Evaluation of serum uric acid changes in different forms of hepatic vascular inflow occlusion in human liver surgeries

Uric acid values in serum have been analyzed as one of the markers to predi ct cellular damage due to ischemia reperfusion injury in the field of organ transplantation. The present study was conducted to confirm that uric acid values in serum could be an efficient marker of ischemic injury of liver p arenchyma following hepatic vascular occlusion in human liver surgery. The changes in serum uric acid values were analyzed at fixed intervals during d ifferent liver surgeries. Significant increases in serum uric acid values w ere observed in patients who received the Pringle's maneuver in which hepat ic vascular inflow was manipulated with a repetition of 15 min occlusion an d 5 min perfusion, whereas almost no changes in uric acid values were found in both groups of patients who received the hemilobal occlusion of the Gli sson's triad in which the right or left vessels were manipulated with a rep etition of 30 min occlusion and 5 min perfusion and the "control method" in which the hepatic vessels of the lesion side were previously cut before li ver resection. Uric acid values in serum increased in patients of Pringle's maneuver compared to those of the hemilobal occlusion of the Glisson's tri ad and the control method though these procedures were used in larger hepat ectomies rather than Pringle's maneuver. The results indicated that serum u ric acid values do not always reflect the severity of ischemia of the liver parenchyma but reflect intestinal congestion because marked intestinal con gestion was observed in patients of Pringle's maneuver but not in patients of the hemilobal occlusion of the Glisson's triad and the control method. T he evaluation of the severity of the ischemic injury of the liver should be done with caution when uric acid is used as a marker in human liver surger y.