Role of platelet-activating factor in hepatectomy with Pringle's maneuver.
BACKGROUND
Interruption of hepatic inflow is commonly used to reduce blood loss during extensive liver resection, but may cause liver dysfunction. The present study investigated the effects of platelet-activating factor (PAF) antagonist E5880 on total liver warm ischemia and 70% hepatectomy.


METHODS
Rabbits were used in this study and were divided into four groups: group 1, those treated with only 70% hepatectomy; group 2, those treated with only 20 min Pringle's maneuver; group 3, those treated with both Pringle's maneuver and 70% hepatectomy without pretreatment; and group 4, those pretreated with PAF antagonist E5880 (0.3 mg/kg) followed by Pringle's maneuver and 70% hepatectomy. The remnant liver function was then evaluated after reperfusion.


RESULTS
Seven-day survival rates in both groups 1 and 2 were 100%. E5880 treatment significantly increased 7-day survival rate (group 4: 38% vs group 3: 0%, P < 0.05) after a combination of Pringle's maneuver and 70% hepatectomy. The elevations of serum liver enzymes (GOT, GPT, mGOT, and LDH) were significantly inhibited in group 4 at 1 and 4 h after reperfusion. Portal venous pressure and the energy charge of liver were also significantly improved in group 4, compared with those in group 3. Endothelin-1 levels of arterial and portal venous blood progressively increased after reperfusion; however, there were no significant differences between the two groups. Leukocyte infiltration into the liver was significantly inhibited in group 4.


CONCLUSIONS
E5880 pretreatment has protective effects on liver function after 70% hepatectomy with Pringle's maneuver in rabbits.
Department of Surgery, Institute of Clinical Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba City, Ibaraki, 305-8575, Japan.
M
M
Gu
Y
Y
Takada
K
K
Fukunaga
S
S
Ishiguro
H
H
Taniguchi
K
K
Seino
K
K
Yuzawa
M
M
Otsuka
T
T
Todoroki
K
K
Fukao
D000227:Adenine Nucleotides / Q000378:metabolism; D000818:Animals; D001794:Blood Pressure / Q000187:drug effects; D019332:Endothelin-1 / Q000097:blood; D004734:Energy Metabolism; D004798:Enzymes / Q000097:blood; D005260:Female; D006489:Hemostatic Techniques; D006498:Hepatectomy / Q000379:methods; D007962:Leukocytes / Q000473:pathology; D008099:Liver / Q000187:drug effects / Q000201:enzymology / Q000378:metabolism / Q000473:pathology; D010880:Piperidines / Q000494:pharmacology; D010972:Platelet Activating Factor / Q000037:antagonists & inhibitors / Q000502:physiology*; D011169:Portal Vein / Q000503:physiopathology; D011184:Postoperative Period; D011726:Pyridinium Compounds / Q000494:pharmacology; D011817:Rabbits; D016019:Survival Analysis
D000227:Adenine Nucleotides; D019332:Endothelin-1; D004798:Enzymes; D010880:Piperidines; D010972:Platelet Activating Factor; D011726:Pyridinium Compounds; C072429:E 5880