Short-Term Changes in Blood Ketone Body Ratios in the Phase Immediately After Hepatic Artery Embolization: Their Clinical Significance

Effect of hepatic artery embolization on the adenylate energy charge level and the redox state of the cirrhotic liver

“…The present results support our recent report on short-term changes in blood ketone body ratios in the phase immediately after hepatic artery embolization of the patients with hepatocellular carcinoma [12]. In these patients, the arterial blood ketone body ratio decreased with a marked rise in blood ketone body concentrations after hepatic artery embolization and usually returns to normal levels within 5 h. However, in patients whose ketone body ratio was still at a low level after 5 h, complications, such as fever or gallbladder necrosis, were severe and hepatic failure sometimes occurred.…”

“…Previous studies from our laboratory showed that the arterial blood ketone body ratio of the patients, which reflects hepatic mitochondrial redox (NAD+/NADH) state, decreases immediately after hepatic arterial embolization because of the acute deprivation of arterial oxygen supply, and that normalization of decreased ketone body ratio usually occurs within 5 h [11,12]. However, in some patients with severe liver cirrhosis, prolonged decrease in ketone body ratio was accompanied by complications, such as fever or gallbladder necrosis.…”

A Predominant Increase of Arterial β-Hydroxybutyrate Concentration during Partial Hepatectomies in Patients with Impaired Indocyanine Green Clearance Test

“…It has been believed that an increase in ketone body production during hepatectomies is caused mainly by a low redox state of the liver mitochondria and that the phenomenon generally occurs in all patients in proportion to intensity of the hepatic hypoxia [5,6]. Nevertheless, our results indicated that the metabolic changes could be observed only in patients with seriously impaired liver function.…”

“…Therefore, they spilled out into the hepatic venous blood without being subjected to any modification in their composition ratio [4]. This idea was adopted by Ozawa et al and introduced as a method of assessing the redox state in the liver mitochondria [5][6][7]. Using arterial blood as a substitute for hepatic venous blood, they showed the total concentration of ketone bodies and their ratios, although numerical data on concentrations of each ketone body were shown in only one patient.…”

The effects of intraoperative glucose infusion on portal blood insulin concentration and hepatic mitochondrial redox state during surgery: Comparison of short-term and continuous infusions

“…Thus, it is possible to assess the hepatic mitochondrial redox state, as well as the hepatic energy status, by measuring the AKBR. 11,[13][14][15][16] In various experimental models of such conditions as obstructive jaundice, hemorrhagic shock, or posthepatectomy, the AKBR levels have been found to well reflect the hepatic mitochondrial energy status. 14,17,18 According to a number of reports, measuring the AKBR may provide valuable information during the postoperative course of patients who have undergone cardiac surgery, 20 hepatectomy, or other major abdominal operations.…”