POSTPERFUSION ENERGY-METABOLISM OF STEATOTIC GRAFT AND ITS RELATION TO EARLY GRAFT VIABILITY FOLLOWING LIVER-TRANSPLANTATION

The present study was designed to assess energy metabolism of steatoti c grafts and to determine its relation to early graft viability. Graft biopsies were taken, and the triglyceride content was determined in 2 9 grafts for the assessment of steatosis. The peak aspartate aminotran sferase level and the concentrations of lactate and pyruvate were stro ngly correlated with the triglyceride content, suggesting that steatot ic grafts are more vulnerable to preservation or reperfusion injury an d that glucose oxidation is inhibited postoperatively in the steatotic grafts. Ketogenesis, an alternative pathway to produce energy substra tes, was not accelerated even when the steatotic grafts produced more free carnitine to enhance the beta-oxidation of fatty acids. The deter ioration of energy metabolism was associated with the increase in prot hrombin time ratio, hepatocyte growth factor, and hyaluronic acid that reflected graft viability. Deterioration of postperfusion energy meta bolism in the steatotic grafts may be involved in the development of i rreversible graft damage.