Toru Beppu1,2, Hidetoshi Nitta1, Hiromitsu Hayashi1, Katsunori Imai1, Hirohisa Okabe1, Shigeki Nakagawa1, Daisuke Hashimoto1, Akira Chikamoto1, Takatoshi Ishiko1, Morikatsu Yoshida3, Yasuyuki Yamashita3, Hideo Baba4. 1. Department of Gastroenterological Surgery, Graduate School of Life Sciences, Kumamoto University, 1-1-1 Honjo, chuo-Ku, Kumamoto, 860-8556, Japan. 2. Department of Multidisciplinary Treatment for Gastroenterological Cancer, Kumamoto University Hospital, Kumamoto, 860-8556, Japan. 3. Department of Diagnostic Radiology, Graduate School of Life Sciences, Kumamoto University, 1-1-1 Honjo, chuo-Ku, Kumamoto, 860-8556, Japan. 4. Department of Gastroenterological Surgery, Graduate School of Life Sciences, Kumamoto University, 1-1-1 Honjo, chuo-Ku, Kumamoto, 860-8556, Japan. hdobaba@kumamoto-u.ac.jp.
Abstract
BACKGROUND:Portal vein embolization (PVE) can decrease the resection ratio for major hepatectomy. (99m)Tc-galactosyl human serum albumin (GSA) scintigraphy is useful for evaluating quantitative functional liver volume. Branched chain amino acids (BCAAs) modulate liver function and regeneration. We analyzed the effects of BCAAs, in terms of liver function and regeneration after PVE, in combination with major hepatectomy. METHODS: This randomized controlled trial was conducted for patients receiving PVE through to complete hepatectomy from September, 2011 to June, 2013. BCAA granules were added two times a day to a conventional diet in the BCAA administration group (BCAA group). The primary end point was functional liver regeneration of the future remnant liver after PVE followed by hepatic resection. Functional liver regeneration was assessed by the liver uptake value obtained from (99m)Tc-GSA scintigraphy single-photon-emission computed tomography/computed tomography fusion images. The secondary end points were volumetric liver regeneration and changes in liver function and laboratory data. RESULTS: A BCAA group (n = 13) and a non-BCAA group (control group; n = 15) were included. The primary end point was partially met: the liver uptake value significantly increased in the BCAA group compared with the control group 6 months after hepatic resection (266.7% vs 77.6%, P = 0.04) and marginally increased after PVE (43.8% vs 17.4%, P = 0.079). Following PVE, the increment of the uptake ratio of the liver to the liver plus heart at 15 min was significantly less in the BCAA group than in the control group (0.0 and 0.01, P = 0.023). CONCLUSIONS:BCAA supplementation improved functional liver regeneration and function in patients undergoing PVE followed by major hepatic resection.
RCT Entities:
BACKGROUND: Portal vein embolization (PVE) can decrease the resection ratio for major hepatectomy. (99m)Tc-galactosyl humanserum albumin (GSA) scintigraphy is useful for evaluating quantitative functional liver volume. Branched chain amino acids (BCAAs) modulate liver function and regeneration. We analyzed the effects of BCAAs, in terms of liver function and regeneration after PVE, in combination with major hepatectomy. METHODS: This randomized controlled trial was conducted for patients receiving PVE through to complete hepatectomy from September, 2011 to June, 2013. BCAA granules were added two times a day to a conventional diet in the BCAA administration group (BCAA group). The primary end point was functional liver regeneration of the future remnant liver after PVE followed by hepatic resection. Functional liver regeneration was assessed by the liver uptake value obtained from (99m)Tc-GSA scintigraphy single-photon-emission computed tomography/computed tomography fusion images. The secondary end points were volumetric liver regeneration and changes in liver function and laboratory data. RESULTS: A BCAA group (n = 13) and a non-BCAA group (control group; n = 15) were included. The primary end point was partially met: the liver uptake value significantly increased in the BCAA group compared with the control group 6 months after hepatic resection (266.7% vs 77.6%, P = 0.04) and marginally increased after PVE (43.8% vs 17.4%, P = 0.079). Following PVE, the increment of the uptake ratio of the liver to the liver plus heart at 15 min was significantly less in the BCAA group than in the control group (0.0 and 0.01, P = 0.023). CONCLUSIONS:BCAA supplementation improved functional liver regeneration and function in patients undergoing PVE followed by major hepatic resection.
Authors: Yoji Kishi; Eddie K Abdalla; Yun Shin Chun; Daria Zorzi; David C Madoff; Michael J Wallace; Steven A Curley; Jean-Nicolas Vauthey Journal: Ann Surg Date: 2009-10 Impact factor: 12.969
Authors: M Angeles Zulet; Itziar Abete; Cristina Galarregui; Irene Cantero; Bertha Araceli Marin-Alejandre; J Ignacio Monreal; Mariana Elorz; Alberto Benito-Boillos; José Ignacio Herrero; Víctor de la O; Miguel Ruiz-Canela; Helen Hermana M Hermsdorff; Josefina Bressan; Josep A Tur; J Alfredo Martínez Journal: Eur J Nutr Date: 2020-08-28 Impact factor: 5.614
Authors: María Eugenia Cornide-Petronio; Ana Isabel Álvarez-Mercado; Mónica B Jiménez-Castro; Carmen Peralta Journal: Nutrients Date: 2020-01-21 Impact factor: 5.717