title: Hepatobiliary transporter expression and post-operative jaundice in patients undergoing partial hepatectomy.
abstract: OBJECTIVE
  Post-operative hyperbilirubinaemia in patients undergoing liver resections is associated with high morbidity and mortality. Apart from different known factors responsible for the development of post-operative jaundice, little is known about the role of hepatobiliary transport systems in the pathogenesis of post-operative jaundice in humans after liver resection.
  
  
  METHODS
  Two liver tissue samples were taken from 14 patients undergoing liver resection before and after Pringle manoeuvre. Patients were retrospectively divided into two groups according to post-operative bilirubin serum levels. The two groups were analysed comparing the results of hepatobiliary transporter [Na-taurocholate cotransporter (NTCP); multidrug resistance gene/phospholipid export pump(MDR3); bile salt export pump (BSEP); canalicular bile salt export pump (MRP2)], heat shock protein 70 (HSP70) expression as well as the results of routinely taken post-operative liver chemistry tests.
  
  
  RESULTS
  Patients with low post-operative bilirubin had lower levels of NTCP, MDR3 and BSEP mRNA compared to those with high bilirubin after Pringle manoeuvre. HSP70 levels were significantly higher after ischaemia-reperfusion (IR) injury in both groups resulting in 4.5-fold median increase. Baseline median mRNA expression of all four transporters prior to Pringle manoeuvre tended to be lower in the low bilirubin group whereas expression of HSP70 was higher in the low bilirubin group compared to the high bilirubin group.
  
  
  CONCLUSIONS
  Higher mRNA levels of HSP70 in the low bilirubin group could indicate a possible protective effect of high HSP70 levels against IR injury. Although the exact role of hepatobiliary transport systems in the development of post-operative hyper bilirubinemia is not yet completely understood, this study provides new insights into the molecular aspects of post-operative jaundice after liver surgery.
authors.affiliation: Division of General Surgery, Department of Surgery, Medical University of Graz, Graz, Austria. gerwin.bernhardt@lkh-voitsberg.at
authors.forename: Gerwin A
authors.initials: GA
authors.lastname: Bernhardt
authors.forename: Gernot
authors.initials: G
authors.lastname: Zollner
authors.forename: Herwig
authors.initials: H
authors.lastname: Cerwenka
authors.forename: Peter
authors.initials: P
authors.lastname: Kornprat
authors.forename: Peter
authors.initials: P
authors.lastname: Fickert
authors.forename: Heinz
authors.initials: H
authors.lastname: Bacher
authors.forename: Georg
authors.initials: G
authors.lastname: Werkgartner
authors.forename: Gabriele
authors.initials: G
authors.lastname: Müller
authors.forename: Kurt
authors.initials: K
authors.lastname: Zatloukal
authors.forename: Hans-Jörg
authors.initials: HJ
authors.lastname: Mischinger
authors.forename: Michael
authors.initials: M
authors.lastname: Trauner
mesh_terms: D018435:ATP Binding Cassette Transporter, Subfamily B / Q000235:genetics / Q000378:metabolism; D000074020:ATP Binding Cassette Transporter, Subfamily B, Member 11; D018528:ATP-Binding Cassette Transporters / Q000235:genetics / Q000378:metabolism; D000368:Aged; D001663:Bilirubin / Q000097:blood; D002352:Carrier Proteins / Q000235:genetics / Q000378:metabolism*; D005260:Female; D015870:Gene Expression; D018840:HSP70 Heat-Shock Proteins / Q000235:genetics / Q000378:metabolism; D006498:Hepatectomy; D006801:Humans; D007565:Jaundice / Q000235:genetics / Q000378:metabolism* / Q000473:pathology; D008111:Liver Function Tests; D008113:Liver Neoplasms / Q000235:genetics / Q000378:metabolism* / Q000556:secondary; D008297:Male; D008875:Middle Aged; D000089762:Multidrug Resistance-Associated Protein 2; D027425:ATP-Binding Cassette, Sub-Family C Proteins / Q000235:genetics / Q000378:metabolism; D029363:Organic Anion Transporters, Sodium-Dependent / Q000235:genetics / Q000378:metabolism; D011183:Postoperative Complications; D012189:Retrospective Studies; D027981:Symporters / Q000235:genetics / Q000378:metabolism
chemical_list: D018435:ATP Binding Cassette Transporter, Subfamily B; D000074020:ATP Binding Cassette Transporter, Subfamily B, Member 11; D018528:ATP-Binding Cassette Transporters; D001663:Bilirubin; D002352:Carrier Proteins; D018840:HSP70 Heat-Shock Proteins; D000089762:Multidrug Resistance-Associated Protein 2; D027425:ATP-Binding Cassette, Sub-Family C Proteins; D029363:Organic Anion Transporters, Sodium-Dependent; D027981:Symporters; C093491:ABCB11 protein, human; C000715087:ABCC2 protein, human; C071908:sodium-bile acid cotransporter; C095122:multidrug resistance protein 3