Type IV collagen, one of the
serum markers for hepatic
fibrosis, was measured perioperatively in patients with and without chronic liver damage to investigate whether this parameter changes in response to acute stress to the liver and can predict the surgical risk of hepatic resection. The serum
type IV collagen level was significantly elevated in patients with
liver cirrhosis. There were significant correlations between serum
type IV collagen levels and the
indocyanine green clearance test and
cholinesterase activity, although the correlation coefficients were not high. The size of the resected hepatic mass was not the primary factor to influence the postoperative serum
type IV collagen level. In patients with
liver cirrhosis, the postoperative serum
type IV collagen level increased significantly compared to that in patients with normal liver or
chronic hepatitis. Postoperative
liver failure occurred in 0%, 11.6%, and 44.4% of patients with preoperative serum
type IV collagen levels of <150, < or = 150 to 300, and > or = 300 ng/ml, respectively. In those with postoperative
liver failure, the serum
type IV collagen levels were significantly higher both pre- and postoperatively compared to those in patients with uneventful courses. Several preoperative liver function tests indicated that
type IV collagen is an independent risk factor for postoperative
liver failure. Thus perioperative measurement of the serum
type IV collagen levels seemed to be useful for predicting the risk of hepatic resection in patients with chronic liver damage.