Delayed oxidation of intramitochondrial pyridine nucleotide oxido reduction state as compared with tissue oxygenation in human liver transplantation.

Intra- and post-operative oxygenation of graft liver and subsequent oxidation of the intramitochondrial redox state of pyridine nucleotide were studied in liver transplantation from living related donors with the arterial ketone body ratio (AKBR), the ratio of oxidized flavoprotein to reduced pyridine nucleotide (FP/PN ratio), and oxygen saturation of hemoglobin in liver tissue (hepatic SO2). The subjects involved in this study consisted of 20 pediatric patients. Hepatic SO2 was measured by near-infrared tissue spectroscopy. FP/PN ratio was measured by two-dimensional fluorometric scanning. Tissue oxygenation was normalized at the end of the operation. By contrast, AKBR remained at a low value at the end of the operation. At 24 and 48 h after the operation, the AKBR values increased to near the control value, indicating that it took 24 h for the intramitochondrial redox state to be normalized. The FP/PN ratio also remained at a low value at the end of the operation as compared with the control value. In conclusion, the observed delay in oxidation of the intramitochondrial redox state as compared with tissue oxygenation indicated the transition of the redox state associated with the changes in the metabolic state, and suggested the important role of microcirculation in the normalization of the redox state.