Abstract
A NEW PERIOPERATIVE THERAPEUTIC AGENT FOR LIVER CANCER: L-CARNITINE MAY RESTORE AMMONIA METABOLISM AND IMPROVE LIVER FUNCTION IN HEPATECTOMIZED PATIENTS

Takehiro Okabayashi MD*, Yasuo Shima MD, Tatsuaki Sumiyoshi MD, Akihito Kozuki MD, Jun Iwata MD, Sojiro Morita MD, Yuichi Saisaka MD, Teppei Tokumaru MD, Kenta Sui MD, Akihito Nishioka MD, Manabu Matsumoto MD, and Tatsuo Iiyama MD.

ABSTRACT

Background: One of the major goals in hepatic resection is the reduction of postoperative liver failure due to metabolic disturbances in the liver. A new therapeutic agent is needed in order to achieve the goal of improved safety in liver surgery. Methods: Twenty-four patients treated with L-carnitine (carnitine group) were compared with a propensity score-matched cohort of 50 patients who had not received L-carnitine (control group). Results: Ammonia levels increased immediately after the operation on the first postoperative day in both groups and the increase was more pronounced in the control group compared with the carnitine group. On the third postoperative day, ammonia levels restored faster to the preoperative levels in the carnitine group than the control group. Furthermore, patients in the carnitine group required significantly shorter hospitalization than those in the control group (p < 0.05). The results of the present study indicate that perioperative oral supplementation with L-carnitine in patients with liver malignancy undergoing curative hepatic resection was clinically associated with preserved postoperative ammonia metabolism and an immediate postoperative recovery of the liver function. Conclusions: L-carnitine may serve as a master regulator of liver injury and repair in metabolic disturbances of the liver following hepatic resection and may reduce the length of postoperative hospitalization.

Keywords: liver, surgery, L-carnitine, ammonia, oxidative stress.


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