Bacterial translocation induces remnant liver injury after subtotal (90%) hepatectomy in rats —The effect of decontamination of gram-negative rods in digestive tract by oral polymyxin B treatment—

Abstract

To clarify the relationship of bacterial translocation (BT) to remnant liver injury after subtotal (90%) hepatectomy, we compared orally polymyxin B treated rats (PL-B (+)), of which gram-negative rods (GNR) in digestive tract decreased, with control rats (PL-B (-)). The increase in intestinal permeability assessed by lactulose/mannitol ratio in urine, the increase in GNR positive in tissue culture including mesenteric lymphnode, liver, spleen, portal blood, and kidney, and the elevation of serum endotoxin levels showed BT after subtotal hepatectomy in PL-B (-) group. Liver injury was also observed by increased serum GPT levels and massive coagulative necrosis of hepatocytes with bleeding in the remnant liver. In PL-B (+) group rats, BT and liver injury decreased and hepatocyte DNA synthesis increased, while intestinal permeability was the same as PL-B (-) group. It is suggested that BT is the cause of remnant liver injury after subtotal hepatectomy, and oral PL-B treatment is effective in preventing liver injury.