J.Jpn. Surg. Soc.. 86(9): 1237-1240, 1985

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Report on the annual meeting

PATHOPHYSIOLOGY AND TREATMENT OF MULTIPLE ORGAN FAILURE AMONG HEPATECTOMIZED CIRRHOTIC PATIENTS

Our previous studies have claimed that cirrhotic rats, induced with CCI₄, showed depressed reticuloendothelial system (RES) function and increased susceptibility to infection. We have also shown that OK-432, a non-specific immunopotentiator, and ATP-MgCI₂, which improves depressed intracellular energy metabolism, improve RES functin of cirrhotic rats and that thereby improve survival following peritonitis or hepatectomy. The present study was undertaken to investigate whether OK-432 or ATP-MgCl₂ could be beneficial for the prevention of multiple organ failure (MOF) following hepatectomy among the cirrhotics.
The cirrhotics with hepatocellular carcinoma, who underwent partial hepatectomy (segmentectomy or subsegmentectomy) were given OK-432 (5KE/day for 4 days) preoperatively or ATP-MgCl₂ (50μmole/kg) within 24 hours following the operation. The rates of postoperative pulmonary complication and the operative mortality were compared among OK-432 group, ATP-MgCl₂ group and controls. The rates of posthepatectomy pulmonary complication and operative mortality were decreased with these treatments compared to the controls. The RES functin was also improved with these treatments.
These data suggest that the cirrhotic patients are the immunocompromised hosts showing the depressed RES function and that the enhancement of RES function with OK-432 or ATP-MgCl₂ is beneficial for the prevention of posthepatectomy MOF among cirrhotiics.

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