Changes in Function of Hepatocyte Tight Junctions and Deal with Endotoxin by Hepatocytes after Hepatic Resection

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[Backgrounds and Aims]It is not known how shear stress onto the hepatic sinusoids influence liver function and regeneration after hepatic resection. Changes in functions of tight junction between hepatocytes were investigated in terms of shear stress represented by portal pressure.[Results]1) After 70% partial hepatectomy in rats, function of tight junction decreased until 7 days after hepatectomy. The function did not improve solely by portal decompression, which was achieved by previous splenic transposition to make portosystemic collaterals. However, the function of tight junction improved by prostaglandin E_1 (PGE_1) infusion.2) To avoid portal hypertension after hepatic resection, portal vein was embolized prior to hepatic resection in pigs. It was clarified that 7 days (after embolization) is enough to accomplish this aim. PGE_1 infusion via the superior mesenteric artery (SMA), which increase portal blood flow without increasing portal pressure, reduced injury to hepatocytes and sinusoidal lining cells after hepatic resection.3) In cases of major hepatic resection, PGE_1 infusion via SMA was performed. Portal blood flow, measured by Doppler US, markedly increased and oxygen saturation of hepatic venous blood also increased. This method was also useful in the treatment of postoperative liver failure.[Conclusion]After hepatic resection, function of tight junction deteriorated in relation to shear stress (portal pressure). To control shear stress after hepatic resection is effective to reduce injury following hepatic resection. PGE_1 infusion via SMA and preoperative portal embolization are both useful.