MARKERS OF HEPATIC FUNCTION, INFLAMMATION, AND ENDOTHELIAL DYSFUNCTION IN THE LONG-TERM PERIOD AFTER LIVER DONATION IN LIVING-RELATED TRANSPLANTATION
Keywords:
living liver donation, hemihepatectomy, subclinical inflammation, endothelial dysfunction, cholestasisAbstract
Objective. To assess liver panel parameters, markers of subclinical inflammation, hemostasis, and endothelial dysfunction in living liver donors in the long-term period after donor hemihepatectomy.
Materials and Methods. The study included 131 living related liver donors. Of these, 120 donors were operated on at a single center and followed up preoperatively and at 12, 24, and 36 months after donation; 11 donors operated abroad were examined at 12–96 months post-donation. Laboratory evaluation comprised complete blood count, liver and metabolic panels, coagulation tests, inflammatory markers (C-reactive protein, interleukin-6), and markers of endothelial dysfunction (von Willebrand factor, homocysteine). Statistical analysis was performed using MedCalc v23.0.8.
Results. Basic metabolic parameters, hemoglobin levels, platelet count, and routine coagulation tests remained within reference ranges throughout follow-up. However, from 12 months after donation, a significant increase in leukocyte and lymphocyte counts was observed (p<0.05). Markers of subclinical inflammation demonstrated progressive elevation, with significant increases in IL-6, C-reactive protein, and fibrinogen at 24 and 36 months. From 24 months onward, laboratory signs of cholestasis emerged, including elevated total and direct bilirubin and alkaline phosphatase. Markers of endothelial dysfunction showed a sustained increase beginning 12 months after donation.
Conclusion. In the long-term period after liver donation, donors develop signs of subclinical inflammation, endothelial dysfunction, and progressive cholestatic changes despite preserved basic laboratory parameters, highlighting the need for long-term targeted monitoring.
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