemistry and post-liver-transplant monitoring

Peter E. Hickman1,a, Julia M. Potter2 and Amadeo J. Pesce3

Department of Chemical Pathology, Queensland Liver Transplant Service,
1 Princess Alexandra Hospital, Woolloongabba, Queensland, Australia 4102, and
2 Royal Brisbane Hospital, Herston, Queensland, Australia 4029.
3 Department of Pathology and Laboratory Medicine, College of Medicine, University of Cincinnati, Cincinnati, OH 45267-0714.
a Author for correspondence. Fax 61 7 3240 7070;

Liver transplantation is an accepted therapy for end-stage liver disease. After allografting, a variety of clinical problems may require laboratory involvement for accurate and timely diagnosis and intervention. Critical factors in the choice of a laboratory test menu to support a transplant program include turnaround times that support clinical decisionmaking, real diagnostic value, and real value for money. Particular clinical problems, whose early presentation must be anticipated, include graft ischemia, primary nonfunction, and hepatic artery thrombosis. Acute rejection is common at 5–10 days posttransplantation, the principal target being the biliary tree. Longer-term problems are associated with the therapeutic drug measurement of cyclosporin A and, increasingly, tacrolimus (FK506); the side effects of immunosuppressant therapy also require monitoring. A successful liver transplant program can be adequately supported with a simple battery of automated tests that are cheap, fast, and available at all times.


Key Words: indexing terms: liver transplantation • liver function tests • laboratory costs • graft ischemia • rejection • therapeutic drug monitoring




The following articles in journals at HighWire Press have cited this article:


Home page
 Clin. Chem.Home page
E. R. Black
Diagnostic strategies and test algorithms in liver disease
Clin. Chem., August 1, 1997; 43(8): 1555 - 1560.
[Abstract] [Full Text] [PDF]


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Copyright © 1997 by the American Association for Clinical Chemistry.