Noninvasive evaluation of cytochrome c oxidase activity of the liver. Its prognostic value for hepatic resection.
OBJECTIVE
To clarify the relationship between the noninvasive evaluation of hepatic mitochondrial function, the redox tolerance test, and cytochrome c oxidase activity of the liver, focusing on surgical risk in hepatic resection.


METHODS
Six-month randomized clinical trial.


METHODS
Inpatients in surgical department.


METHODS
Forty patients who underwent hepatic resection (n = 36) and other abdominal operations (n = 4).


METHODS
Preoperative, noninvasive: The redox tolerance test, which measures the changes in arterial ketone body ratio in response to 75 g of oral glucose loading. Intraoperative, invasive: Cytochrome c oxidase activity and energy charge of the liver.


METHODS
Correlation of the index in the redox tolerance test (RTI) with cytochrome c oxidase activity, both of which predict the postoperative course.


RESULTS
The RTI values were negatively correlated with the maximal velocity (Vmax) and Michaelis constant (Km) values of cytochrome c oxidase activity. The maximal velocity and Michaelis constant values in patients with RTI values above or equal to 0.5 (group A, n = 29) were significantly lower than those in patients with RTI values below 0.5 (group B, n = 11). Eight (72.7%) of 11 patients in group B experienced postoperative complications.


CONCLUSIONS
The RTI is a noninvasive method of assessing the hepatic energy metabolism and can be a useful index for evaluating surgical risk in hepatectomy.
Ueda
J
J
Second Department of Surgery, Kyoto University Faculty of Medicine, Japan.
Mori
K
K
Sakai
Y
Y
Tanaka
A
A
Katayama
T
T
Maki
A
A
Shimahara
Y
Y
Yamaoka
Y
Y
Ozawa
K
K
D000227:Adenine Nucleotides / Q000378:metabolism; D000328:Adult; D000368:Aged; D003576:Electron Transport Complex IV / Q000378:metabolism*; D005069:Evaluation Studies as Topic; D005260:Female; D005951:Glucose Tolerance Test; D006498:Hepatectomy; D006801:Humans; D007657:Ketone Bodies / Q000097:blood; D008099:Liver / Q000201:enzymology*; D008297:Male; D008875:Middle Aged; D008930:Mitochondria, Liver / Q000201:enzymology; D010084:Oxidation-Reduction; D011379:Prognosis
D000227:Adenine Nucleotides; D007657:Ketone Bodies; D003576:Electron Transport Complex IV