FALSE-POSITIVE ENDOTOXEMIA DERIVES FROM GAUZE GLUCAN AFTER HEPATECTOMY FOR HEPATOCELLULAR-CARCINOMA WITH CIRRHOSIS

Background/Aims: The purpose of this study was to evaluate the occurre nce of false-positive endotoxemia after hepatectomy for hepatocellular carcinoma in patients with cirrhosis. The chromogenic conventional li mulus test (Toxicolor test) revealed transiently increased blood endot oxin, levels after hepatic resection for hepatocellular carcinoma in p atients with liver cirrhosis. However, clinical signs of endotoxemia w ere not observed in all of the cases. Methodology: Pre- and postoperat ive changes of blood endotoxin levels and beta-glucan were measured in 20 patients with liver cirrhosis who underwent hepatic resection for hepatocellular carcinoma, using the Toxicolor test, the Endospecy test (which specifically reacts with endotoxin) and the Gluspecy test (whi ch specifically reacts with beta-glucan). The changes in endotoxin lev els and beta-glucan in ascitic fluid during surgery were also studied. Results: The Toxicolor test revealed transiently increased blood endo toxin levels, but Endospecy test results were not elevated. The change s in the Gluspecy test were almost the same as in. the Toxicolor test. During surgery, beta-glucan levels in the ascitic fluid increased rem arkably due to their release from the surgical gauze. Digestion studie s using 1-3-beta-D-glucanase on specimens which showed high Toxicolor and Gluspecy test values resulted in a lack of response for both tests . Conclusion: The cause of false-positive endotoxemia was determined t o be caused by beta-glucan, which was released from the surgical gauze .