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Hepatic functional reserve in patients with obstructive jaundice: an assessment by the redox tolerance test
T Tsubono1, K Tsukada, K Hatakeyama
1Department of Surgery, Niigata University School of Medicine, Japan.
Purpose:
Hepatic mitochondrial response to oral glucose load (redox tolerance test) was evaluated as an indicator of hepatic functional reserve of patients with obstructive jaundice.
Patients And Methods:
The redox tolerance test was performed in 29 patients with obstructive jaundice before percutaneous transhepatic biliary drainage and 2 weeks after the procedure.
Results:
The redox tolerance index (RTI) before drainage was not related to conventional parameters other than albumin, but was significantly associated with bilirubin half-life (P < 0.01). Of 19 patients with an RTI > or = 0.5 before drainage, all maintained similar values after drainage and experienced satisfactory clinical courses, even after major surgery. Of 10 patients with an RTI < 0.5 before drainage, 5 showed improvement and 5 deteriorated after drainage. Four of the latter 5 died within 60 days after drainage. The hospital mortality was significantly greater in patients with initial RTI < 0.5 than in patients with RTI > or = 0.5 (P < 0.01).
Conclusion:
The redox tolerance test is useful for evaluating hepatic functional reserve and prognosis in patients with obstructive jaundice.