Serum levels of transforming growth factor-alpha in patients after partial hepatectomy as determined with an enzyme-linked immunosorbent assay.

A sandwich enzyme-linked immunosorbent assay for measuring serum transforming growth factor-alpha levels was developed with monoclonal IgM and polyclonal IgG antihuman transforming growth factor-alpha antibodies and a system to amplify the activity of the conjugated enzyme. The assay detected serum transforming growth factor-alpha levels as low as 5 pg/ml. Serum transforming growth factor-alpha levels were below the detection limit of the assay in 19% of healthy adults, with a mean (+/- S.D.) detectable level of 22.0 +/- 16.7 pg/ml. In 13 patients who underwent partial hepatectomy, serum transforming growth factor-alpha levels were determined serially after surgery. The levels were increased within 28 days of surgery in all the patients, with a mean maximal level of 118.2 +/- 90.8 pg/ml. The maximal level achieved in each case correlated significantly with the resected volume of the liver and the increased volume of the remaining liver 28 days after hepatectomy (r = 0.59, p < 0.05, and r = 0.71, p < 0.005, respectively). In contrast, serum transforming growth factor-alpha levels showed no increase after laparotomy for nonhepatic surgery. Serum transforming growth factor-alpha levels may vary depending on the regenerative stimulus and reflect the degree to which liver regeneration will occur in patients after partial hepatectomy.