IBC Oxford Oral Abstract 11 - Predictors of impaired liver synthetic function-preliminary results from patient who have undergone metabolic and bariatric surgery (MBS)

Abstract Background Morbid obesity and related comorbidities determine risk factors and disease complications. Impaired liver synthetic function increases the risk of cardiovascular complications and risk factor stratification mandatory influence to the introduction for preventive and therapeutic measures. The accurate predictive markers for prediction altered synthetic liver function related to obesity are not analysed. Objectives Demonstration of liver function impairment by an impaired response to low molecular weight heparin (LMWH) in patients undergoing MBS interventions and mandatory dose adjustment. Methods Study included 77 patients underwent MBS at UMC Ljubljana in 3 years period. Native anti-Xa levels and levels 4 h after administration of a subtherapeutic dose of LMW, dosed according to the patient’s BMI, were examined. Native anti-Xa levels and levels 4 h after administration of a subtherapeutic dose of LMWH, adjusted to BMI, were examined. LASSO test and visualisation were used to present correlations and associations between the variables and compared to liver ICG clearance, liver wedge biopsy analysed with Kliner classification and NAS score. Results The analysis of the results aimed at showing the association between liver function tests and LMWH administration showed the most important predictive indicators reflecting liver synthetic function: proteins, PT and ALT. The results showed a limited number of significant predictors for predicting anti-Xa levels, suggesting the potential for more targeted modelling and correlation to ICG liver clearance and Kliner classification. Conclusion The study showed a significant and reliable correlation between PT, ALT and total protein levels and the response to LMWH administration, directly indicating impaired synthetic liver function in morbidly obese patients.