Effects of extrahepatic obstructive jaundice on Kupffer cell clearance capacity
W. D. Clements, M. I. Halliday, M. D. McCaigue, R. G. Barclay and B. J. Rowlands
Department of Surgery, Queen's University of Belfast, Northern Ireland.
Systemic endotoxemia consistently occurs in jaundiced patients undergoing
surgery. Kupffer cell dysfunction is implicated in the development of
endotoxemia and its postoperative complications. A novel in situ
single-pass hepatic perfusion technique using a fluorescein
isothiocyanate-labeled latex probe was developed for measuring Kupffer cell
clearance capacity and was applied in an animal model of biliary
obstruction. Control rats and rats jaundiced for 1, 2, 3, and 4 weeks'
duration were studied. Kupffer cell clearance capacity, plasma bilirubin,
endotoxin, and anticore glycolipid concentrations were measured. Maximal
hyperbilirubinemia preceded reduced Kupffer cell clearance capacity. Rats
jaundiced for greater than 2 weeks had a significantly decreased Kupffer
cell clearance capacity but significantly higher endotoxin and anticore
glycolipid concentrations. Anticore glycolipid concentrations correlated
strongly with systemic endotoxemia and both were inversely correlated with
duration of jaundice. Impairment of Kupffer cell clearance capacity may
contribute to endotoxemia associated with cholestasis.
