Relationship between GH/IGF-1 axis, graft recovery, and early survival in patients undergoing liver transplantation

生长激素/胰岛素样生长因子-1轴、移植物恢复和肝移植患者早期生存率之间的关系

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Abstract

BACKGROUND: High levels of IGF-1 have been reported in patients with initial poor function of the graft after liver transplantation (LT). Correlation with other clinical variables or early survival has not been extensively investigated. AIM: To evaluate the GH/IGF-1 profile as a function of liver recovery and patients' early survival after LT. METHODS: 30 transplanted patients (23 survivors and 7 nonsurvivors), were retrospectively enrolled in the study. GH and IGF-1 serum levels were assessed at baseline, graft reperfusion, and 1, 7, 15, 30 , 90, and 360 days after LT. Individual biochemical variables were also recorded. RESULTS: After grafting, IGF-1 in blood linearly correlated with cholesterol (r = 0.6, P = 0.001). IGF-1 levels from day 15 after surgery were statistically higher in survivors as compared to nonsurvivors. ROC curves analysis identified an IGF-1 cut-off >90 μg/L, from day 15 after surgery, as a good predictor of survival (sensitivity 86%, specificity 95%, and P < 0.001). CONCLUSIONS: After LT, GH levels correlate with the extent of cytolysis, while IGF-1 is an indicator of liver synthetic function recovery. IGF-1 levels >90 μg/L (day 15-30) seem to be an indicator of short-term survival.

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