Taki Y, Gubernatis G, Yamaoka Y, Oellerich M, Yamamoto Y, Ringe B, Okamoto R, Bunzendahl H, Beneking M, Burdelski M
Second Department of Surgery, Kyoto University, Japan.
Transplantation. 1990 Mar;49(3):535-9. doi: 10.1097/00007890-199003000-00012.
Arterial ketone body ratio (KBR), which reflects the NAD+/NADH ratio of hepatic mitochondria, was measured sequentially in 39 liver transplantations. In 22 cases, KBR was increased to above 0.7 within 6 hr after reperfusion (group A). In 11 cases, restoration of KBR was delayed until the first postoperative day (group B) and in 6 cases, KBR failed to recover (group C). The patients in group A survived liver transplantation without complications. By contrast, morbidity and mortality were significantly higher in groups B and C. In 2 cases in group C, the livers were clinically diagnosed as initially nonfunctioning grafts and the patients underwent retransplantation. Another two died of hepatic failure soon after the operation. It is suggested that delayed recovery of KBR is an early indicator of metabolic overload in the liver allograft, and that a delay exceeding 24 hr may imply the need for retransplantation.
动脉血酮体比率（KBR）反映了肝脏线粒体的NAD⁺/NADH比率，在39例肝移植手术中对其进行了连续监测。22例患者在再灌注后6小时内KBR升至0.7以上（A组）。11例患者KBR的恢复延迟至术后第一天（B组），6例患者KBR未能恢复（C组）。A组患者肝移植术后存活且无并发症。相比之下，B组和C组的发病率和死亡率显著更高。C组有2例患者，其肝脏临床诊断为原发性无功能移植物，患者接受了再次移植。另外2例患者术后不久死于肝衰竭。提示KBR恢复延迟是同种异体肝代谢超负荷的早期指标，延迟超过24小时可能意味着需要再次移植。
