Stress response to hepatectomy in patients with a healthy or a diseased liver
Abstract
Partial hepatectomy is a major upper abdominal operation associated with certain stress to the patient. Successful adaptation to such stress is a prerequisite for survival. Donor hepatectomy with maximal safety is a principal concern during living donor liver transplantation. The purpose of the study was to compare the stress response by assessing cytokines and the acute-phase response induced by hepatectomy in patients with a healthy liver and those with a diseased liver. Fourteen patients undergoing partial right hepatectomy were enrolled in this study. Seven of them were donors for living related liver transplantation (group 1, or GI); the other seven were patients with hepatocellular carcinoma due to chronic hepatitis B (Child's class A) (GII). Blood samples for interleukin-6 (IL-6), tumor necrosis factor-alpha (TNFalpha), and C-reactive protein (CRP) assays were collected before the operation, at the beginning and end of the operation, and 24 and 48 hours after the operation. The data were analyzed and compared in the same group using the Friedman test and between groups using the Mann-Whitney U-test. A value of p < 0.05 was regarded as significant. Results showed that resection of the liver in patients with both healthy and disease livers leads to significant increases in IL-6 and CPR but not TNFalpha. Significantly lower levels of IL-6 before and after operation in GI patients compared to those in GII patients suggests that GI patients adapted to surgical stress more e…
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The review included 12 publications with a collective 589 patients, with a range of 14 to 128 patients.
“A final number of 12 publications with a collective 589 patients (range 14–128) were included in this review (Table 1) [20,21,22,23,24,25,26,27,28,29,30,31].”
From The Role of Perioperative Interleukin-6 Serum Levels on Liver Dysfunction and Infectious Complications After Hepatectomy—A Systematic Review (2025) · cites this paper as [21]
Perioperative CRP levels were not significantly different between HCC patients with chronic hepatitis B and healthy liver donors.
“In contrast, perioperative CRP levels were not significantly different between the two groups.”
From The Role of Perioperative Interleukin-6 Serum Levels on Liver Dysfunction and Infectious Complications After Hepatectomy—A Systematic Review (2025) · cites this paper as [21]
Healthy liver donor cases have more capacity to adapt to surgical stress than patients with underlying liver disease.
“The authors concluded that healthy liver donor cases have more capacity to adapt to surgical stress than patients with underlying liver disease.”
From The Role of Perioperative Interleukin-6 Serum Levels on Liver Dysfunction and Infectious Complications After Hepatectomy—A Systematic Review (2025) · cites this paper as [21]
In patients undergoing liver resection for hepatocellular carcinoma due to chronic hepatitis B compared with healthy donors for living liver transplantation, IL-6 rose significantly on POD1 in both groups, with a lower increase in the healthy donor group.
“Postoperative laboratory results showed a significant rise in IL-6 levels on POD1 in both groups, with a lower increase in the healthy donor group (IL-6 preop/POD1/POD2: 4.12/47.51/25.81 pg/mL) compared to HCC patients (11.50/141.90/109.50; all p < 0.05).”
From The Role of Perioperative Interleukin-6 Serum Levels on Liver Dysfunction and Infectious Complications After Hepatectomy—A Systematic Review (2025) · cites this paper as [21]
Cites
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Liver Failure and Defective Hepatocyte Regeneration in Interleukin-6-Deficient Mice
Cressman, D. E., Greenbaum, L. E., DeAngelis, R. A., Ciliberto, G., Furth, E. E., Poli, V., & Taub, R. (1996) · Science · doi:10.1126/science.274.5291.1379 · Cited by 1,536 · see citing works
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Kofler, A., Trattner, M., Mairinger, V., Urban, I., Søreide, K., Stättner, S., & Primavesi, F. (2025) · Cancers · doi:10.3390/cancers17193120 · Cited by 4 · see citing works
“In a small, prospective case–control study ( n = 14) from 2003 [21], the acute phase response and cytokine levels in patients undergoing liver resection for hepatocellular carcinoma (HCC) due to chronic hepatitis B were compared to those of healthy donors for living liver transplantation.”
- Authors
- Lan, A. K., Luk, H., Goto, S., Chen, S. S., Eng, H., Chen, Y., de Villa, V. H., Wang, C. C., Cheng, Y., Chen, C., Lee, J., & Jawan, B.
- Affiliations
- Chang Gung Memorial Hospital (TW)
- Department of General Surgery Chang Gung Memorial Hospital Ta‐pei Road 123, Niao Shung Hsiang 83305 Kaohsiung Taiwan, Republic of China
- Department of Radiology Ta‐pei Road 123, Niao Shung Hsiang 83305 Kaohsiung Taiwan, Republic of China
- Venue
- World Journal of Surgery
- Publisher
- Wiley
- Published
- 2003-05-23
- Volume
- 27
- Issue
- 7
- Pages
- 761-764
- ISSN
- 0364-2313 (ISSN-L)
- 1432-2323
- OpenAlex
- W2083592521
- Cited by
- 29
- References
- 2
- Citations by year
- 2026: 1 · 2025: 1 · 2022: 2 · 2020: 2 · 2017: 1 · 2015: 2 · 2014: 2 · 2013: 1
- FWCI
- 2.24
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- World Journal of Surgery (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Science Council
- Topics
- Health Sciences › Medicine › Surgery › Organ Transplantation Techniques and Outcomes
- Health Sciences › Medicine › Hepatology › Liver physiology and pathology
- Health Sciences › Medicine › Psychiatry and Mental health › Cancer, Stress, Anesthesia, and Immune Response
- Keywords
- partial hepatectomy, surgical stress response, living donor liver transplantation, hepatocellular carcinoma, chronic hepatitis B, interleukin-6, C-reactive protein, TNF-α, acute phase response, cytokines, liver disease
- MeSH terms
- Adaptation, Physiological, Adult, C-Reactive Protein, Female, Hepatectomy, Humans, Liver Cirrhosis, Liver Neoplasms, Male, Middle Aged, Probability, Prospective Studies, Stress, Physiological, Tumor Necrosis Factor-alpha, Biomarkers, Interleukin-6, Case-Control Studies, Liver Transplantation, Statistics, Nonparametric, Living Donors
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