GLYCOGEN-CONTENT OF THE DONOR LIVER AND ITS RELATION TO POSTREPERFUSION HEPATIC ENERGY-METABOLISM

Many studies have suggested that glycogen in donor livers is an import ant fuel during cold ischemic time and at reperfusion, However, it rem ains unclear as to whether the depression of glycogen content in the g raft results in a critical derangement of energy metabolism after repe rfusion. The purpose of this study was to assess the possible implicat ions of the glycogen concentration of donor livers for the hepatic ene rgy metabolism after reperfusion, Methods: The glycogen content of 28 donor livers and the plasma concentrations of metabolic substrates wer e measured during liver transplantation. Results: Gluconeogenesis was maintained even in the glycogen-depleted graft at reperfusion, However , glycogen-depleted grafts produced more ketone bodies until 24 h afte r reperfusion, Free carnitine concentrations in these patients were si gnificantly higher than those in the patients with glycogen-nondepleat ed grafts until 48 h after reperfusion, Conclusions: A glycogen-deplet ed liver graft may restore essential metabolic function by producing e nergy substrates through enhanced ketogenesis in the postreperfusion p eriod, The enhanced production of carnitine by the graft provides a su bstrate for the production of ketone bodies and thus may be relevant t o the enhanced ketogenesis.