Serum hepatocyte growth factor as an index of extensive catabolism of patients awaiting liver transplantation

Background-Whole body catabolism as the result of intrahepatic metabolic de rangement is common in liver transplant candidates. However, individual nut ritional assessment parameters lack sensitivity and specificity in determin ing energy status of these patients. Recently, serum hepatocyte growth fact or (HGF) has been shown to reflect the recovery of hepatic energy metabolis m after liver transplantation. Aims-The relation between preoperative levels of serum HGF and metabolic va riables was investigated to clarify the clinical value of measuring HGF in evaluations of the catabolism. Patients/Methods-Blood samples were obtained from 30 liver transplant recip ients, and biopsy specimens were taken from each recipient's rectus muscle and the explanted liver. Preoperative serum concentration of HGF was determ ined. Whole body energy metabolism was assessed by measuring glycogen conte nts of biopsy specimens and plasma or serum levels of glucose, insulin, tot al ketone bodies, total carnitine, and amino acids. Results-Serum HGF concentration was elevated in 22 of 30 patients and corre lated with the Child-Pugh score. It showed a negative association with musc le glycogen content, and a positive correlation with serum levels of glucos e, total carnitine, and total ketone bodies. Patients with elevated serum H GF concentrations had higher preoperative plasma levels of aromatic amino a cids and branched chain amino acids, associated with lower branched chain t o aromatic amino acid ratios. Conclusions-The elevated serum concentration of HGF in liver transplant can didates reflected inhibition of peripheral glucose storage, enhanced lipid oxidation, and increased peripheral release of branched chain amino acids, and thus extensive energy catabolism.