DETERIORATION OF PLATELET ENERGY-METABOLISM FOLLOWING ENERGY-CRISIS OF LIVER AFTER HEPATECTOMY

The aim of this study is to investigate the relationship in energy met abolism between the platelet and the liver. The adenylate energy charg e of human platelets and arterial ketone body ratio (AKBR: acetoacetat e/3-hydroxybutyrate) were measured in 11 patients after hepatectomy. H epatic energy crisis was defined as the decrease of AKBR below 0.7. Th e platelet energy charge was measured on the first (Day 1), the second (Day 2), third (Day 3) and sixth (Day 6) day during AKBR decreased an d remained under 0.7. The values before AKBR decreased were employed a s the control. The values of the platelet energy charge were 0.917 +/- 0.008 in the control (n = 11) and 0.896 +/- 0.009 in all samples afte r AKBR decreased under 0.7 (n = 30). There was no significant differen ce between them. The values of energy charge were divided into four gr oups according to the periods of time after AKBR decreased and remaine d under 0.7 and compared. The energy charge was 0.923 +/- 0.006 (Day 1 , n = 11), 0.907 +/- 0.008 (Day 2, n = 10), 0.890 +/- 0.005 (Day 3, n = 5), and 0.815 +/- 0.012 (Day 6, n = 4). The energy charge of Day 3 w as significantly lower than that of Day 1 (p < 0.01). The energy charg e of Day 6 was significantly lower than that of Day 1, 2, 3 (p < 0.001 , p < 0.001, and p < 0.01, respectively). The 4 patients whose AKBR re mained under 0.7 for more than 6 days had hemostatic disorder. The det erioration of the platelet energy charge metabolism lags behind that o f the liver. AKBR may be capable of predicting hemostatic disorder in patients with hepatic failure after hepatectomy.