Research Article Relationship between GH/IGF-1 Axis, Graft Recovery, and Early Survival in Patients Undergoing Liver Transplantation Angela Salso, 1 Giuseppe Tisone, 2 Laura Tariciotti, 2 Ilaria Lenci, 1 Tommaso Maria Manzia, 2 and Leonardo Baiocchi 1 1 Hepatology Unit, Department of Internal Medicine, University of Rome “Tor Vergata”, Via Montpellier 1, 00133 Rome, Italy 2 Transplant Unit, Department of Surgery, “Tor Vergata” University, Via Montpellier 1, 00133 Rome, Italy Correspondence should be addressed to Leonardo Baiocchi; baiocchi@uniroma2.it Received 10 February 2014; Revised 27 February 2014; Accepted 5 March 2014; Published 1 April 2014 Academic Editor: Salvador Benlloch Copyright © 2014 Angela Salso et al. his is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Background. High levels of IGF-1 have been reported in patients with initial poor function of the grat ater liver transplantation (LT). Correlation with other clinical variables or early survival has not been extensively investigated. Aim. To evaluate the GH/IGF- 1 proile as a function of liver recovery and patients’ early survival ater 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, grat reperfusion, and 1, 7, 15, 30 , 90, and 360 days ater LT. Individual biochemical variables were also recorded. Results. Ater grating, IGF-1 in blood linearly correlated with cholesterol ( = 0.6,  = 0.001). IGF-1 levels from day 15 ater surgery were statistically higher in survivors as compared to nonsurvivors. ROC curves analysis identiied an IGF-1 cut-of >90 g/L, from day 15 ater surgery, as a good predictor of survival (sensitivity 86%, speciicity 95%, and  < 0.001). Conclusions. Ater LT, GH levels correlate with the extent of cytolysis, while IGF-1 is an indicator of liver synthetic function recovery. IGF-1 levels >90 g/L (day 15–30) seem to be an indicator of short-term survival. 1. Introduction he growth hormone/insulin like growth factor-1 (GH/IGF-1) axis is of paramount importance in growth and development and is also a lifespan determinant in animal models [1–5]. IGF-1 is considered the principal mediator of GH efects in tissues. Its production is stimulated primarily in the liver through STAT 5 pathway [1, 2]. While the GH remains the major regulator of IGF-1 liver production, in turn IGF- 1 counteracts GH synthesis in a classic negative feedback system. Liver diseases such as cirrhosis are characterized by a deranged GH-IGF-1 system, with increased levels of GH and reduction in IGF-1 production [6–9]. As a result patients with liver cirrhosis exhibit GH serum levels, and half-lives, that are twofold those of normal subjects. his is possibly due to reduced GH clearance and/or acquired resistance for decreased IGF-1 liver production. Reduced IGF-1 serum levels are associated with an unfavourable prognosis in cirrhotic patients [10, 11]. he reasons may be related to consequent malnutrition, insulin resistance, and immunologic impairment. In this perspective some attempts with replacement hormonal therapy have been made in liver cirrhosis showing encouraging results [12, 13]. Few studies are available on the GH-IGF-1 axis in adult patients undergoing liver transplantation (LT) [14–17]. All studies show the prompt return to normal of the GF-IGF-1 axis ater transplant. One of these studies attempted to analyze the GH-IGF-1 axis trend as a function of grat recovery [18]. he authors described higher levels of IGF-1 on the irst day ater LT in patients with Initial Poor Function (IPF) and a normalization of IGF-1 serum levels over a longer period (≈3 months) in this category of subjects. Unfortunately, this interesting work, probably given the small number of patients, did not ind correlations between luctuation of GH-IGF-1 axis and other biochemical variables, and patient survival was not examined. In the present study we reassessed this issue, using a larger retrospective cohort of patients and including data on GH and IGF-1 in correlation with common biochemical variables and patient survival. Hindawi Publishing Corporation BioMed Research International Volume 2014, Article ID 240873, 6 pages http://dx.doi.org/10.1155/2014/240873