Abstract
Insulin and glucagon have opposite effects on various hepatic functions, including energy metabolism, which is essential for hepatic viability. To evaluate the effects of insulin and glucagon on the recovery of graft liver function, changes in these levels were investigated in relation to arterial ketone body ratio (AKBR) during a 30-h period after graft liver reperfusion in 2i recipients of living related liver transplants. Insulin levels did not change significantly throughout this study, while glucagon levels decreased immediately after reperfusion, indicating a rapid degradation of glucagon by the graft liver. The insulin/glucagon (I/G) ratio increased after reperfusion concomitantly with AKBR. In addition, the I/G ratio was significantly correlated with AKBR after reperfusion. It is concluded that the increase in the I/G ratio was closely related to the recovery of graft liver function as reflected by the AKBR in living related liver transplantation.
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References
Atchison SR, Rettke SR, Fromme GA, Janossy TA, Kunkel SE, Williamson KR, Perkins JD, Rakela J (1989) Plasma glucose concentrations during liver transplantation. Mayo Clin Proc 64: 241–245
Mallett SV, Kang Y, Freeman JA, Aggarwal S, Gasior T, Fortunato FL (1987) Prognostic significance of blood glucose levels during liver transplantation. Anesthesiology 67: A313
Mallett S, Virji MA, DeWolf AM, Kang YG, Aggarwal S, Freeman JA, Seifert R (1989) Hormonal control of glucose metabolism during liver transplantation. Transplant Proc 21: 3529
Marco J, Diego J, Villanueba ML, Diaz-Fierros M, Valverde I, Segovia JM (1973) Elevated plasma glucagon levels in cirrhosis of the liver. N Engl J Med 289: 1107–1111
Mori K, Ozawa K, Kiuchi T, Takada Y, Yamaguchi T, Sadamoto T, Shimahara Y, Kobayashi N, Yamaoka Y, Kumada K (1991) Insulinopenia as a risk factor in hepatectomy and its resolution by intraportal insulin administration. Am J Surg 162: 43–49
Ozawa K, Yamaoka Y, Nanbu H, Honjo I (1974) Insulin as the primary factor governing changes in mitochondrial metabolism leading to liver regeneration. Am J Surg 127: 669–675
Ozawa K, Aoyama H, Yasuda K, Shimahara Y, Nakatani T, Tanaka J, Yamamoto M, Kamiyama Y, Tobe T (1983) Metabolic abnormalities associated with postoperative organ failure. A redox theory. Arch Surg 118: 1245–1251
Starzl TE, Watanabe K, Porter KA, Putnam CW (1976) Effects of insulin, glucagon, and insulin/glucagon infusions on liver morphology and cell division after complete portocaval shunt in dogs. Lancet 1: 821–825
Takada Y, Yamaguchi T, Kiuchi T, Mori K, Shimahara Y, Kobayashi N, Yamaoka Y, Ozawa K (1991) Effect of glucagon on hepatic energy charge and arterial ketone body ratio in normal rabbits. Gastroenterology 100: 1041–1045
Takada Y, Ozaki N, Ringe B, Mori K, Gubernatis G, Oellerich M, Yamaguchi T, Kiuchi T, Shimahara Y, Yamaoka Y, Sakurai K, Ozawa K, Pichlmayr R (1992) Receiver operating characteristic (ROC) analysis of the ability of arterial ketone body ratio to predict graft outcome after liver transplantation — its sensitivity and specificity. Transpl Int 5: 23–26
Takada Y, Ozawa K, Yamaoka Y, Uemoto S, Tanaka A, Morimoto T, Honda K, Shimahara Y, Mori K, Inamoto T, Tanaka K (1993) Arterial ketone body ratio and glucose administration as an energy substrate in relation to changes in ketone body concentration after living-related liver transplantation in children. Transplantation 55: 1314–1319
Tanaka A, Kitai T, Iwata S, Hirao K, Tokuka A, Sato B, Yanabu N, Mori S, Inomoto T, Yamaoka Y, Tanaka K, Ozawa K, Chance B (1993) Delayed oxidation of intramitochondrial pyridine nucleotide oxidoreduction state as compared with tissue oxygenation in human liver transplantation. Biochim Biophys Acta 1182: 250–256
Tanaka K, Uemoto S, Tokunaga Y, Fujita S, Sano K, Nashizawa T, Sawada H, Shirahase I, Kim H-J, Yamaoka Y, Ozawa K (1993) Surgical techniques and innovations in living related liver transplantation. Ann Surg 217: 82–91
Uemoto S, Tanaka K, Honda K, Tokunaga Y, Sano K, Katoh H, Yamamoto E, Takada Y, Ozawa K (1993) Experience with FK506 in living-related liver transplantation. Transplantation 55: 288–292
Uno S, Itoh K, Kurono Y, Yamaoka Y, Kamiyama Y, Ozawa K (1987) A simple and sensitive assay for blood ketone bodies using highly purified 3-hydroxybutyrate dehydrogenase. Clin Chim Acta 168: 253–255
Yamada T, Yamamoto M, Ozawa K, Honjo I (1977) Insulin requirements for hepatic regeneration following hepatectomy. Ann Surg 185: 35–42
Yamaoka Y, Ozawa K, Tanaka A, Mori K, Morimoto T, Shimahara Y, Zaima M, Tanaka K, Kumada K (1991) New devices for harvesting a hepatic graft from a living donor. Transplantation 52: 157–160
Yamaoka Y, Washida M, Manaka D, Gubernatis G, Ringe R, Ozaki N, Yamaguchi T, Takada Y, Ollerich M, Ozawa K, Pichlmayr R (1993) Arterial ketone body ratio as a predictor of donor liver viability in human liver transplantation. Transplantation 55: 92–95
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Ichimiya, M., Takada, Y., Shimahara, Y. et al. Insulin and glucagon levels in living related liver transplantation: their interaction with the recovery of graft liver function. Transpl Int 8, 165–168 (1995). https://doi.org/10.1007/BF00336531
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DOI: https://doi.org/10.1007/BF00336531