THE INFLUENCE OF PORTOSYSTEMIC SHUNT OPERATION ON IMMUNOGLOBULINS AND ESCHERICHIA COLI ANTIBODIES IN PATIENTS WITH CIRRHOSIS OF THE LIVER

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Abstract
Serum γ‐globulin levels have been determined by paper electrophoresis in 54 patients with cirrhosis of the liver before and after establishment of a portocaval shunt. As a control group 23 patients operated on for cancer of the lung were studied in the same way. A significant average increase from 18.6 to 23.0 g/1 in the cirrhotics was found, whereas no increase in the control group was observed. Serum immunoglobulins and antibodies to E. coli 0 group antigens were studied in 31 patients with cirrhosis and a portocaval shunt and 128 patients with cirrhosis without portocaval shunt. Significantly higher levels of IgG and E. coli antibodies were found in the patients with a portocaval shunt. It is proposed that these observations can be explained by the change in liver circulation brought about by the operation. If the cirrhotic liver has retained some of the ability of the normal liver to inhibit immunogens as previously proposed by us, the observed changes in immunoglobulins and E. coli antibodies should be expected.