Circulating heat-shock protein 70 is associated with postoperative infection and organ dysfunction after liver resection

Background: Although extracellular heat-shock protein 70 (Hsp70) potentially mediates an inflammatory response, the association of circulating Hsp70 with complications after surgery is poorly understood. Methods: Perioperative plasma concentrations of Hsp70 and interleukin-6 were measured by immumoassays in 64 consecutive patients undergoing liver resection. Results: Plasma concentrations of Hsp70 and interleukin-6 showed a striking increase immediately after surgery, and on postoperative day 1. The Hsp70 levels correlated significantly with operation time, hepatic ischemia time, postoperative alanine aminotransferase levels, and maximum interleukin-6 levels (P<0.01). The Hsp70 and interleukin-6 concentrations were associated significantly with postoperative infection (P<0.05); Hsp70 concentrations and blood loss but not interleukin-6 were associated significantly with postoperative organ dysfunction (P<0.05) in multivariate analyses. Conclusions: These results suggest that circulating Hsp70 and IL-6 potentially play a pivotal role in pathophysiology of postoperative infection, and that circulating Hsp70 and blood loss may represent a prognostic marker for postoperative organ dysfunction. (C) 2004 Excerpta Medica, Inc. All rights reserved.