SERUM HYALURONIC-ACID LEVEL REFLECTS VOLUME AND ATP LEVELS OF THE LIVER AFTER EXTENDED HEPATECTOMY WITH AND WITHOUT PREOPERATIVE PORTAL-VEIN OCCLUSION

The purpose of this study was to examine the hypothesis that the serum hyaluronic acid (HA) level reflects the volume and adenosine triphosp hate (ATP) levels of the liver after extended hepatectomy (ExHx) with and without preoperative portal vein occlusion (PVO). Rats were random ly divided into two groups, PVO-ExHx and sham-ExHx. At the first stage , they underwent PVO or sham surgery by an occlusion of the portal vei n supplying the left lateral and median lobes or by similar manipulati on but without PVO, respectively. Seven days after first-stage surgery , both groups received ExHx exceeding portal vein-occluded lobes, whic h was the excision of the left lateral, median, and right lateral lobe s of the liver reported as a 90% hepatectomy model. On Days 0, 1, 2, a nd 3 after ExHx, the serum HA concentrations, liver weights, and hepat ic ATP levels were determined. Liver volumes were restored to similar levels in both groups, but restoration was faster in the PVO-ExHx grou p because preoperative PVO allowed the excised liver less volume. Lowe r serum HA levels were significantly associated with significantly hig her hepatic ATP levels and with a lower mortality rate in the PVO-ExHx group. The serum HA level correlated significantly (P < 0.001) with t he liver weight and hepatic ATP level. The serum HA level serves as a proxy for clinically important parameters following major hepatic surg ery. (C) 1997 Academic Press.