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Bacterial translocation in acute liver failure induced by 90 per cent hepatectomy in the rat
X D Wang1, V Soltesz, R Andersson
1Department of Surgery, Lund University, Sweden.
Abstract:
Bacterial infection and bacteraemia have been observed in patients with acute liver failure. The exact source of bacteria and nature of pathophysiological mechanisms explaining the development of infection remain unclear. In the present study, acute liver failure was induced by 90 per cent hepatectomy in the rat. The mesenteric lymph nodes and organs were harvested aseptically for bacteriological culture after sham operation or 90 per cent hepatectomy. Function of the liver and reticuloendothelial system (RES) was assayed; gut oxygen extraction was also measured. Translocation of enteric bacteria occurred 2 h after operation and increased with time following hepatectomy. Overgrowth of Escherichia coli in the distal small intestine started 2 h after operation. RES function decreased immediately after 90 per cent hepatectomy; uptake rates per gram tissue in other organs increased significantly. These results indicate that bacterial translocation occurred early after 90 per cent hepatectomy, associated with a decrease in RES function and gut oxygen extraction, and overgrowth of intestinal bacteria.
Insights
Bacterial translocation and intestinal overgrowth occur early after acute liver failure in rats. This is linked to reduced liver function and gut oxygen use, increasing infection risk.
Area of Science:
- Hepatology
- Microbiology
- Surgical Research
Background:
- Bacterial infection and bacteremia are common in acute liver failure (ALF).
- The origins of bacteria and mechanisms driving infection in ALF remain poorly understood.
- Investigating bacterial translocation is crucial for understanding ALF pathogenesis.
Purpose of the Study:
- To investigate the occurrence and timing of bacterial translocation following acute liver failure.
- To examine the relationship between bacterial translocation, liver function, and the reticuloendothelial system (RES).
- To assess changes in intestinal bacterial overgrowth and gut oxygen extraction after hepatectomy.
Main Methods:
- Acute liver failure was induced in rats via 90% hepatectomy.
- Bacteriological cultures of mesenteric lymph nodes and organs were performed post-surgery.
- Liver function, RES function, and gut oxygen extraction were measured.
- Bacterial translocation and intestinal microbial overgrowth were quantified over time.
Main Results:
- Bacterial translocation from the gut was detected as early as 2 hours post-hepatectomy, increasing over time.
- Significant overgrowth of Escherichia coli in the distal small intestine occurred 2 hours after surgery.
- Reticuloendothelial system (RES) function decreased immediately after hepatectomy.
- Gut oxygen extraction was reduced following hepatectomy.
Conclusions:
- Bacterial translocation is an early event in acute liver failure induced by major hepatectomy.
- Reduced RES function and impaired gut oxygen extraction contribute to bacterial translocation.
- Intestinal bacterial overgrowth exacerbates the risk of infection in acute liver failure.