Usefulness of granular BCAA after hepatectomy for liver cancer complicated with liver cirrhosis.
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.
Togo
Shinji
S
Department of Gastroenterological Surgery, Yokohama City University Graduate School of Medicine, Yokohama, Japan. togo@med.yokohama-cu.ac.jp
Tanaka
Kuniya
K
Morioka
Daisuke
D
Sugita
Mitsutaka
M
Ueda
Michio
M
Miura
Yasuhiko
Y
Kubota
Toru
T
Nagano
Yasuhiko
Y
Matsuo
Kenichi
K
Endo
Itaru
I
Sekido
Hitoshi
H
Shimada
Hiroshi
H
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
D000597:Amino Acids, Branched-Chain; D012709:Serum Albumin