Role of direct bilirubin and total bilirubin ratio in the differential diagnosis of complications after liver transplantation

Objective To investigate the role of direct bilirubin（ DBil）and total bilirubin （ TBil）ratio in the identification of complications after liver transplantation. Methods Two hundred and sixteen recipients of liver transplant were divided into without jaundice,mild jaundice and moderate jaun-dice group according to the preoperative TBil levels. On the other hand,the 216 recipients were also di-vided into common,failure,rejection and obstruction group by postoperative complications. TBil and DBil/ TBil levels were analyzed in each group. Results The postoperative TBil level rapidly fall at the first day and then gradually declined in moderate jaundice group and severe jaundice group,but it was still higher than that in without jaundice group and mild jaundice group within 2 weeks after operation （P ﹤ 0. 05）. The DBil/ TBil levels in no jaundice group,mild jaundice group moderate and severe jaun-dice group significantly increased after operation,and reached peak value on the 3rd day after operation, and then decreased slowly. DBil/ TBil level was relatively high in patients with high TBil,on the 3rd day after operation,that in mild jaundice group（0. 72 ±0. 1）and moderate and severe jaundice group（0. 75 ± 0. 11）,was higher than that in no jaundice group（P ﹤0. 05）. The TBil level within 5 d after operation of failure,obstruction and rejection group first decreased and then increased,and was higher than that in common group（P ﹤0. 05）. Postoperative DBil/ TBil levels in obstruction,rejection and common group with- Key words: Liver transplantation; Bilirubin; Direct bilirubin; Complication; Diagnosis