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Background  Post‐operative serum transaminases have been proposed as possible early predictors of morbidity after liver resection. This study aimed to verify the clinical value of post‐operative serum transaminases.    Methods  Clinical data from 2001 to 2016 in a single non‐academic referral HPB center were collected from a prospectively held database. Post‐operative day 1 serum aspartate transaminase (AST) and alanine transaminase (ALT) were tested for their relationship with post‐operative major morbidity, defined by a Clavien‐Dindo score 3 or higher, and mortality.    Results  For this analysis, 371 patients were included, including 149 (40%) undergoing major liver resections. In total, 17% of the patients developed major morbidity. Stepwise logistic regression demonstrated that AST, and not ALT, is an independent predictor for major morbidity ( p  = 0.017). The probability of major morbidity significantly increased with increasing AST values. A threshold value of 242 U/L was found to be predictive for one or more major complications.    Conclusions  In this study, post‐operative serum AST on day 1 was a predictive factor for major morbidity after liver resection. For patients with low AST value, early discharge could be considered. However, because of the substantial inter‐individual variability of AST values, more studies are needed to translate these results into clinical practice.

Post‐operative Day 1 Serum Transaminase Levels in Relation to Morbidity After Liver Resection