title: Circulating adrenomedullin is increased in relation with increased creatinine and atrial natriuretic peptide in liver-transplant recipients.
abstract: OBJECTIVE
  Circulating adrenomedullin (ADM), a potent vasorelaxing and natriuretic peptide involved in cardiovascular homeostasis, is increased after cardiac and renal transplantation. ADM is also implicated in hemodynamic abnormalities during liver cirrhosis, but whether ADM is increased late after liver transplantation is unknown.
  
  
  METHODS
  A total of 18 subjects--10 liver-transplant patients (Ltx) and 8 healthy subjects--were enrolled in the study.
  
  
  METHODS
  After a 15-min rest period in supine position, heart rate and systemic blood pressure were determined in all subjects. Then, venous blood samples were obtained in order to simultaneously determine the cyclosporine through levels, the biological (cyclosporine, renal and hepatic functions) and hormonal (ADM and atrial natriuretic peptide (ANP)) characteristics of the Ltx.
  
  
  RESULTS
  ADM (27.2+/-4.1 vs. 53.8+/-6.9 pmol/l, P=0.02), and ANP (5.9+/-0.9 vs. 12.8+/-1.4 pmol/l, P=0.001) were significantly increased in late, stable Ltx (35.4+/-9.6 months after transplantation). Furthermore, increased ADM correlated positively with elevated creatinine (r=0.76, P=0.01) and ANP (r=0.64, P=0.04) after liver transplantation.
  
  
  CONCLUSIONS
  Liver-transplant patients exhibit a sustained increase in circulating ADM. Such an increase likely results from renal impairment associated with volume regulation abnormalities, suggesting a potential role for ADM in volume regulation after liver transplantation.
authors.affiliation: Service de Physiologie Clinique et Equipe d'Accueil 3072, Institut de Physiologie, Faculté de Médecine, 67085 Strasbourg Cedex, France. Bernard.Geny@physio-ulp.u-strasbg.fr
authors.forename: Bernard
authors.initials: B
authors.lastname: Geny
authors.forename: Bernard
authors.initials: B
authors.lastname: Ellero
authors.forename: Anne
authors.initials: A
authors.lastname: Charloux
authors.forename: Gabrielle
authors.initials: G
authors.lastname: Brandenberger
authors.forename: Stéphane
authors.initials: S
authors.lastname: Doutreleau
authors.forename: François
authors.initials: F
authors.lastname: Piquard
mesh_terms: D053607:Adrenomedullin; D000328:Adult; D000704:Analysis of Variance; D009320:Atrial Natriuretic Factor / Q000097:blood*; D015992:Body Mass Index; D003401:Creatine / Q000097:blood*; D006439:Hemodynamics / Q000502:physiology; D006801:Humans; D008099:Liver / Q000378:metabolism; D008111:Liver Function Tests; D016031:Liver Transplantation; D008875:Middle Aged; D010455:Peptides / Q000097:blood*; D011184:Postoperative Period; D013997:Time Factors
chemical_list: D010455:Peptides; D053607:Adrenomedullin; D009320:Atrial Natriuretic Factor; D003401:Creatine