Effect of L-ornithine L-aspartate on some liver function parameters in patients after liver resection


  • I.I. Lisnyy National Cancer Institute, Kyiv, Ukraine
  • O.A. Lazareva National Cancer Institute, Kyiv, Ukraine
  • A.K. Onishchenko National Cancer Institute, Kyiv, Ukraine
  • Kh.A. Zakalska National Cancer Institute, Kyiv, Ukraine
  • M.O. Katrychenko National Cancer Institute, Kyiv, Ukraine
  • A.A. Burlaka National Cancer Institute, Kyiv, Ukraine




liver resection, Hepa-Merz, L-ornithine L-aspartate, transferrin


The article deals with the questions of L-ornithine L-aspartate (Hepa-Merz) effect on the protein-synthesizing function of the liver at its resection in the primary or metasta­tic lesions. L-ornithine L-aspartate — the salt of natural amino acids of ornithine and aspartate, which improve the survival of hepatocytes, increases their number and significantly increases secretion of transferrin in vitro. At the premises of the department of anesthesiology and intensive care of National Cancer Institute (Kyiv), a prospective study was conducted on the efficacy of L-ornithine L-aspartate when used in oncological patients in the perioperative period, it included 42 patients operated under general inhalation anesthesia in combination with extended epidural anesthesia, who were divi­ded into two groups. Patients of group 1 received L-ornithine L-aspartate in a dose of 10 ml (5 g) once daily 2 days before and 3–4 days after the surgery, patients in the control group didn’t take L-ornithine L-aspartate. It was demonstrated that the perioperative administration of L-ornithine L-aspartate in patients with liver resection can positively affect the synthetic function of the liver.


Download data is not yet available.


Management of Postoperative Hepatic Failure / Motaz Qadan, James Garden, Carlos U. Corvera, Brendan C. Vis­ser // Journal American College of Surgeons. — 2016. — 222. — С. 195-208.

Post-hepatectomy liver failure in patients with colorectal liver metastases / M. Narita, E. Oussoultzoglou, P. Bachellier, D. Jaeck // Surgery Today. — 2015. — № 45. — С. 1218-26.

Posthepatectomy liver failure: A definition and grading by the International Study Group of Liver Surgery (ISGLS) / [N. Rahbari, J. Garden, R. Padbury et al. // Surgery. — 2011. — 149. — С. 713-724.

Safety, Tolerability and Pharmacokinetics of L-Ornithine Phenylacetate in Patients with Acute Liver Injury/Failure and Hyperammonemia. [Електронний ресурс] // Hepatology. — 2017. — Oct 28. — Режим доступу: https://www.ncbi.nlm.nih.gov/pubmed/29080224.

Balzan S. The ‘‘50–50 criteria’’ on postoperative day 5: an accurate predictor of liver failure and death after hepatectomy / Balzan S., Belghiti J., Farges O. // Annals of surgery. — 2005. — № 242. — С. 824-8.

Liver failure after partial hepatic resection: de¢nition, pathophysiology, risk factors and treatment / Maartje A.J. van den Broek, Steven W.M. Olde Damink, Cornelis H.C. Dejong et al. // Liver International. — 2008. — № 1478. — С. 767.

The critical value of remnant liver volume-to-body weight ratio to estimate posthepatectomy liver failure in cirrhotic patients / Lin X.J., Yang J., Chen X.B. et al. // The journal of surgical research. — 2014. — № 188. — С. 489-95.

DeLeve L.D., Shulman H.M., McDonald G.B. Toxic injury to hepatic sinusoids: sinusoidal obstruction syndrome (venoocclusive disease) // Semin. Liver Dis. — 2002. — 22. — 27-42.

Rubbia-Brandt L., Mentha G., Terris B. Sinusoidal obstruction syndrome is a major feature of hepatic lesions associated with oxaliplatin neoadjuvant chemotherapy for liver colorectal metastases // J. Am. Coll. Surg. — 2006. — 202. — 199-200.

Fong Y., Bentrem D.J. CASH (chemotherapy-associatedsteatohepatitis) costs // Ann. Surg. — 2006. — 243. — 8-9.

Prediction of Postoperative Hepatic Failure after Liver Resection for Hepatocellular Carcinoma: Significance of the Aspartate Aminotransferase-to-Platelet Ratio Index / Tanaka S., Iimuro Y., Hirano T. et al. // Hepatogastroenterology. — 2014. — № 61. — С. 755-61.

Effect of ornithine on transferrin secretion of rat and human hepatocyte cultures / G. Lescoat, О. Loreal, B. Desvergne та ін. // Liver. — 1988. — № 8. — С. 360-365.

Stauch S., Kircheis G., Adler G., Beckh K., Ditschuneit H., Gortelmeyer R. et al. Oral L-ornithine-L-aspartate therapy of chronic hepatic encephalopathy: results of a placebo-controlled double-blind study // J. Hepatol. — 1998. — 28. — 856-864.

L-ornithine L-aspartate in bouts of overt hepatic ence­phalopathy / Sidhu S.S., Sharma B.C., Goyal O. et al. // Hepato­logy. — 2017. — Dec 27.

Transferrin as a Predictor of Survival in Cirrhosis / Viveiros A., Finkenstedt A., Schaefer B. et al. // Liver Transplantation. — 2017. — Nov 17.

Low serum transferrin correlates with acute-on-chronic organ failure and indicates short-term mortality in decompensated cirrhosis / Bruns T., Nuraldeen R., Mai M. et al. // Liver International. — 2017. — № 37. — С. 232-241.

Guidelines for Perioperative Care for Liver Surgery: Enhanced Recovery After Surgery (ERAS) Society Recommendations / Emmanuel Melloul, Martin Hubner, Michael Scott et al. // World Journal of Surgery. — 2016. — № 40. — С. 2425-2440.

Shalimar, Acharya S.K. Management in Acute Liver Failure / Shalimar, Subrat K. Acharya // Journal of Clinical & Experimental Hepatology. — 2015. — 5. — S104-S115.

Randomised clinical trial: L-ornithine-L-aspartate reduces significantly the increase of venous ammonia concentration after TIPSS / Bai M., Yin Z., Niu J. et al. // Alimentary pharmacology and therapeutics. — 2014. — 1. — 63-71.

Lowering blood ammonia prevents hepatocyte injury and apoptosis / Gao G., Yu Z., Yan J. et al. // International journal of clinical and experimental medicine. — 2015. — 8. — 12347-55.

Lescoat G., Theze N., Fraslin J.M., Pasdewup N., Kneip В. Influence of ornithine on albumin synthesis by fetal and neonatal hepatocytes maintained in culture // Cell. Differ. — 1987. — 21. — 21-29.

Oratz M., Rothshcild M.A., Schreiber S.S., Burks A. The role of the urea cycle and polyamines in albumin synthesis // He­patology. — 1983. — 3. — 567-571.

Stokes C.S., Goh E.T., Vilstrup H., Morgan M.Y., Gluud L.L. L-ornithine aspartate for people with cirrhosis and hepatic encephalopathy (Protocol) // Cochrane Database of Systematic Reviews. — 2016. — 10.



How to Cite

Lisnyy, I., Lazareva, O., Onishchenko, A., Zakalska, K., Katrychenko, M., & Burlaka, A. (2021). Effect of L-ornithine L-aspartate on some liver function parameters in patients after liver resection. EMERGENCY MEDICINE, (2.89), 47–52. https://doi.org/10.22141/2224-0586.2.89.2018.126602



Original Researches