Abstract
In situ cold perfusion was employed in two patients with large hepatocellular carcinoma. Fructose-1,6-bisphosphate, a cytoprotective drug, was added to the oxygenated perfusate, resulting in reduction of the liver injury that occurs during liver perfusion and allowing hepatic resection to proceed safely. Recovery after, reperfusion of the energy charge in the hepatic tissue sampled during surgery was good in both patients. During the postoperative course, serum GOT and GPT values in the two patients were normalized 7–13 days postoperatively after a peak on the 1st and 2nd postoperative days, respectively. This finding was similar to the usual course after hepatectomy. Serum total bilirubin gradually decreased from the peak 2.3 mg/dl on the 5th postoperative day in case 1, and from 3.6 mg/dl on the 7th postoperative day in case 2. There were no serious complications in either patient.
Similar content being viewed by others
References
Yamoto H, Tanimura H, Mori K, Nakai T (1993) Beneficial effects of fructose-1,6-diphosphate on cellular viability in cold perfused liver (in Japanese with English abstract). Ishoku (Jpn J Transplant) 28 (Suppl):623–626
Heaney JP, Stanton WK, Halbert DS, Seidel J, Vice T (1966) An improved technique for vascular isolation of the liver: Experimental study and case reports. Ann Surg 163:237–241
Huguet C, Nordlinger B, Galopin JJ, Bloch P, Gallot D (1978) Normothermic hepatic vascular exclusion for extensive hepatectomy. Surg Gynecol Obstet 147:689–693
Fortner JG, Shiu MH, Kinne DW, Kim DK, Castro EB, Watson RC, Howland WS, Beattie EJ (1974) Major hepatic resection using vascular isolation and hypothermic perfusion. Ann Surg 180:644–652
Markov AK (1986) Hemodynamics and metabolic effects of fructose-1,6-diphosphate in ischemia and shock; experimental and clinical observations. Ann Emerg Med 15:1470–1477
Tavazzi B, Starnes JW, Lazzarino G, DiPierro D, Nuutinen EM, Giardina B (1992) Exogenous fructose-1,6-bisphosphate is a metabolizable substrate for the isolated normoxic rat heart. Basic Res Cardiol 87:280–289
Rao SB, Mehendale HM (1989) Protective role of fructose 1,6-bisphosphate during CCl4 hepatotoxicity in rats. Biochem J 262:721–725
Oliveira JR, Rosa JL, Ambrosio S, Bartrons R (1992) Effect of galactosamine on hepatic carbohydrate metabolism: Protective role of fructose-1,6-bisphosphate. Hepatology 15:1147–1153
Nakai T, Tanimura H, Tabuse K Nagai Y, Mori K, Yamoto H (1991) Beneficial effects of fructose-1,6-diphosphate infusion on hepatic regeneration after partial hepatectomy by microwave tissue coagulator (in Japanese with English abstract). Nippon Geka Gakkai Zasshi (J Jpn Surg Soc) 92:150–159
Nakai T, Tanimura H, Tabuse K, Nagai Y, Mori K, Yamoto H (1991) Beneficial effects of fructose-1,6-diphosphate infusion on liver regeneration after ischemic liver injury. Gastroenterol Jpn 26:611–618
Yamaoka Y, Ozawa K, Kumada K, Shimahara Y, Tanaka K, Mori K, Takayasu T, Okamoto R, Kobayashi N, Konishi Y, Egawa H (1992) Total vascular exclusion for hepatic resection in cirrhotic patients. Arch Surg 127:276–280
Author information
Authors and Affiliations
About this article
Cite this article
Nakai, T., Tanimura, H., Taniguchi, K. et al. Clinical evaluation of fructose-1,6-bisphosphate for in situ cold perfusion in hepatic resection. J Hep Bil Pancr Surg 2, 163–168 (1995). https://doi.org/10.1007/BF02348743
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF02348743