Reduction in albumin binding function following liver resection in patients with and without cirrhosis

Background: The aim of this study is to investigate effects of liver resection on albumin binding function in patients with and without cirrhosis. Methods: An observational study was performed on 42 patients with cirrhosis and hepatocellular carcinoma (HCC), and 17 patients without cirrhosis diagnosed with hepatic cavernous hemangioma, all of whom underwent tumor resection. Control group consisted of 50 healthy volunteers. Albumin metal ion binding capacity was assayed as ischemia-modified albumin transformed (IMAT, equal to 1-IMA), and albumin fatty acid binding strength was also tested. All indicators were measured 1 day before and 1, 3, 7 days after surgery. Results: Preoperative IMAT was significantly higher in healthy volunteers than cirrhotic patients (P=0.02), but not than non-cirrhotic patients (P=0.79). Following surgery, a prolonged and sharp reduction was observed in cirrhotic patients; whereas, in non-cirrhotic patients, the result rose sooner and faster. Albumin fatty acid binding strength in both operated groups decreased for the first 3 days after hepatectomy, then both increased to preoperative levels by day 7. Albumin fatty acid binding strength was higher in noncirrhotic than cirrhotic patients at all time points. Conclusions: This is the first study to show that albumin binding function decreases following liver resection in patients with and without cirrhosis. It is more objective than albumin concentration and less affected by albumin infusion. It may be an important indicator of liver function.