Salso Angela, Tisone Giuseppe, Tariciotti Laura, Lenci Ilaria, Manzia Tommaso Maria, Baiocchi Leonardo
Hepatology Unit, Department of Internal Medicine, University of Rome "Tor Vergata", Via Montpellier 1, 00133 Rome, Italy.
Transplant Unit, Department of Surgery, "Tor Vergata" University, Via Montpellier 1, 00133 Rome, Italy.
Biomed Res Int. 2014;2014:240873. doi: 10.1155/2014/240873. Epub 2014 Apr 1.
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.
To evaluate the GH/IGF-1 profile as a function of liver recovery and patients' early survival after LT.
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.
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).
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.
据报道，肝移植（LT）后移植物初始功能不佳的患者体内胰岛素样生长因子-1（IGF-1）水平较高。其与其他临床变量或早期生存率的相关性尚未得到广泛研究。
评估生长激素/IGF-1水平与肝移植后肝脏恢复情况及患者早期生存率之间的关系。
本研究回顾性纳入了30例接受肝移植的患者（23例存活者和7例非存活者）。在基线、移植物再灌注时以及肝移植后1、7、15、30、90和360天评估血清生长激素（GH）和IGF-1水平。同时记录个体生化变量。
移植后，血液中的IGF-1与胆固醇呈线性相关（r = 0.6，P = 0.001）。术后15天起，存活者的IGF-1水平在统计学上高于非存活者。ROC曲线分析确定，术后15天起IGF-1临界值>90μg/L是生存的良好预测指标（敏感性86%，特异性95%，P < 0.001）。
肝移植后，GH水平与细胞溶解程度相关，而IGF-1是肝脏合成功能恢复的指标。IGF-1水平>90μg/L（术后15 - 30天）似乎是短期生存的指标。
