J.Jpn. Surg. Soc.. 91(9): 1182-1185, 1990

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Report on the annual meeting

HEPATIC PROTEIN REPRIORITIZATION IN SURGICAL STRESS

We investigated the hepatic protein metabolism in dogs with surgical stress and in patients with various operations. Hepatic uptake of total amino acids, glutamine and alanine was increased following laparotomy and administration of IL-1 or TNF in dogs. While plama levels of some acute-phase proteins essential for host defense were increased, levels of other hepatic proteins unessential to survival were decreased in patients with operation. This reprioritization of hepatic protein synthesis seems to be accelerated after operations with severe surgical stress and in sepsis. In contrast, cirrhosis and preoperative malnutrition may attenuate the reprioritization of hepatic acute-phase protein release after surgery. These results suggest that the reprioritization of hepatic plasma protein may be influenced by the preoperative hepatic function, malnutrition, type of operation and postoperative sepsis.

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