Miki C, Iriyama K, Harrison J D, Gunson B K, D'Silva M, Suzuki H, McMaster P
Department of Surgery II, Mie University Medical School, Tsu, Japan.
Am J Gastroenterol. 1997 May;92(5):863-6.
Many studies have suggested that glycogen in donor livers is an important fuel during cold ischemic time and at reperfusion. However, it remains unclear as to whether the depression of glycogen content in the graft results in a critical derangement of energy metabolism after reperfusion. The purpose of this study was to assess the possible implications of the glycogen concentration of donor livers for the hepatic energy metabolism after reperfusion.
The glycogen content of 28 donor livers and the plasma concentrations of metabolic substrates were measured during liver transplantation.
Gluconeogenesis was maintained even in the glycogen-depleted graft at reperfusion. However, glycogen-depleted grafts produced more ketone bodies until 24 h after reperfusion. Free carnitine concentrations in these patients were significantly higher than those in the patients with glycogen-nondepleated grafts until 48 h after reperfusion.
A glycogen-depleted liver graft may restore essential metabolic function by producing energy substrates through enhanced ketogenesis in the postreperfusion period. The enhanced production of carnitine by the graft provides a substrate for the production of ketone bodies and thus may be relevant to the enhanced ketogenesis.
许多研究表明，供肝中的糖原是冷缺血期和再灌注时的重要能量来源。然而，移植肝中糖原含量的降低是否会导致再灌注后能量代谢的严重紊乱仍不清楚。本研究的目的是评估供肝糖原浓度对再灌注后肝脏能量代谢的可能影响。
在肝移植过程中测量28个供肝的糖原含量和代谢底物的血浆浓度。
即使在再灌注时糖原耗竭的移植肝中，糖异生仍得以维持。然而，糖原耗竭的移植肝在再灌注后24小时内产生更多的酮体。在再灌注后48小时内，这些患者的游离肉碱浓度显著高于糖原未耗竭移植肝的患者。
糖原耗竭的肝移植可能通过在再灌注期增强酮体生成来产生能量底物，从而恢复基本的代谢功能。移植肝中肉碱生成的增加为酮体生成提供了底物，因此可能与酮体生成增加有关。
