Role of platelet-activating factor in hepatectomy with Pringle's maneuver

Background. Interruption of hepatic inflow is commonly used to reduce blood loss during extensive liver resection, but may cause liver dysfunction, Th e present study investigated the effects of platelet-activating factor (PAF ) antagonist E5880 on total liver warm ischemia and 70% hepatectomy. Methods. Rabbits were used in this study and were divided into four groups: group 1, those treated with only 70% hepatectomy; group 2, those treated w ith only 20 min Pringle's maneuver; group 3, those treated with both Pringl e's maneuver and 70% hepatectomy without pretreatment; and group 4, those p retreated with PAF antagonist E5880 (0.3 mg/kg) followed by Pringle's maneu ver and 70% hepatectomy. The remnant liver function was then evaluated afte r reperfusion. Results. Seven-day survival rates in both groups 1 and 2 were 100%, E5880 t reatment significantly increased 7-day survival rate (group 4: 38% vs group 3: 0%, P < 0.05) after a combination of Pringle's maneuver and 10% hepatec tomy. The elevations of serum liver enzymes (GOT, GPT, mGOT, and LDH) were significantly inhibited in group 4 at 1 and 4 h after reperfusion. Portal v enous pressure and the energy charge of liver were also significantly impro ved in group 4, compared with those in group 3. Endothelin-1 levels of arte rial and portal venous blood progressively increased after reperfusion; how ever, there were no significant differences between the two groups. Leukocy te infiltration into the liver was significantly inhibited in group 4. Conclusion. E5880 pretreatment has protective effects on liver function aft er 70% hepatectomy with Pringle's maneuver in rabbits. (C) 2001 Academic Pr ess.