REDUCTION OF HEPATIC ACUTE-PHASE RESPONSE AFTER PARTIAL-HEPATECTOMY IN ELDERLY PATIENTS

The hepatic capacity for acute phase protein synthesis after partial h epatectomy in the elderly patients was prospectively studied. Forty-on e patients who consecutively underwent a partial hepatectomy were grou ped according to age of greater or less than 70 years; 12 were in the older group and 29 in the younger. The changes in the levels of serum interleukin-6, alpha(1)-antitrypsin, alpha(1)-acid glycoprotein, hapto globin, and plasma fibrinogen were measured after surgery. The postope rative changes in standard liver function tests were also measured. Th e incidence of postoperative infected complications was 25% in the old er group and 7% in the younger (P = 0.28). Although postoperative leve ls of serum interleukin-6 were similar between the two groups, those o f serum alpha(1)-antitrypsin, alpha(1)-acid glycoprotein, and haptoglo bin were significantly lower in the elderly (P<0.05). Postoperative le vels of serum al-antitrypsin and plasma fibrinogen showed an increase of about 30% compared with the preoperative values (P<0.05) in the you nger group, but no significant increase in the older. Postoperative de terioration of serum albumin levels and hepaplastin test values was al so significantly more severe in the older group (P<0.05). We conclude that in the older patients, a reduction of acute phase protein synthes is occurs after partial hepatectomy as a result of a global deteriorat ion of liver function, and may render patients liable to infection.