Activity of aminotransferases as a marker of liver injury in home parenteral nutrition patients

Karolina M. Dąbrowska; Zuzanna Zaczek; Karolina Złotogórska; Krystyna Majewska; Joanna Kaczanowska; Jacek Sobocki

doi:10.5114/ceh.2022.115124

eISSN: 2449-8238
ISSN: 2392-1099

Clinical and Experimental Hepatology

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abstract:

Original paper

Activity of aminotransferases as a marker of liver injury in home parenteral nutrition patients

Karolina M. Dąbrowska

¹

,

Zuzanna Zaczek

^{1, 2}

,

Karolina Złotogórska

²

,

Krystyna Majewska

¹

,

Joanna Kaczanowska

¹

,

Jacek Sobocki

^{1, 2}

Department of General Surgery and Clinical Nutrition, Centre of Postgraduate Medical Education, Warsaw, Poland
Faculty of Health Sciences, Medical University of Warsaw, Warsaw, Poland

Clin Exp HEPATOL 2022; 8, 2: 132-138

DOI: https://doi.org/10.5114/ceh.2022.115124

Online publish date: 2022/04/01

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Aim of the study
Parenteral nutrition associated liver disease (PNALD) is a frequently reported complication of long-term parenteral nutrition. Early diagnosis and treatment of PNALD can help prevent end-stage liver disease. The aim of the study was to evaluate the activity of aminotransferases as a marker of liver dysfunction in patients receiving home parenteral nutrition under the care of a reference center.

Material and methods
A comprehensive analysis of patients’ medical records from a 9-year period (December 2012 – December 2021) was conducted and the following parameters were evaluated: parenteral nutrition mixture composition, total plasma bilirubin, activity of the liver enzymes alanine aminotransferase (ALT) and aspartate aminotransferase (AST), standardized time factor prothrombin (international normalized ratio [INR] factor) and serum albumin. The analysis covered 630,537 days of parenteral nutrition. The study included 251 patients (140 women and 111 men) included in the Home Parenteral Nutrition Program.

Results
PNALD was diagnosed in 11 parenteral fed patients, which gives the frequency of 8.3%/9 years of treatment. Two deaths were classified as cause of death related to liver disease but not related to PNALD. None of the patients included in the analysis developed end-stage liver failure.

Conclusions
The above analysis shows that individual selection of the composition of the mixture for intravenous nutrition significantly reduces the risk of PNALD and may prevent liver failure in this context.

keywords:

Activity of aminotransferases as a marker of liver injury in home parenteral nutrition patients

Karolina M. Dąbrowska 1 , Zuzanna Zaczek 1, 2 , Karolina Złotogórska 2 , Krystyna Majewska 1 , Joanna Kaczanowska 1 , Jacek Sobocki 1, 2

liver disease, PNALD, home parenteral nutrition, aminotransferases

Karolina M. Dąbrowska

¹

,

Zuzanna Zaczek

^{1, 2}

,

Karolina Złotogórska

²

,

Krystyna Majewska

¹

,

Joanna Kaczanowska

¹

,

Jacek Sobocki

^{1, 2}