Blood Cobalamin Level Pre-and Post-liver Transplantation

Abstract

AIM: To evaluate the cobalamin (vitamin B12) blood level pre- and post-liver transplantation in patients with liver diseases. METHODS: Cobalamin level was measured in 30 patient’s blood samples pre- and post-liver transplantation. The majority of patients 21 (70%) had viral hepatitis either B or C, whereas the rest 9 (30%) had other liver diseases. Cobalamin level was analyzed with the Advia Centure immunochemiluminometric assay (Siemens, USA) with normal range of 155-672 pmol/L and compared to other blood liver tests such as alinine transaminase (ALT), aspartate transaminass (AST), and bilirubin levels. The p-values were analyzed using the Wilcoxon signed ranks test and the statistical analysis was done by SPSS software. RESULTS: The mean of blood coblamin level was decreased (26%) from 692±220 pmol/L to 508±248 pmol/L post-liver transplantation (p=0.002). A decrease in cobalamin level by 23% was observed in hepatitis B and hepatitis C when grouped together (531±287 pmol/L; p=0.019), by 21% in hepatitis C (559±302 pmol/L, p=0.039), and by 31% in non-viral hepatitis (459±125 pmol/L; p=0.021). The cobalamin level was normalized earlier with a mean of 7.6±1.7 days compared to other routine liver function tests (ALT, AST and bilirubin) 27.4±3.9 days (p<0.0001). CONCLUSION: Blood cobalamin level has been normalized earlier than other routine liver markers in post-liver transplantation; However, larger study is needed to evaluate the benefit of measuring blood cobalamine level in combination with other liver tests for monitoring graft function recovery post liver transplant.