Miki C, Iriyama K, Mirza D F, Mayer A D, Buckels J A, Suzuki H, McMaster P
Department of Surgery II, Mie University Medical School, Tsu, Japan.
Dig Dis Sci. 1998 Jan;43(1):74-9. doi: 10.1023/a:1018824004318.
The present study was designed to assess energy metabolism of steatotic grafts and to determine its relation to early graft viability. Graft biopsies were taken, and the triglyceride content was determined in 29 grafts for the assessment of steatosis. The peak aspartate aminotransferase level and the concentrations of lactate and pyruvate were strongly correlated with the triglyceride content, suggesting that steatotic grafts are more vulnerable to preservation or reperfusion injury and that glucose oxidation is inhibited postoperatively in the steatotic grafts. Ketogenesis, an alternative pathway to produce energy substrates, was not accelerated even when the steatotic grafts produced more free carnitine to enhance the beta-oxidation of fatty acids. The deterioration of energy metabolism was associated with the increase in prothrombin time ratio, hepatocyte growth factor, and hyaluronic acid that reflected graft viability. Deterioration of postperfusion energy metabolism in the steatotic grafts may be involved in the development of irreversible graft damage.
本研究旨在评估脂肪变性移植物的能量代谢，并确定其与早期移植物活力的关系。采集移植物活检样本，测定29个移植物中的甘油三酯含量以评估脂肪变性。天冬氨酸转氨酶峰值水平以及乳酸和丙酮酸浓度与甘油三酯含量密切相关，这表明脂肪变性移植物更容易受到保存或再灌注损伤，且脂肪变性移植物术后葡萄糖氧化受到抑制。生酮作用作为产生能量底物的替代途径，即使脂肪变性移植物产生更多游离肉碱以增强脂肪酸的β氧化，也未加速。能量代谢的恶化与反映移植物活力的凝血酶原时间比值、肝细胞生长因子和透明质酸的增加有关。脂肪变性移植物灌注后能量代谢的恶化可能与不可逆移植物损伤的发生有关。
