Changes of Immunological Function after Hepatectomy in Patients with Malignant Liver Tumors

Michiyoshi Hisanaga, Yoshiyuki Nakajima, Hiromichi Kanehiro, Yoshinori Murao, Toshiyuki Fukuoka, Junichiro Taki, Yukio Aomatsu, Masato Horikawa, Kiyoshi Kido, Atsushi Yoshimura, Masayoshi Ueno, Hiroshige Nakano

First Department of Surgery, Nara Medical University

Changes in immunological function were investigated after hepatectomy in 25 patients with malignant liver tumors by various parameters until 4th postoperative week. The patients were divided into two groups consisting of 15 patients associated with liver cirrhosis or active hepatitis (n=15, group A) and 10 patients with no other liver diseases (n=10, group B). The lymphocyte counts and Th/Ts ratio dropped to their minimum levels on the 3rd and 7th postoperative days, respectively. Both NK and LAK activities decreased significantly in the 2nd postoperative week (p<0.05), and showed virtual recovery in the 4th weeks. In group A, this decrease was particularly marked and recovery was delayed. No obvious changes were found in ADCC activity during the course of study. IgG, IgA and IgM levels were reduced on the 3rd postoperative day and recovered by the end of the first week, with group A showing significantly higher values throughout the monitoring period (p<0.05). Both C₃ and C₄ were significantly elevated at 1 week (p<0.05), and then normalized at 2 weeks. In conclusion, in patients undergoing hepatectomy, the suppression of immunological function persists until the 2nd postoperative week. This suppression was more pronounced and recovery was delayed longer in patients associated with combined liver disease.

Key words
hepatectomy, immunological function, liver tumor, liver cirrhosis, active hepatitis

Reprint requests
Michiyoshi Hisanaga First Department of Surgery, Nara Medical University
840 Shijo-cho, Kashihara, 634 JAPAN

Accepted
September 4, 1991

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