Transcatheter hepatic arterial drug infusion therapy for hepatocellular carcinoma. Effect on the arterial ketone body ratio.

The arterial ketone body ratio (acetoacetate to beta-hydroxybutyrate) was measured in 15 patients with chronic liver disease before and after the infusion of anticancer drugs or embolic agents (gelatin sponge or iodized oil) into the hepatic artery. The arterial ketone body ratio decreased after hepatic angiography and decreased further at 15 min after infusion therapy. When the arterial ketone body ratio decreased to 1.0 or less on at least one occasion after infusion therapy, the ratio after hepatic angiography was always 1.35 or less. Such patients developed marked systemic symptoms like fever and severe liver dysfunction. Ascites also developed in three patients in whom the arterial ketone body ratio was reduced to 0.7 or less at 24 h after infusion therapy. The arterial ketone body ratios improved at 3-7 days after infusion therapy. In the seven patients treated with gelatin sponge embolization, the ratio at 3-7 days after therapy was actually higher than that before angiography.