Significance of Circulating Hepatocyte Growth Factor in Protein-Losing Enteropathy After Fontan Operation

The purpose of this study was to measure serum hepatocyte growth factor (HGF) and elucidate the relationship between HGF and protein-losing enteropathy (PLE) after Fontan operation (FO). Ten patients with PLE (mean age 15.7 +/- A 8.7 years) who underwent FO were enrolled. Control group 1 comprised 20 patients without PLE after FO, and control group 2 comprised 10 patients with nephrotic syndrome (NS). Serum HGF, vascular endothelial growth factor, albumin, and random stool alpha-1 antitrypsin concentration were measured. Transthoracic echocardiography was completed. Serum HGF level was significantly greater in the PLE patients (0.61 +/- A 0.27 ng/ml) after FO than in the two control groups (0.41 +/- A 0.12 ng/ml [P = 0.024] for the Fontan group without PLE and 0.26 +/- A 0.12 ng/ml [P = 0.002] for the patients with NS). Serum albumin of patients with PLE (2.82 +/- A 0.96 g/dl) showed significantly lower levels compared with those of patients without PLE after FO (4.30 +/- A 0.37 g/dl, P < 0.001) but significantly greater levels compared with patients with NS (1.91 +/- A 0.33 g/dl, P = 0.019). Patients with greater serum HGF levels showed significant correlation with lower serum albumin level (P = 0.006, r = -0.495). Because serum HGF levels were significantly greater in patients with PLE after FO, HGF may play a role in the development of PLE after FO.