-Acylcarnitines are derived from mitochondrial acyl-CoA metabolism and have been associated with diet-induced insulin resistance. However, plasma acylcarnitine profiles have been shown to poorly reflect whole body acylcarnitine metabolism. We aimed to clarify the individual role of different organ compartments in whole body acylcarnitine metabolism in a fasted and postprandial state in a porcine transorgan arteriovenous model. Twelve cross-bred pigs underwent surgery where intravascular catheters were positioned before and after the liver, gut, hindquarter muscle compartment, and kidney. Before and after a mixed meal, we measured acylcarnitine profiles at several time points and calculated net transorgan acylcarnitine fluxes. Fasting plasma acylcarnitine concentrations correlated with net hepatic transorgan fluxes of free and C2-and C16-carnitine. Transorgan acylcarnitine fluxes were small, except for a pronounced net hepatic C2-carnitine production. The peak of the postprandial acylcarnitine fluxes was between 60 and 90 min. Acylcarnitine production or release was seen in the gut and liver and consisted mostly of C2-carnitine. Acylcarnitines were extracted by the kidney. No significant net muscle acylcarnitine flux was observed. We conclude that liver has a key role in acylcarnitine metabolism, with high net fluxes of C2-carnitine both in the fasted and fed state, whereas the contribution of skeletal muscle is minor. These results further clarify the role of different organ compartments in the metabolism of different acylcarnitine species.acylcarnitines; pigs; fatty acid oxidation; mixed-meal test ACYLCARNITINES ARE INTERMEDIATES of mitochondrial acyl-CoA metabolism, which have gained much attention as markers of inherited metabolic diseases (34) and more recently for their possible involvement in diet-induced insulin resistance and glucose intolerance (2,12,14,16, 18,24). Acylcarnitines are carboxylic acids of different chain lengths derived from different substrates (e.g., fatty acids, amino acids or acetyl-CoA) that are transesterified from CoA to L-carnitine, enabling them to enter or exit the mitochondrion (33). Exchange of acylcarnitines also occurs over the cell membrane. This leads to a specific acylcarnitine profile in plasma composed of acylcarnitines originating from and consumed by the different organs and compartments where the respective acyl-CoAs are metabolized (33). Historically, acylcarnitine profiles have been measured to detect mitochondrial fatty acid oxidation (FAO) disorders (34). More recently, studies have discussed alterations in the acylcarnitine profile, measured mostly in plasma, in relation to deranged FAO and glucose intolerance or insulin resistance (2,12,14). Because increased acylcarnitine levels correlated with markers of glucose intolerance in obesity, acylcarnitines were proposed to potentially induce insulin resistance (10,11,26).However, we have shown previously that the plasma acylcarnitine profile should be interpreted with caution, as it does not reflect the acylcarniti...