Introduction: Transarterial chemoembolization (TACE) for hepatocellular carcinoma (HCC) is usually followed by hepatic dysfunction that limits its efficacy. L-carnitine is recently studied as hepatoprotective agent. Our aim is to evaluate the L-carnitine effects against the deterioration of liver functions after TACE.
Method: 53 patients with intermediate stage HCC were assigned into two groups; L-carnitine group (26 patients) who received L-carnitine 300 mg tablet twice daily from 2 wk before to 12 wk after TACE and control group (27 patients) without L-carnitine therapy. 28 of studied patients received branched chain amino acids granules.
Results: There were significant differences between L-carnitine Vs control group in mean serum albumin change from baseline to 1 wk and 4 wk after TACE (p < 0.05). L-Carnitine maintained Child-Pugh score at 1 wk after TACE and exhibited improvement at 4k w after TACE (p < 0.01 Vs 1 week after TACE). Control group has significant Child-Pugh score deterioration from baseline to 1 wk after TACE (p < 0.05) and 12 wk after TACE (p < 0.05). There were significant differences between L-carnitine and control groups in mean Child-Pugh score change from baseline to 4 wk (p < 0.05) and 12 wk after TACE (p < 0.05). L-carnitine displayed improvement in (PT) from baseline to 1 wk, 4 w (p < 0.05) and 12 wk after TACE. PT in control group declined less than baseline along all follow up intervals. Total bilirubin in L-carnitine group decreased at 1 wk post TACE while in control group, it significantly increased at 1 wk (p = 0.01). ALT and C-reactive protein elevation were suppressed at 1 wk after TACE in Lcarnitine group. The hepatoprotective effects of L-carnitine were enhanced by concomitant use of branched chain amino acids.
Conclusion: L-carnitine and BCAA combination therapy offer a novel supportive strategy after TACE in HCC patients.