Changes in tumor necrosis factor-a and interleukin-1 beta production following liver surgery on cirrhotic patients.

Background/Aims : The purpose of this study is to investigate the possible participation of inflammatory cytokine release from macrophages/ monocytes following liver surgery on cirrhotic patients in the pathogenesis of postoperative organ failures. Materials and Methods : Postoperative changes in tumor necrosis factor-a and interleukin-1β production in peripheral blood monocytes stimulated by lipopolysaccharide were examined in cirrhotic patients with hepatocellular carcinoma undergoing hepatic resections. Results : Monocytes separated from the blood in cirrhotic patients prior to operation showed a greater ability to produce tumor necrosis factor-a and interleukin-1β than those in healthy volunteers. Monocytes in postoperative cirrhotic patients showed a greater ability to produce tumor necrosis factor-a and interleukin-1 in the presence of lipopolysaccharide than healthy controls and preoperative cirrhotic patients. In the case of postoperative hepatic failure, tumor necrosis factor-a and interleukin-production in monocytes showed a remarkable rise along with progression toward hepatic failure. Conclusion : These results indicate that tumor necrosis factor-a and interleukin-1β play an important role in the pathogenesis of postoperative liver failures. When there are any stimuli to produce cytokines in monocytes, such as ischemia, significant tissue injury and/or endotoxin, organ failures could develop and progress subsequently.