Usefulness of liver function tests in postmortem samples

J Forensic Leg Med. 2018 May:56:51-54. doi: 10.1016/j.jflm.2018.03.011. Epub 2018 Mar 10.

Abstract

Liver function tests have been investigated in the forensic setting in several biological fluids collected at autopsy. Nevertheless, the results of these investigations have provided diverging information on postmortem stability of liver function markers and postmortem reliability of liver function assessment. The first aim of this study was to determine gamma-glutamyltransferase, alanine aminotransferase, aspartate aminotransferase, alkaline phosphatase, total bilirubin, total proteins, and albumin in antemortem and postmortem serum samples in a series of cases that underwent forensic investigations and had both samples available. The second aim was to measure total bilirubin and gamma-glutamyltransferase in cerebrospinal fluid. Preliminary results indicated that femoral (and cardiac) blood postmortem serum concentrations of bilirubin, total proteins, and albumin, as well as femoral blood postmortem serum concentrations of gamma-glutamyltransferase, can be considered to reliably reflect antemortem serum concentrations, thus suggesting that postmortem values could be used as surrogates for antemortem levels. Measurable bilirubin levels were demonstrable in cerebrospinal fluid samples in both preservative-free and sodium fluoride tubes, though with levels varying widely and unpredictably, irrespective of liver disease severity.

Keywords: Autopsy; Cerebrospinal fluid; Liver function tests; Postmortem biochemistry; Postmortem serum.

MeSH terms

  • Alanine Transaminase / blood
  • Alkaline Phosphatase / blood
  • Aspartate Aminotransferases / blood
  • Bilirubin / blood
  • Bilirubin / cerebrospinal fluid
  • Biomarkers / analysis
  • Biomarkers / cerebrospinal fluid
  • Blood Proteins / analysis
  • Female
  • Forensic Medicine*
  • Humans
  • Liver Diseases / diagnosis*
  • Liver Function Tests*
  • Male
  • Middle Aged
  • Serum Albumin / analysis
  • gamma-Glutamyltransferase / blood
  • gamma-Glutamyltransferase / cerebrospinal fluid

Substances

  • Biomarkers
  • Blood Proteins
  • Serum Albumin
  • gamma-Glutamyltransferase
  • Aspartate Aminotransferases
  • Alanine Transaminase
  • Alkaline Phosphatase
  • Bilirubin