Acute reactant cytokines and neutrophil adhesion after warm ischemia in cirrhotic and noncirrhotic human livers

摘要: Animal studies suggest that acute phase reactant cytokines and polymorphonuclear leukocytes (PMN) may play a critical role in ischemia-reperfusion injury. To evaluate whether similar mechanisms are operative human liver, six cirrhotic nine noncirrhotic patients undergoing right hepatectomy were randomized for utilization of hepatic vascular exclusion (HVE) as model Portal systemic levels (interleukin 6 [IL-6], interleukin 1 [IL-1], tumor necrosis factor alpha [TNF-alpha]) neutrophil adhesion serial liver biopsy specimens studied. Correlations among mediators, leukocyte adhesion, markers injury also evaluated. Hepatic resulted substantial reproducible changes portal arterial IL-6 both patients. cytokine comparable most instances, whereas usually higher than Negative correlations found between at the time reperfusion later TNF-alpha levels. correlated negatively with numerous hepatocellular number postoperative complications. increased neutrophils after but not In patients, degree several This study humans shows released during ischemia and, interestingly, strongly correlate clinical laboratory measures Further to possible causal relationship warranted, emphasis on PMN adhesion.