title: Growth hormone/insulin-like growth factor 1 dynamics in adult living donor liver transplantation.
abstract: End-stage liver disease is accompanied by decreased serum levels of insulin-like growth factor 1 (IGF1) and inversely increased serum levels of growth hormone (GH). Previous reports have demonstrated rapid GH/IGF1 axis recovery after orthotopic liver transplantation. This study investigated the effect in an adult-to-adult living donor liver transplantation (LDLT) model and characterized GH/IGF1 alterations and liver regeneration in both donors and recipients. Sequential blood samples were prospectively collected from 30 donor-recipient pairs during the perioperative course of LDLT. A distinct set of biochemical parameters, including serum GH, serum IGF1, and standard liver blood tests, was analyzed at different time points (preoperatively and during 12 months of follow-up after surgery). Recipients showed significantly higher GH serum levels and lower IGF1 serum levels in comparison with donors before surgery and throughout the first postoperative days (PODs). The GH serum levels of recipients declined, whereas donor levels inversely increased during the early postoperative period to a normal range. Recipients' IGF1 serum levels were restored within the first operative week. In parallel, donor IGF1 levels decreased by 50% after living donation, and preoperative serum levels were restored after 6 months. Donors showed delayed recovery of liver function in comparison with recipients. The dynamics of IGF1 strongly correlated with routine laboratory parameters of liver function. In conclusion, recipients showed a rapid recovery of the GH/IGF1 hormonal axis and liver function after LDLT, whereas donors showed altered GH signaling and regenerative delay in the early PODs after living donation.
authors.affiliation: Department of General, Visceral, and Transplantation Surgery, Campus Virchow Klinikum, Charité-Universitätsmedizin Berlin, Berlin, Germany.
authors.forename: Maximilian
authors.initials: M
authors.lastname: Jara
authors.forename: Antje
authors.initials: A
authors.lastname: Schulz
authors.forename: Maciej
authors.initials: M
authors.lastname: Malinowski
authors.forename: Gero
authors.initials: G
authors.lastname: Puhl
authors.forename: Johan Friso
authors.initials: JF
authors.lastname: Lock
authors.forename: Daniel
authors.initials: D
authors.lastname: Seehofer
authors.forename: Peter
authors.initials: P
authors.lastname: Neuhaus
authors.forename: Martin
authors.initials: M
authors.lastname: Stockmann
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000097:blood; D058625:End Stage Liver Disease / Q000097:blood / Q000175:diagnosis / Q000601:surgery*; D005260:Female; D006498:Hepatectomy; D019382:Human Growth Hormone / Q000097:blood*; D006801:Humans; D007334:Insulin-Like Growth Factor I / Q000378:metabolism*; D008111:Liver Function Tests; D008115:Liver Regeneration; D016031:Liver Transplantation / Q000379:methods*; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D020127:Recovery of Function; D013997:Time Factors; D066027:Transplant Recipients; D016896:Treatment Outcome
chemical_list: D015415:Biomarkers; C583557:IGF1 protein, human; D019382:Human Growth Hormone; D007334:Insulin-Like Growth Factor I