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Hepatobiliary transporter expression and post‐operative jaundice in patients undergoing partial hepatectomy
Author(s) -
Bernhardt Gerwin A.,
Zollner Gernot,
Cerwenka Herwig,
Kornprat Peter,
Fickert Peter,
Bacher Heinz,
Werkgartner Georg,
Müller Gabriele,
Zatloukal Kurt,
Mischinger HansJörg,
Trauner Michael
Publication year - 2012
Publication title -
liver international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.873
H-Index - 110
eISSN - 1478-3231
pISSN - 1478-3223
DOI - 10.1111/j.1478-3231.2011.02625.x
Subject(s) - bile salt export pump , bilirubin , medicine , gastroenterology , jaundice , transporter , hepatectomy , liver injury , surgery , biology , resection , biochemistry , gene
Background and aims Post‐operative hyperbilirubinaemia in patients undergoing liver resections is associated with high morbidity and mortality. Apart from different known factors responsible for the development of post‐operative jaundice, little is known about the role of hepatobiliary transport systems in the pathogenesis of post‐operative jaundice in humans after liver resection. Methods Two liver tissue samples were taken from 14 patients undergoing liver resection before and after P ringle manoeuvre. Patients were retrospectively divided into two groups according to post‐operative bilirubin serum levels. The two groups were analysed comparing the results of hepatobiliary transporter [Na‐taurocholate cotransporter ( NTCP ); multidrug resistance gene/phospholipid export pump( MDR 3); bile salt export pump ( BSEP ); canalicular bile salt export pump ( MRP 2)], heat shock protein 70 ( HSP 70) expression as well as the results of routinely taken post‐operative liver chemistry tests. Results Patients with low post‐operative bilirubin had lower levels of NTCP, MDR 3 and BSEP mRNA compared to those with high bilirubin after P ringle manoeuvre. HSP 70 levels were significantly higher after ischaemia–reperfusion ( IR ) injury in both groups resulting in 4.5‐fold median increase. Baseline median mRNA expression of all four transporters prior to P ringle manoeuvre tended to be lower in the low bilirubin group whereas expression of HSP 70 was higher in the low bilirubin group compared to the high bilirubin group. Discussion Higher mRNA levels of HSP 70 in the low bilirubin group could indicate a possible protective effect of high HSP 70 levels against IR injury. Although the exact role of hepatobiliary transport systems in the development of post‐operative hyper bilirubinemia is not yet completely understood, this study provides new insights into the molecular aspects of post‐operative jaundice after liver surgery.