Growth hormone/insulin-like growth factor 1 axis recovery after liver transplantation: a preliminary prospective study.
Many studies on cirrhotic patients have shown that insulin-like growth factor 1 (IGF-1) plasma levels are related to the severity of liver dysfunction. This result suggests that IGF-1 is probably useful for monitoring liver function in the perioperative course of orthotopic liver transplantation (OLT). Growth hormone (GH), IGF-1 plasma levels, and routine liver function tests were measured in 15 adult cirrhotic patients undergoing OLT. Measurements were made at the beginning of the operation; during OLT; 24 hours after reperfusion; and in the morning on days 7, 30, and 90. Twenty age-matched healthy volunteers with normal liver function served as controls. The study group had significantly higher GH levels and lower IGF-1 levels in the preoperative period compared with the controls. All patients achieved a complete functional hepatic recovery 1 month after OLT, although in 6 of them, the graft had an initial poor function (Group-IPF). GH and IGF-1 levels achieved near normal range within 1 week after OLT, and they had no significant correlations with other routine biochemistry tests in this period. IGF-1 levels in Group-IPF rose more slowly than in the group with a normal recovery of graft function. Surprisingly, 24 hours after reperfusion, IGF-1 levels were higher in Group-IPF than in the group with normal graft function. In conclusion, the severe GH/IGF-1 axis impairment found in patients with end-stage cirrhosis reverted very rapidly in the first days after successful OLT. Such a quick, postoperative modulation of IGF-1 plasma level by the graft suggests that this hormone has the potential to become one of the early indicators of post-OLT liver function recovery.
Bassanello
Marco
M
Clinica Chirurgica I, Dipartimento di Scienze Chirurgiche e Gastroenterologiche, University of Padua, School of Medicine, Padua, Italy.
De Palo
Elio Franco
EF
Lancerin
Federica
F
Vitale
Alessandro
A
Gatti
Rosalba
R
Montin
Umberto
U
Ciarleglio
Francesco Antonio
FA
Senzolo
Marco
M
Burra
Patrizia
P
Brolese
Alberto
A
Zanus
Giacomo
G
D'Amico
Davide Francesco
DF
Cillo
Umberto
U
D000328:Adult; D005260:Female; D013006:Growth Hormone / Q000097:blood; D006801:Humans; D007334:Insulin-Like Growth Factor I / Q000032:analysis*; D008103:Liver Cirrhosis / Q000097:blood* / Q000601:surgery*; D008111:Liver Function Tests; D016031:Liver Transplantation / Q000502:physiology*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011184:Postoperative Period; D011446:Prospective Studies; D015424:Reperfusion
D007334:Insulin-Like Growth Factor I; D013006:Growth Hormone