Kupffer cell-mediated inhibition of liver regeneration after combined hepatectomy and pancreatectomy |
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Authors: | Toshiki Rikiyama MD Masanori Suzuki MD Michiaki Unno MD Kenji Fukuhara MD Tetsuyuki Uchiyama MD Seiki Matsuno MD FACS |
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Institution: | (1) First Department of Surgery, Tohoku University School of Medicine, 1-1 Seiryo-machi, Aoba-ku, 980-77 Sendai, Japan |
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Abstract: | Recently, simultaneous hepatectomy and pancreatoduodenectomy has been performed for the treatment of some biliary tract cancers
in Japan. Postoperative hepatic failure is a common and potentially fatal complication. The aim of this study was to examine
the reduction in the rate of liver regeneration after 70% hepatectomy (Hx) alone or in combination with 70% pancreatectomy
(HPx). Male Sprague-Dawley rats underwent hepatectomy or simultaneous hepatectomy and pancreatectomy. The ratio of liver weight
to body weight, the labeling index of hepatocytes in vivo, and DNA synthesis of the hepatocytes and/or Kupffer cells in primary
culture were analyzed. The ratio of liver weight to body weight and the labeling index in HPx rat were found to be significantly
lower than those values in Hx rats. There were no significant differences in plasma alanine aminotransferase levels between
the two groups. The inhibitory effect on DNA synthesis was observed with coculture of hepatocytes and Kupffer cells when the
portal plasma obtained 1 hour after operation was added. We further observed that the conditioned medium of Kupffer cells
stimulated by the addition of the portal plasma that was obtained 1 hour after HPx inhibited DNA synthesis of hepatocytes.
This effect was abolished after incubation at 56° C for 30 minutes. These results strongly suggest the existence of a growth
inhibitory factor in portal plasma after HPx. This heat-labile growth inhibitory factor was released from Kupffer cells and
would appear to act on hepatocytes in a paracrine manner.
Supported by the Kanae Foundation for Life and Sociomedical Science, Japan.
Presented at the Thirty-Eighth Annual Meeting of The Society-for Surgery of the Alimentary Tract, Washington, D.C., May 11–14,
1997. |
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Keywords: | Liver regeneration hepatocyte culture hepatectomy pancreatectomy growth inhibitory factor |
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