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Impaired leukocyte phagocytosis in patients undergoing hemihepatectomy for liver metastases
Author(s) -
Wiezer Marinus J.,
Meijer Catharina,
WallastGroenewoud Howard P.,
Tool Anton T.J.,
Prins Hubert A.,
Houdijk Alexander P.J.,
Beelen Rob H.J.,
Meijer Sybren,
Hack C. Erik,
van Leeuwen Paul A.M.
Publication year - 1999
Publication title -
liver transplantation and surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.814
H-Index - 150
eISSN - 1527-6473
pISSN - 1074-3022
DOI - 10.1002/lt.500050311
Subject(s) - phagocytosis , medicine , opsonin , flow cytometry , fluorescein isothiocyanate , staphylococcus aureus , immunology , hepatectomy , metastasis , gastroenterology , surgery , biology , cancer , resection , physics , quantum mechanics , bacteria , fluorescence , genetics
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.