Blood carnitine status after orthotopic liver transplantation in patients with end-stage liver disease

We determined the effects of orthotopic liver transplantation on plasma and red cell carnitine concentrations in patients with end-stage liver disease. Before transplantation, plasma and red cell carnitine were significantly elevated above normal. The partitioning factor (ratio of red cell carnitine to plasma carnitine) was four times greater than that observed in our reference population. After hepatic replacement, plasma and red cell carnitine approached normal levels within 6 mo. The partitioning factor, however, remained elevated at that time. These results indicate that 1) there is no evidence for carnitine deficiency in severe liver disease on the basis of carnitine concentrations in the plasma and red compartments and 2) altered partitioning of carnitine between plasma and red cells persists for greater than or equal to 6 mo after hepatic replacement.