A longitudinal study of tryptophan involvement in hepatic coma

Duane G. Hutson, Jiroichi Ono, Roy S. Dombro, Joe U. Levi, Alan Livingstone, Robert Zeppa

Research output: Contribution to journalArticlepeer-review

18 Scopus citations


Previous cross-sectional studies have demonstrated that hepatic coma is associated with abnormally high levels of plasma free tryptophan. Establishment of a more definitive relationship between this biochemical abnormality and hepatic coma requires an evaluation of biochemical changes in individual patients as they undergo alterations in the function of their central nervous systems. The present report is an evaluation of tryptophan and substances believed to influence its entry into the brain in six patients whose clinical status progressed from hepatic coma to complete recovery. Consistent significant decreases in plasma free tryptophan and free fatty acids were demonstrated to occur as the patients recovered. No consistent changes, however, were found in the plasma levels of the amino acids which have been reported to compete with tryptophan for transport across the blood-brain barrier, except for leucine which was significantly decreased in all six patients upon recovery from coma. Assay of lumbar cerebrospinal fluid for both tryptophan and the serotonin metabolite, 5-hydroxyindoleacetic acid (5-HIAA), showed no consistent changes as the patients recovered from hepatic coma.

Original languageEnglish (US)
Pages (from-to)235-239
Number of pages5
JournalThe American Journal of Surgery
Issue number2
StatePublished - Feb 1979

ASJC Scopus subject areas

  • Surgery


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