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This Article Full Text Full Text (PDF) All Versions of this Article: 293/5/G956    most recent 00366.2006v1 Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in Web of Science Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Web of Science (1) Citing Articles via Google Scholar Google Scholar Articles by van de Poll, M. C. G. Articles by Dejong, C. H. C. Search for Related Content PubMed PubMed Citation Articles by van de Poll, M. C. G. Articles by Dejong, C. H. C.

LIVER AND BILIARY TRACT

Effect of major liver resection on hepatic ureagenesis in humans

Departments of ¹Surgery, Nutrition, and Toxicology and ⁴Radiology, Research Institute Maastricht, University Hospital Maastricht, Maastricht, the Netherlands; and ²Clinical and Surgical Sciences (Surgery), ³Department of Radiology, University of Edinburgh, Royal Infirmary, Scotland, United Kingdom

Submitted 6 August 2006 ; accepted in final form 12 August 2007

Changes in hepatic ureagenesis following major hepatectomy are not well characterized. We studied the relation between urea synthesis and liver mass before and after major hepatectomy in humans. Fifteen patients scheduled for resection of malignancies in otherwise healthy livers were studied. Pre- and postoperative liver volume was assessed by computerized tomography-volumetry. During surgery, a primed, continuous infusion of [¹³C]urea was administered intravenously, and arterial blood samples were obtained hourly. Indocyanine green clearance was determined before and after resection. Seven patients underwent major hepatectomy, and eight patients underwent minor [<5% functional liver volume (total volume – tumor volume)] or no resection, serving as controls. Resected functional liver volume in the major hepatectomy group averaged 60%. Urea synthesis per gram of functional liver tissue increased 2.6-fold following major hepatectomy, maintaining whole body urea synthesis. Arterial ammonia remained unchanged throughout the study, whereas following hepatectomy a hyperaminoacidemia occurred. In conclusion, immediately following major hepatectomy, urea synthesis per gram of functional liver tissue increases rapidly and proportionately to the amount of liver tissue resected, maintaining whole body urea synthesis at preoperative levels. This rapid and complete adaptation suggests that the capacity of urea synthesis is not limiting the maximum resectable volume in otherwise healthy livers.

liver function; liver volume; computerized tomography-volumetry; stable isotopes

This article has been cited by other articles:

				M. C. G. van de Poll, G. C. Ligthart-Melis, S. W. M. Olde Damink, P. A. M. van Leeuwen, R. G. H. Beets-Tan, N. E. P. Deutz, S. J. Wigmore, P. B. Soeters, and C. H. C. Dejong The gut does not contribute to systemic ammonia release in humans without portosystemic shunting Am J Physiol Gastrointest Liver Physiol, October 1, 2008; 295(4): G760 - G765. [Abstract] [Full Text] [PDF]