title: Reduction of hepatic acute phase response after partial hepatectomy in elderly patients.
abstract: The hepatic capacity for acute phase protein synthesis after partial hepatectomy in the elderly patients was prospectively studied. Forty-one patients who consecutively underwent a partial hepatectomy were grouped according to age of greater or less than 70 years; 12 were in the older group and 29 in the younger. The changes in the levels of serum interleukin-6, alpha 1-antitrypsin, alpha 1-acid glycoprotein, haptoglobin, and plasma fibrinogen were measured after surgery. The postoperative changes in standard liver function tests were also measured. The incidence of postoperative infected complications was 25% in the older group and 7% in the younger (P = 0.28). Although postoperative levels of serum interleukin-6 were similar between the two groups, those of serum alpha 1-antitrypsin, alpha 1-acid glycoprotein, and haptoglobin were significantly lower in the elderly (P < 0.05). Postoperative levels of serum alpha 1-antitrypsin and plasma fibrinogen showed an increase of about 30% compared with the preoperative values (P < 0.05) in the younger group, but no significant increase in the older. Postoperative deterioration of serum albumin levels and hepaplastin test values was also significantly more severe in the older group (P < 0.05). We conclude that in the older patients, a reduction of acute phase protein synthesis occurs after partial hepatectomy as a result of a global deterioration of liver function, and may render patients liable to infection.
authors.affiliation: Department of Surgery, Omiya Red Cross Hospital, Yono, Japan.
authors.forename: F
authors.initials: F
authors.lastname: Kimura
authors.forename: M
authors.initials: M
authors.lastname: Miyazaki
authors.forename: T
authors.initials: T
authors.lastname: Suwa
authors.forename: S
authors.initials: S
authors.lastname: Kakizaki
mesh_terms: D000209:Acute-Phase Proteins / Q000032:analysis; D000210:Acute-Phase Reaction / Q000503:physiopathology*; D000368:Aged; D000375:Aging / Q000502:physiology*; D005260:Female; D006498:Hepatectomy; D006801:Humans; D008099:Liver / Q000503:physiopathology*; D008107:Liver Diseases / Q000503:physiopathology / Q000601:surgery*; D008297:Male
chemical_list: D000209:Acute-Phase Proteins