Significance of Host Defense Mechanisms in Hepatoma Patients with Chronic Active Hepatitis Indicating for Hepatic Resection

Kiyoaki Ouchi, Shuji Matsubara, Masanori Suzuki, Tsuyoshi Tominaga, Taisei Muto, Seiki Matsuno

The First Department of Surgery, Tohoku University School of Medicine

Patients with chronic active hepatitis (CAH) tend to have hepatic failure after major surgical procedures such as hepatic resection. Four patients with CAH who died of hepatic failure after hepatectomy were compared with six with inactive cirrhosis who had an uneventful postoperative course after hepatectomy. Parameters indicating host defense mechanisms such as reticuloendothelial phagocytic index, opsonic index, CH₅₀, fibronectin and Leu 11 were measured. All those parameters were significantly lower after the operation in patients with CAH than in those with inactive cirrhosis. In addition, preoperative values of opsonic index (82.3±9.4% vs 97.2±3.7%) and CH₅₀ (23.7±5.9 u/ml vs 38.4±5.1 u/ml) were significantly lower in the former than in the latter group. It should be noted that patients with deteriorated host defense mechanisms possibly have active inflammatory lesions in the liver. Parameters indicating host defense mechanisms, therefore, could be important determinants of indications for surgery, operative procedure of choice, and short term post operative survival.

Key words
chronic active hepatitis, liver failure, host defense mechanism

Reprint requests
Kiyoaki Ouchi The First Department of Surgery, Tohoku University School of Medicine
1-1 Seiryocho, Aoba-ku, Sendai 980 JAPAN

Accepted
November 20, 1991

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