Neutrophil phenotype and function in partial hepatectomy in man.
OBJECTIVE
Hepatic resections are still associated with considerable morbidity mainly because of postoperative infection. Adequate function of neutrophils is a crucial element in host defense. The aim of the study was to characterize neutrophils during partial hepatectomy.


METHODS
Fourteen patients undergoing partial liver resection were enrolled. Twenty-four hours pre-, intra- (after induction of anesthesia, after preparation of the liver, and 15 min after release of the Pringle maneuver), as well as postoperatively (3 h after Pringle; 24, 48, and 120 h after surgery), blood samples were obtained. In addition, healthy volunteers (n = 5) were investigated. Adhesion molecules (CD 62, CD 18), Fcy receptors (CD 16, CD 32), and phagocytosis by neutrophils were characterized by fluorescence-activated cell sorter analysis. Spontaneous and stimulated (formyl-methionyl-leucyl-phenylalanine) oxygen radical generation was measured by lucigenin-enhanced chemiluminescence.


RESULTS
Numeric upregulation of CD 62 and CD 18 on neutrophils was seen before the use of Pringle maneuver and persisted thereafter (p < 0.05). Spontaneous numeric expression of Fcy receptors (CD16 and CD 32) was unchanged during liver dissection but downregulated after Pringle maneuver was opened (p < 0.05). Although numeric Fcy receptors were downregulated, phagocytosis of heterologous opsonized Escherichia coli bacteria by neutrophils was unaffected. Spontaneous oxygen radical production peaked sharply 15 min after release of the Pringle maneuver (p < 0.05), contrary to stimulated oxygen radical production, which was depressed 3 h after the release of the Pringle maneuver (ns).


CONCLUSIONS
Uneventful partial hepatectomy in man resulted already in a significant change in the phenotype but in less significant changes in the functions of neutrophils.
Holzer
Katharina
K
Department of General Surgery, Johann-Wolfgang Goethe-University, Theodor- Stern- Kai 7, 60590, Frankfurt, Germany. Holzer@em.uni-frankfurt.de
Hofmann
Dennis
D
Oppermann
Elsie
E
Zeuzem
Stefan
S
Mönch
Christian
C
Henrich
Dirk
D
Bechstein
Wolf-Otto
WO
D000328:Adult; D000368:Aged; D005260:Female; D006498:Hepatectomy / Q000379:methods*; D006801:Humans; D008113:Liver Neoplasms / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009504:Neutrophils / Q000276:immunology*; D010587:Phagocytosis; D010641:Phenotype; D017382:Reactive Oxygen Species; D011956:Receptors, Cell Surface / Q000276:immunology
D017382:Reactive Oxygen Species; D011956:Receptors, Cell Surface