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Excerpt
We have shown that immediately after liver transplantation(LT) the recipient exhibits elevated glucagon, depleted hepatic glycogen stores, increased whole body glucose production(WBGP), increased fractional synthetic rate(FSR) of fibrinogen and decreased FSR of fixed liver proteins. The purpose of this study was to evaluate the effect of nutritional and hormonal supplementation on these observations 24 hours after LT. Two groups of pigs were studied one day after LT using radioisotopic and arteriovenous difference techniques. A control group(Tx Control) underwent LT with saline infusion and a supplemented group(Tx Suppl) underwent LT with infusion of glucose, amino acids(6 and 1.3 mg/kg/min respectively), and intraportal insulin(0.6mu/kg/min) and glucagon(1.3 ng/kg/min). Primed constant infusions of 3H-glucose and 3H-leucine were used to determine WBGP and WBPB(whole body protein breakdown). The results are presented as means ± SEM with t-test; p<0.05*, p=0.06†. Normal ranges from our lab are shown. Table Nutritional and hormonal supplementation immediately after liver transplantation: 1) elevated plasma glucose and insulin levels, 2) normalized glucagon levels, 3) resulted in net hepatic glucose uptake, 4) suppressed whole body glucose production, 5) initiated hepatic glycogen storage, 6) reduced fibrinogen FSR, and 7) normalized fixed liver protein FSR. In conclusion, nutritional and hormonal supplementation enhances early metabolic hepatic allograft recovery.
