Systemic macrophage migration inhibitory factor release following hepatic resection

We set out to determine the responses of macrophage migration inhibitory fa ctor (MIF) to hepatic resection and investigate its role in predicting shor t-term postoperative morbidity and outcome. Blood samples from 29 patients undergoing hepatic resection and eight healthy volunteers were obtained ser ially for 24h and assayed for serum MIF, cortisol, and tumor necrosis facto r (TNF)-alpha. The MIF and cortisol levels showed a parallel increase and t heir peak levels were significantly correlated (r(2) = 0.33, P = 0.0011). T he TNF-alpha levels also increased during and after hepatic resection, but did not correlate with the MIF levels. The patients were classified into an extended hepatectomy group (n = 9); a lobectomy/segmentectomy group (n = 1 2); and a subsegmentectomy group (n = 8). There were no differences in the time courses of MIF (P = 0.8699), cortisol (P = 0.7485), and TNF-alpha (P = 0.3819) among the three groups. No patients developed organ dysfunction an d all were discharged from the intensive care unit without any complication s. Our findings demonstrate that MIF production occurs in patients undergoi ng hepatic resection. Surgical stress may play a more important role in MIF secretion than inflammatory stimulus by TNF-alpha in these patients. There fore, MIF minimally affects short-term postoperative morbidity and outcome.