effect of pentoxifylline on hepatocyte growth factor and liver functions in cirrhotic patients undergoing splenectomy and decongestion

ABSTRACT

High morbidity and mortality rates in cirrhotic patients undergoing intraabdominal surgery underscore the need for identifying a therapy that will decrease postoperative hepatic dysfunction and enhance hepatic regenerative activity. Perioperative administration of pentoxifylline [PTX] is suggested to decrease liver fibrosis and enhance hepatic regenerative activity in cirrhotic patients. Hepatocyte growth factor [HGF] is hepatocyte mitogen, that is suggested to play a role in liver regeneration during injury. The aim of this study is to investigate the value of perioperative administration of PTX on reducing liver injury as reflected by changes in serum level of hepatocyte growth factor [HGF], and standard liver functions in cirrhotic patients undergoing Splenectomy and decongestion. 20 adult patients with cirrhotic liver were randomly allocated into two equal groups. Patients in the first group [PTX Gp], received 300 mg i.v. PTX before induction of general anesthesia followed by 100 mg /h PTX in 500 ml glucose 5% infused in 10 hours. Patients in the second group [control Gp], received 15ml i.v. glucose 5% solution before induction of general anesthesia followed by 500 ml glucose 5% infused in 10 hours. All patients' were Child class A. Hepatocyte growth factor increased significantly at postoperative time when it was compared with preoperative value in control group. Liver enzymes SGOT, SGPT, prothrombin activity, total bilirubin, serum albumin, blood urea and creatinine did not significantly change in the studied groups when postoperative values were compared with preoperative ones or when the studied groups were compared with each other. White blood count and platelets increased significantly postoperatively compared with preoperative values in the studied groups. The current study suggested that perioperative administration of PTX could produce hepatocyte protection during intra-abdominal surgery as hepatocyte growth factor did not significantly increase at postoperative time in PTX group meanwhile, it increased significantly at postoperative time compared to preoperative value in control group. It did not influence liver or kidney functions, as SGOT, SGPT, prothrombin activity, serum albumin, total bilirubin as well as blood urea and creatinine did not significantly change postoperatively compared with preoperative values in both studied groups