PLASMA CARNITINE KINETICS DURING ORTHOTOPIC LIVER-TRANSPLANTATION

Background: Carnitine is synthesized mainly in the liver and plays an essential role in the transport of fatty acids in liver mitochondria f or subsequent oxidation and energy production. Methods: The plasma con centrations of free carnitine, acylcarnitine, total ketone bodies, lac tate, pyruvate, and hepatocyte growth factor (HGF) were measured durin g liver transplantation. Results: The plasma free carnitine and acylca rnitine concentrations and the lactate to pyruvate ratio in patients w ith compromised grafts (group A) were significantly higher than those in patients with well-functioning grafts (group B) after reperfusion. The acylcarnitine concentration in group B decreased after Incision, b ut it remained at a high level in group A. Significant correlations we re found between the concentrations of HGF and free and acylcarnitine after reperfusion. Conclusion. The accelerated flux of carnitine in th e graft may be associated with deterioration of energy metabolism in t he graft. An increased acylcarnitine concentration may reflect impaire d liver regeneration.