title: Usefulness of granular BCAA after hepatectomy for liver cancer complicated with liver cirrhosis.
abstract: OBJECTIVE
  Nutritional disturbances such as ascites and hypoalbuminemia frequently arise after hepatectomy for liver cancer with liver cirrhosis. We examined the possibility of maintaining a favorable state of nutrition by outpatient administration of branched-chain amino acid (BCAA) granules.
  
  
  METHODS
  Forty-three patients who had gross liver cirrhosis complicated by liver cancer and underwent surgery up to May 2002 were given BCAA granules (n = 21, BCAA group) or no granules (n = 22, control group).
  
  
  RESULTS
  1) Background details such as age, sex, surgical technique, blood loss, and duration of surgery showed no significant differences. 2) Among objective findings, improvement of ascites and edema tended to occur sooner in the BCAA group, but without a significant difference. 3) Although serum albumin recovered its preoperative value 9 mo after surgery in the control group, only 6 mo was required for recovery in the BCAA group. Total protein showed similar changes, but neither group showed any difference in changes of aspartate aminotransferase, alanine transferase, or platelets. 4) One year postoperatively, the change from the preoperative indocyanine green retention rate at 15 min after intravenous administration tended to be worse in the control group, but not significantly so. 5) In the BCAA group, hyaluronic acid and type IV collagen 7S improved significantly sooner than in the control group.
  
  
  CONCLUSIONS
  BCAA supplementation after hepatectomy promotes rapid improvement in protein metabolism and inhibits progression to liver cirrhosis. Administration of BCAA after hepatectomy is considered beneficial to a patient's nutritional state.
authors.affiliation: Department of Gastroenterological Surgery, Yokohama City University Graduate School of Medicine, Yokohama, Japan. togo@med.yokohama-cu.ac.jp
authors.forename: Shinji
authors.initials: S
authors.lastname: Togo
authors.forename: Kuniya
authors.initials: K
authors.lastname: Tanaka
authors.forename: Daisuke
authors.initials: D
authors.lastname: Morioka
authors.forename: Mitsutaka
authors.initials: M
authors.lastname: Sugita
authors.forename: Michio
authors.initials: M
authors.lastname: Ueda
authors.forename: Yasuhiko
authors.initials: Y
authors.lastname: Miura
authors.forename: Toru
authors.initials: T
authors.lastname: Kubota
authors.forename: Yasuhiko
authors.initials: Y
authors.lastname: Nagano
authors.forename: Kenichi
authors.initials: K
authors.lastname: Matsuo
authors.forename: Itaru
authors.initials: I
authors.lastname: Endo
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Sekido
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Shimada
mesh_terms: D000368:Aged; D000597:Amino Acids, Branched-Chain / Q000097:blood / Q000627:therapeutic use*; D000704:Analysis of Variance; D001201:Ascites / Q000517:prevention & control; D004487:Edema / Q000517:prevention & control; D005260:Female; D005500:Follow-Up Studies; D006498:Hepatectomy; D006801:Humans; D008099:Liver / Q000187:drug effects; D008103:Liver Cirrhosis / Q000150:complications*; D008111:Liver Function Tests / Q000379:methods; D008113:Liver Neoplasms / Q000150:complications* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009752:Nutritional Status / Q000502:physiology; D011183:Postoperative Complications / Q000517:prevention & control*; D012709:Serum Albumin / Q000187:drug effects; D013997:Time Factors
chemical_list: D000597:Amino Acids, Branched-Chain; D012709:Serum Albumin