Improved liver function following infusion of fructose-1, 6-bisphosphate in posthepatectomy patients

The clinical effect of fructose-1,6-bisphosphate (FBP) administered to posthepatectomy patients was examined. FBP at 0.25 mmol/kg was administered continuously into the hepatic artery for 60 minutes on the 1st postoperative day in 11 cases. Hepatic arterial infusion of 0.25 mmol/kg glucose was performed in 7 cases. Furthermore, in 10 cases in which a catheter was not inserted in to the hepatic artery, 0.25 mmol/kg FBP was administered intravenously over a 60-minute period. Arterial ketone body ratio (AKBR) and serum levels of cyclic adenosine monophosphate, immunoreactive insulin, inorganic phosphorus, glucose, fructose, pyruvate, lactate and pyruvate kinase (PK) in the arterial blood were measured before and after administration. AKBR hardly changed after hepatic arterial infusion of glucose. It rose until 3 hours after intravenous or intrahepatic arterial administration of FBP. Especially, after hepatic arterial infusion of FBP, the AKBR was significantly higher up to 2 hours after administration than that before administration (P < 0.01). With hepatic arterial infusion of FBP, serum pyruvate transiently increased immediately after infusion (P < 0.01). PK activity was significantly elevated after administration of FBP (P < 0.05). Serum lactate levels decreased significantly after hepatic arterial infusion of FBP (P < 0.05). There was no difference in the recovery of protein synthetic ability and the postoperative changes in serum liver function test values among the three groups. Hepatic arterial infusion of FBP was suggested to promote adenosine triphosphate production by acceleration of the glycolytic pathway and lactate uptake in the hepatic cell.