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Long-term effects of L-carnitine on hyperammonemia and hepatic encephalopathy in patients with liver cirrhosis: a multicenter retrospective study Joji Tani a Akio Moriya b Tetsu Tomonari c Chikara Ogawa d Akemi Tsutsui e Asahiro Morishita a Teppei Sakamoto f Hiroki Tai a Rie Yano a Mai Nakahara a Kyoko Oura a Tomoko Tadokoro a Koji Fujita a Shima Mimura a Takashi Himoto g Hironori Tanaka c Ryosuke Imado d Takushi Manabe d Kei Takuma a Takuya Nagano e Koichi Takaguchi e Tetsuji Takayama c Hideki Kobara a Objective Long-term efficacy data for L-carnitine in managing blood ammonia concentration (BAC) and preventing hepatic encephalopathy recurrence remain limited