Impaired leukocyte phagocytosis in patients undergoing hemihepatectomy for liver metastases

Abstract

Patients undergoing partial hepatectomy have an increased susceptibility to infection. To investigate whether this increased risk is related to impaired leukocyte function, we studied polymorphonuclear leukocyte (PMN) phagocytosis in patients undergoing a hemihepatectomy because of liver metastasis (LM, n ‫؍‬ 11) and in patients undergoing major abdominal surgery because of abdominal malignancy (AM, n ‫؍‬ 8). Eight healthy volunteers (HVs) served as controls. Leukocyte suspensions were incubated with fluorescein isothiocyanate-labeled Staphylococcus aureus, and phagocytosis was measured by flow cytometry. Preoperative PMN phagocytosis, in the presence of autologous plasma, was significantly less in patients with LM compared with patients with AM or HVs. This impaired phagocytosis was potentially restored in the presence of normal plasma.The decreased phagocytic capacity of PMNs from patients with LM was not related to levels of known plasma opsonins or phenotypic changes of PMNs. Rather, it was related to a deficiency of unidentified plasma factors. After surgery, the phagocytic capacity of PMNs of patients with AM decreased by approximately 30%, which correlated with decreasing levels of immunoglobulin G and C3. In conclusion, patients with LM had a decreased PMN phagocytic capacity before surgery. This impairment in phagocytosis disappeared 1 week after surgery. We propose that the presence of LM leads to a deficiency of factor(s) in the blood that impairs PMN phagocytic capacity.Copyright 1999 by the American Association for the Study of Liver Diseases P artial hepatectomy is the first choice of treatment for patients with liver metastasis (LM) of colorectal cancer. During the last decade, major advances in anesthetic and surgical techniques, as well as improvement in postoperative care, have significantly reduced mortality and morbidity after liver resection. Nevertheless, extensive liver resection is still associated with a high incidence of infectious complications. [1][2][3][4] Elimination of pathogenic microorganisms by the host immune system occurs mainly through phagocytosis by polymorphonuclear leukocytes (PMNs). By virtue of this capacity, PMNs constitute the initial cellular barrier against infection. Therefore, infections occurring in the immediate postoperative period after partial hepatectomy may be related to a decreased phagocytic capacity of these cells. To investigate this idea, we evaluated the ex vivo phagocytosis of bacteria by PMNs from patients before and after a hemihepatectomy for metastatic colorectal carcinoma. As controls, patients undergoing abdominal surgery because of malignancy, as well as healthy volunteers (HVs), were studied. Materials and Methods PatientsEleven patients undergoing (extended) hemihepatectomy (resection of Ն three liver segments) for LM of colorectal carcinoma (9 men and 2 women; mean age, 60.8 Ϯ 2.5 years) and 8 patients undergoing resection of colorectal cancer, without liver metastases (AM; 6 men and 2 women; mean age, 61.8 Ϯ 3.7 years) were included. Eight...

Phagocytic Activity and Nitric Oxide Production of Circulating Polymorphonuclear Leukocytes from Patients with Peritoneal Carcinomatosis

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Role of Ca2+ in activation of reactive oxygen species production in polymorphonuclear leukocytes during tumour growth in rats

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“…Probably, they account for those contradictory results on ROS generation during tumour growth in animals and humans, as described previously (1)(2)(3)(4)(5)(6)(7)(8). tPMNL are shown in Fig.…”

Bactericidal/Permeability-Increasing Protein Preserves Leukocyte Functions After Major Liver Resection

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