Background/Purpose: Hemorrhage and ischemic liver injuries associated with hepatic resection are thought to play a role in postoperative complications, possibly through altered cytokine production. The current study was performed to investigate the effects of hepatectomy on cytokine gene expression. Methods: We collected blood preoperatively, at completion of operation, and on postoperative days 1 and 5 from ten patients undergoing hepatic resection. The peripheral blood mononuclear cells were evaluated with real-time quantitative reverse transcription-polymerase chain reaction (RT-PCR) for gene expression of interleukin-10 (IL-10), proinflammatory cytokines (interferon-γ [IFNγ ], IL-15, tumor necrosis factor α [TNFα], and chemokines regulated on activation, normal T expressed and secreted [RANTES ], macrophage inflammatory protein 1 alpha [ MIP-1β], [MIP-1β ]). Wilcoxon Rank and paired t-tests were used for statistical analysis. Results: Immediately following hepatectomy there was a significant (31.4 ± 60.5-fold; P < 0.05) increase in IL-10 gene expression that was sustained until the first postoperative day. In contrast, there was a significant downregulation (38 ± 71 eight fold lower than preoperative; P < 0.05) of IFNγ gene expression on day 1. By postoperative day 5, the changes in gene transcript levels of both IL-10 and IFNγ had returned to the preoperative baselines. This contrasting change in IL-10 and IFNγ gene expression in response to hepatic resection was statistically significant (P = 0.02). Conclusions: Hepatectomy elicits an imbalance towards the immunosuppressive type-2 cytokine profile in the early postoperative period. Measurement of cytokine gene transcripts following hepatic resection may have predictive value for clinical outcome, and deserves further study.
- Hepatic resection
ASJC Scopus subject areas