title: Gut and liver handling of interleukin-6 during liver resection in man.
abstract: BACKGROUND
  Plasma interleukin-6 (IL-6) levels increase during liver resection. The source of this IL-6 is hitherto unclear. It has been demonstrated that the hepatosplanchnic area takes up IL-6 but the role of the gut and liver is unknown. The aim of the present study was to investigate the role of the gut and liver in IL-6 homeostasis during liver surgery.
  
  
  METHODS
  Before and after partial hepatectomy, IL-6 was measured in blood sampled from the radial artery, and the hepatic and portal vein. Blood flow was measured to assess IL-6 fluxes (flow times AV-differences) across the gut, liver and hepatosplanchnic area.
  
  
  RESULTS
  In 22 patients undergoing liver resection, IL-6 release from the gut after transection was 90.9 (30.1) ng/min (P < 0.001), whereas net IL-6 uptake by the liver equalled 83.4 (41.7) ng/min (P < 0.01). Overall hepatosplanchnic flux was 7.3 (43.5) ng/min after transection and did not differ significantly from zero. Overall hepatosplanchnic flux was 87.8 (41.5) ng/min in the major resection group and -59.8 (67.5) ng/min in the minor resection group (P < 0.05).
  
  
  CONCLUSIONS
  The gut releases IL-6 and the liver takes up IL-6 before and after liver resection. The loss of IL-6 uptake as a result of a small functional remnant liver could lead to higher IL-6 levels after surgery.
authors.affiliation: Department of Surgery, Maastricht University Medical Center & Nutrim School for Nutrition, Toxicology and Metabolism, Maastricht University, Maastricht, the Netherlands. s.dello@maastrichtuniversity.nl
authors.forename: Simon A W G
authors.initials: SA
authors.lastname: Dello
authors.forename: Johanne G
authors.initials: JG
authors.lastname: Bloemen
authors.forename: Marcel C G
authors.initials: MC
authors.lastname: van de Poll
authors.forename: Ronald M
authors.initials: RM
authors.lastname: van Dam
authors.forename: Jan H M B
authors.initials: JH
authors.lastname: Stoot
authors.forename: Maartje A J
authors.initials: MA
authors.lastname: van den Broek
authors.forename: Wim A
authors.initials: WA
authors.lastname: Buurman
authors.forename: Marc H A
authors.initials: MH
authors.lastname: Bemelmans
authors.forename: Steven W M
authors.initials: SW
authors.lastname: Olde Damink
authors.forename: Cornelis H C
authors.initials: CH
authors.lastname: Dejong
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001783:Blood Flow Velocity; D005260:Female; D041981:Gastrointestinal Tract / Q000098:blood supply / Q000378:metabolism*; D006498:Hepatectomy; D006503:Hepatic Veins; D006706:Homeostasis; D006801:Humans; D015850:Interleukin-6 / Q000097:blood* / Q000378:metabolism; D008099:Liver / Q000098:blood supply / Q000378:metabolism / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011169:Portal Vein; D017534:Radial Artery; D012039:Regional Blood Flow; D012044:Regression Analysis; D013152:Splanchnic Circulation; D013997:Time Factors
chemical_list: C508600:IL6 protein, human; D015850:Interleukin-6