INFLUENCE OF HEPATIC-FUNCTION ON SERUM LEVELS OF PROSTATE-SPECIFIC ANTIGEN

Purpose: Recent studies have suggested that the primary site of metabo lism for prostate specific antigen (PSA) is the liver. We evaluated me n undergoing liver transplantation to determine whether chronic hepati c insufficiency affected serum PSA levels and whether improved hepatic function altered serum PSA levels. Materials and Methods: Ten men wit h a mean age of 46 years (range 23 to 67) undergoing liver transplanta tion were evaluated. Liver function tests, including serum bilirubin, serum glutamic-oxaloacetic transaminase and serum glutamic pyruvic tra nsaminase, as well as serum PSA were determined 1 day before and a mea n of 12.6 months (range 4 to 18) after transplantation. Results: Serum bilirubin and serum glutamic-oxaloacetic transaminase declined signif icantly after liver transplantation. There was no difference in mean s erum PSA levels before and after liver transplantation. Conclusions: O ur results suggest that severe hepatic dysfunction does not significan tly alter the serum concentration of PSA. These data, combined with re cent investigations demonstrating an intrahepatic mechanism for PSA el imination, suggest that the liver has a significant reserve to metabol ize the relatively small quantities of PSA in the circulation.