Bonus Post: Liver Labs explained

This is a bonus post for today, June 14, so don't miss our normal update post below.

Blood Tests Explained

Immediately after surgery, Sarah expressed an interest in knowing more about the labs, and being the big picture sort of guy I am, I was more focused on Porter's general condition and comfort, and not the lab numbers. But, then my science teacher brain kicked in and I had to learn more about the lab tests that are done on Porter's blood every day. Here's what I've learned.

We knew Porter's body would recover well since he was relatively healthy going into transplant and his only disorder or symptoms were associated with the OTC and not widespread liver dysfunction, as is the case with many other transplant recipients. But, how exactly do we know his new liver is functioning well? Daily blood tests give us and the doctor team a inside look at how the liver is faring.

First, his ammonia level dropped steadily following surgery without medication, so this was an initial sign that his liver was processing the ammonia appropriately. But, without food in his system, the ammonia processing is hard to interpret ultimately.

Then, his daily labs include "liver function tests" which are measurements of various enzymes and compounds that are associated with liver function. In general, Porter's liver function tests have been trending in the right direction, downward in most cases, and this tells us that his liver is steadily improving its function following the trauma of the surgery.

Bilirubin: This is a byproduct processed by the liver. High levels may indicate low processing, and compromised liver function

Albumin: This is a main protein made by the liver. Low levels may indicate poor liver function.

Porter's Bilirubin and Albumin have been steady. This is good news, I guess. Rising bilirubin or dropping albumin would be concerning

ALT - Alanine Transaminase. This liver enzyme functions in normal metabolism, but a damaged liver will release this enzyme into the blood.

AST - Aspartate Aminotransferase. This enzyme is also released into the blood when a liver is damaged, but it can also be found and released from cell elsewhere in the body, so it is usually used in conjunction with ALT for analysis.

Porters ALT has been steadily dropping from 257 units/L to 168 units/L. And, AST has also dropped from 107 units/L to 56 units/L.

Levels of liver Lactate Dehydrogenase (my favorite enzyme!) are also dropping, a good sign.

Since Porter is also on a Heparin drip to control clotting factors and facilitate blood flow to the new organ, the doctors are also keeping an eye on his coagulation factors. But coagulation is a story for another day!