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March 1994

Noninvasive Evaluation of Cytochrome c Oxidase Activity of the Liver: Its Prognostic Value for Hepatic Resection

Author Affiliations

From the Second Department of Surgery, Kyoto (Japan) University Faculty of Medicine.

Arch Surg. 1994;129(3):303-308. doi:10.1001/archsurg.1994.01420270079018

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.

Design:  Six-month randomized clinical trial.

Setting:  Inpatients in surgical department.

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

Intervention:  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.

Main Outcome Measure:  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.

Conclusion:  The RTI is a noninvasive method of assessing the hepatic energy metabolism and can be a useful index for evaluating surgical risk in hepatectomy.(Arch Surg. 1994;129:303-308)

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