[Effect of portocaval shunt and arterialization of the liver on antibodies to Escherichia coli in patients with cirrhosis of the liver (author's transl)].

The effect of a portocaval shunt with and without portal arterialization of the liver on serum immunoglobulin concentrations and on the incidence of antibodies to 8 different serotypes of Escherichia coli was studied in 29 patients with cirrhosis of the liver. Compared with healthy controls, the serum concentrations of IgG, IgA and IgM were significantly elevated in cirrhotic patients. No difference in immunoglobulin concentrations could be observed between shunted and arterialized cirrhotics. The incidence of E. coli antibodies was significantly higher in patients with cirrhosis of the liver, showing a further increase in patients with portocaval shunt operations. Portal arterialization of the liver after portocaval shunting did prevent this additional increase, presumably by restoring the antigen clearing capacity of the cirrhotic liver, thus avoiding an additional stimulation of the antigen response after the portocaval shunt. The quantitative contribution of E. coli antibodies to the hyperimmunoglobulinemia of patients with cirrhosis of the liver seems to be of little significance. The results of this study underline the significance of the portal hepatic blood flow for the function of the reticulo-endothelial system of the liver.