Metabolic changes induced by reperfusion after warm liver ischemia

ABSTRACT

Experimental studies have demonstrated a decrease in hepatocyte transmembrane potential (HTP) during ischemia, whereas HTP is improved in livers with greater glycogen reserves. The present study was undertaken to assess blood glucose. pH, K+ and hepatic glycogen levels during determined periods of warm liver ischemia and after reperfusion. The study was conducted on 15 mongrel dogs (9-17 kg) submitted to warm liver ischemia by clamping of the portal vein and hepatic artery (90 ñ 20 min) with blood flow of the infradiaphragmatic region shunted into left external jugular vein through a venovenous bypass draining the portal vein and the inferior vena cava. Blood samples and hepatic tissue biopsies were obtained before ischemia (control), after 15 and 45 min of ischemia, and 15 min after liver reperfusion. A significant increase in blood glucose was observed during reperfusion of the liver (p < O.05 vs control, 15 and 45 min of ischemia). The period of ischemia had a progressive glycogenolysis which became more marked after reperfusion, possibly explaining the increase in blood glucose levels observed during this period.