Changes in arterial ketone body ratio(AKBR) during and after a liver surgery were investigated preliminarily in 9 patients who underwent partal hepatectomy orthotopic liver transplantation during the period from July 1992 through August 1992.
During
partial hepatectomy, hepatic vascular occlusion induced reduction in AKBR below 0.4 in all 8 cases, indicating that AKBR promptly reflects the intraoperative metabolic insults imposed on the liver. After the completion of operation, AKBR's were
restored
to the normal value of above 0.7 in cases without cirrhosis. In contrast, 3 of 5 cases with cirrhosis exhibited delayed recovery in AKBR(p<0.1). The mean value of ICGR15 in the latter group was 14.7%, significantly lower than 8.0% in the former
(p<0.05). It seems that postoperative restoration of liver function in patients with poor hepatic functional reserve takes more time, as reflected in delayed recovery of AKBR. Changes in AKBR during and after liver transplantation were as
follows'
reduction below 0.4 during anhepatic phase; recovery above 0.4 concomitant with functioning of the new liver, maintenance over 0l66 during the first few days after the operation. Such findings were useful in monitoring the function of the grafted
liver
during the critical perioperative period.
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