scholarly journals Cellular Liver Regeneration after Extended Hepatic Resection in Pigs

HPB Surgery ◽  
2009 ◽  
Vol 2009 ◽  
pp. 1-7 ◽  
Author(s):  
Ruth Ladurner ◽  
Frank Traub ◽  
Martin Schenk ◽  
Alfred Königsrainer ◽  
Jörg Glatzle
Keyword(s):  
Liver Regeneration ◽  
De Novo ◽  
Liver Volume ◽  
Portosystemic Shunt ◽  
Remnant Liver ◽  
De Novo Synthesis ◽  
Extended Resection ◽  
Operation Procedure ◽  
Left Hemihepatectomy

Background. The liver has an enormous capacity to regenerate itself. The aim of this study was to evaluate whether the regeneration is due to hypertrophy or hyperplasia of the remnant liver after extended resection and whether a portosystemic shunt is beneficial. Material and methods. An extended left hemihepatectomy was performed in 25 pigs, and in 14 after performing a portosystemic shunt. During follow up, liver regeneration was estimated by macroscopic markers such as liver volume and size of the portal fields as well as the amount of hepatocytes per portal field and the amount of hepatocytes per . Results. Regardless of the operation procedure, the volume of the remnant liver increased about 2.5 fold at the end of the first week after resection. The size of the portal fields increased significantly as well as the number of hepatocytes in the portal fields. Interestingly, the number of hepatocytes per remained the same. Conclusion. After extended resection, liver regeneration was achieved by an extensive and significant hyperplasia of hepatocytes within the preexisting portal fields and not by de novo synthesis of new portal fields. However, there was no difference in liver regeneration regarding the operation procedure performed with or without portosystemic shunt.

scholarly journals Influence of Portosystemic Shunt on Liver Regeneration after Hepatic Resection in Pigs

HPB Surgery ◽  
2009 ◽  
Vol 2009 ◽  
pp. 1-8 ◽  
Author(s):  
R. Ladurner ◽  
M. Schenk ◽  
R. Margreiter ◽  
F. Offner ◽  
A. Königsrainer
Keyword(s):  
Liver Regeneration ◽  
Portosystemic Shunt ◽  
Control Group ◽  
Minimal Amount ◽  
Remnant Liver ◽  
Ki 67 ◽  
Tissue Sections ◽  
Hepatocyte Regeneration ◽  
Shunt Group ◽  
Left Hemihepatectomy

Objective. The minimal amount of liver mass necessary for regeneration is still a matter of debate. The aim of the study was to analyze liver regeneration factors after extended resection with or without portosystemic shunt. Methods. An extended left hemihepatectomy was performed in 25 domestic pigs, in 15 cases after a portosystemic H-shunt. The expression of Ki-67, VEGF, TGF-, FGF, and CK-7 was analyzed in paraffin-embedded tissue sections. Results. The volume of the remnant liver increased about 2.5-fold at the end of the first week after resection. With 19 cells/10 Glisson fields versus 4/10, Ki-67-expression was significantly higher in the H-shunt group. VEGF- and CK-7-expressions were significantly higher in the control group. No significant change was found in FGF-expression. The expression of TGF- was higher, but not significantly, in the control group. Conclusions. The expression of Ki-67, and therefore hepatocyte regeneration, was increased in the shunt group. The expression of CK-7 on biliary epithelium and the expression of VEGF, however, were stronger in the control group.

Preoperative Alanine Aminotransferase and Remnant Liver Volume Predict Liver Regeneration After Live Donor Hepatectomy

2019 ◽  
Vol 24 (8) ◽  
pp. 1818-1826
Author(s):  
Nihar Mohapatra ◽  
Piyush Kumar Sinha ◽  
Shridhar Vasantrao Sasturkar ◽  
Yashwant Patidar ◽  
Viniyendra Pamecha
Keyword(s):  
Liver Regeneration ◽  
Alanine Aminotransferase ◽  
Liver Volume ◽  
Remnant Liver ◽  
Live Donor ◽  
Donor Hepatectomy ◽  
Remnant Liver Volume

scholarly journals Preoperative Chemotherapy on Functional Liver Regeneration for Colorectal Liver Metastases Assessed With 99mTc-GSA SPECT/CT Imaging

2018 ◽  
Vol 102 (9-10) ◽  
pp. 431-439 ◽  
Author(s):  
Toru Beppu ◽  
Hiromitsu Hayashi ◽  
Morikatsu Yoshida ◽  
Hidetoshi Nitta ◽  
Katsunori Imai ◽  
...  
Keyword(s):  
Liver Resection ◽  
Liver Metastases ◽  
Liver Regeneration ◽  
Preoperative Chemotherapy ◽  
Colorectal Liver Metastases ◽  
Major Hepatectomy ◽  
Liver Volume ◽  
Control Group ◽  
Remnant Liver ◽  
Resection Rate

Objective: To investigate the functional liver regeneration after chemotherapy and liver resection for colorectal liver metastases (CRLM). Background/Purpose: Preoperative chemotherapy followed by liver resection for CRLM has been increasing; however, its negative impact on liver regeneration remains unknown. Methods: From January 2009 to December 2013, we enrolled 40 selected patients who underwent major hepatectomy without viral hepatitis and severe liver fibrosis. CRLM patients with preoperative chemotherapy (CT-CRLM group, n = 12) and patients without preoperative chemotherapy (control group, n = 28) were evaluated. Liver volume (LV) and functional liver volume (FLV) was assessed using Tc-99m–labeled galactosyl human serum albumin (99mTc-GSA) scintigraphy, single-photon emission computed tomography (SPECT), CT-fused images. Preoperative, future remnant liver, and post 1-month values were compared. Results: Median course of preoperative chemotherapy was 8 (range: 6–16). Preoperative background factors were almost identical including resection rate and functional resection rate. In the CT-CRLM group and in the control group, the percentage increases in LV were 39.3% ± 29.0% and 23.2% ± 23.5% (P = 0.037), and FLV were 79.4% ± 43.1% and 57.0% ± 33.4% (P = 0.417), respectively; absolute differences in LV were 216.2 ± 155.7 cm3 and 148.7 ± 134.7 cm3 (P = 0.086) and FLV were 19.4% ± 8.5%/m2 and 17.4% ± 7.9%/m2 (P = 0.235), respectively. We found no obvious tendency for negative influence on liver functional regeneration by the preoperative regimens for CRLM. Conclusions: Several courses of preoperative chemotherapy may not affect functional liver regeneration for CRLM patients after major hepatectomy.

scholarly journals A Protective Effect of Sivelestat From Ischemia/Reperfusion Injury in a Porcine Hepatectomy Model

2018 ◽  
Vol 103 (3-4) ◽  
pp. 191-198 ◽  
Author(s):  
Mitsugi Shimoda ◽  
Yoshimi Iwasaki ◽  
Shuji Suzuki
Keyword(s):  
Liver Regeneration ◽  
Ischemia Reperfusion Injury ◽  
Ischemia Reperfusion ◽  
Liver Volume ◽  
Therapeutic Drug ◽  
Control Group ◽  
Tunel Staining ◽  
Remnant Liver ◽  
Elastase Inhibitor ◽  
Sivelestat Sodium Hydrate

Summary of background data: Sivelestat sodium hydrate (Sive), a neutrophil elastase inhibitor, has been approved as a worldwide therapeutic drug for acute lung injury associated with systemic inflammatory response syndrome. Yet how Sive influences hepatic ischemic reperfusion (I/R) injury and liver regeneration has not been clarified. Objective: We investigated the effect of Sive against hepatic I/R injury and liver regeneration using porcine hepatectomy model, and found that Sive contributes significantly in increasing the liver volume. Methods: We induced 1-hour ischemia by occluding the vessels and the bile duct of the right and median lobes. About 40% left hepatectomy was performed after reperfusion. A total of 6 animals received Sive (10 mg/kg/h) intravenously and 6 control animals received physiologic saline (10 mg/kg/h) from commencement of laparotomy. Remnant liver volume, hemodynamics, and liver function test were compared between the groups. Expressions of TRL4 mRNA in hepatic tissues were examined using RT-PCR. Apoptosis and cell proliferation were demonstrated by TUNEL staining. Results: AST, LDH, and LA levels at 5 minutes after reperfusion were significantly lower in Sive group than in the control group. Sive significantly increased the liver volume, yet did not have any effect for liver regeneration. Conclusion: Sive is considered to reduce hepatic injury in the early phase of I/R injury.

Triggered Liver Regeneration: From Experimental Model to Clinical Implications

2015 ◽  
Vol 54 (3-4) ◽  
pp. 148-161 ◽  
Author(s):  
Attila Szijártó ◽  
András Fülöp
Keyword(s):  
Liver Resection ◽  
Surgical Technique ◽  
Liver Regeneration ◽  
Molecular Mechanisms ◽  
Liver Tumors ◽  
Therapeutic Option ◽  
Liver Volume ◽  
Postoperative Liver Failure ◽  
Remnant Liver ◽  
Comprehensive Overview

Background: Major liver resection is the only therapeutic option for patients with malignant liver tumors. However, extended hepatectomy often leads to postoperative liver failure, mainly due to insufficient amounts of the remnant liver. Recently, selective portal vein occlusion (PVO) has been introduced to increase the remnant liver volume. This novel surgical technique initiated a progressive development in liver surgery, resulting in a significant increment in potential candidates for curative liver resection. Summary: The theoretical basis for this great advancement is formed by an understanding of the mechanisms of PVO-induced liver regeneration, mainly obtained from animal studies. The aim of this review is to give a comprehensive overview of the relevant animal models of PVO and to discuss the main characteristics of triggered liver regeneration, including the induced hemodynamic, morphological and functional alterations as well as the underlying molecular mechanisms, which might be of interest in both the laboratory and the clinic. Key Messages: Although basic research revealed the main characteristics of PVO-triggered liver regeneration within the last decades, several important issues regarding the regenerative process remain uncertain. To answer these open questions, additional well-designed animal experiments are needed in the future, which allow further refinement of this surgical technique.

Liver regeneration after hemihepatectomy in patients with hepatocellular carcinoma.

2018 ◽  
Vol 36 (4_suppl) ◽  
pp. 339-339
Author(s):  
Wen-Feng Gong ◽  
Jian-Hong Zhong ◽  
Liang Ma ◽  
Bang-De Xiang ◽  
Le-Qun Li
Keyword(s):  
Hepatocellular Carcinoma ◽  
Liver Cirrhosis ◽  
Liver Function ◽  
Liver Failure ◽  
Liver Regeneration ◽  
Liver Volume ◽  
Remnant Liver ◽  
Clinical Factors ◽  
Liver Remnant ◽  
Factors Associated

339 Background: We explored clinical factors associated with extent of liver regeneration after hemihepatectomy to treat hepatocellular carcinoma (HCC), as well as how the extent of regeneration influences postoperative recovery of liver function. Methods: In this prospective study of 125 patients who underwent hemihepatectomy, future liver remnant volume (as a percentage of functional liver volume, %FLRV) and remnant liver volume were measured preoperatively and at 1, 5, 9 and 13 weeks postoperatively. Logistic regression was used to identify clinical factors associated with liver regeneration. Influence of liver regeneration on postoperative liver function was evaluated. Results: After hepatectomy, 1 of 125 patients (0.8%) died within 3 months, 13 (10.4%) experienced liver failure and 99 (79.2%) experienced complications. %FLRV was able to predict liver failure with an area under the receiver operating characteristic curve of 0.900, and a cut-off value of 42.7% showed sensitivity of 85.7% and specificity of 88.6%. Postoperative median growth ratio was 21.3% at 1 week, 30.9% at 5 weeks, 34.6% at 9 weeks and 37.1% at 13 weeks. Multivariate analysis identified three predictors associated with liver regeneration: FLRV < 601 cm3 (OR 0.230, 95%CI 0.074-0.717), %FLRV (OR 0.271, 95%CI 0.077-0.960) and liver cirrhosis (OR 7.740, 95%CI 2.748-21.798). At postoperative weeks 1 and 5, liver function indicators were significantly better among patients showing high extent of regeneration than among those showing low extent, but these differences disappeared by postoperative week 9. Conclusions: FLRV, %FLRV and liver cirrhosis strongly influence extent of liver regeneration after hepatectomy. %FLRV values below 42.7% are associated with greater risk of post-hepatectomy liver failure.

scholarly journals Evaluation of liver regeneration and post-hepatectomy liver failure after hemihepatectomy in patients with hepatocellular carcinoma

2019 ◽  
Vol 39 (8) ◽  
Author(s):  
Wen-Feng Gong ◽  
Jian-Hong Zhong ◽  
Zhan Lu ◽  
Qiu-Ming Zhang ◽  
Zhi-Yuan Zhang ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Liver Cirrhosis ◽  
Liver Failure ◽  
Liver Regeneration ◽  
Characteristic Curve ◽  
Liver Volume ◽  
Future Liver Remnant ◽  
Remnant Liver ◽  
Liver Remnant ◽  
Growth Ratio

Abstract Aim: To explore clinical factors associated with extent of liver regeneration after hemihepatectomy to treat hepatocellular carcinoma (HCC). Methods: Future liver remnant volume (as a percentage of functional liver volume, %FLRV) and remnant liver volume were measured preoperatively and at 1, 5, 9, and 13 weeks postoperatively. Results: After hepatectomy, 1 of 125 patients (0.8%) died within 3 months, 13 (10.4%) experienced liver failure, and 99 (79.2%) experienced complications. %FLRV was able to predict liver failure with an area under the receiver operating characteristic curve of 0.900, and a cut-off value of 42.7% showed sensitivity of 85.7% and specificity of 88.6%. Postoperative median growth ratio was 21.3% at 1 week, 30.9% at 5 weeks, 34.6% at 9 weeks, and 37.1% at 13 weeks. Multivariate analysis identified three predictors associated with liver regeneration: FLRV < 601 cm3, %FLRV, and liver cirrhosis. At postoperative weeks (POWs) 1 and 5, liver function indicators were significantly better among patients showing high extent of regeneration than among those showing low extent, but these differences disappeared by POW 9. Conclusions: FLRV, %FLRV, and liver cirrhosis strongly influence extent of liver regeneration after hepatectomy. %FLRV values below 42.7% are associated with greater risk of post-hepatectomy liver failure.

Tandem isonitrile insertion/azacyclopropylidene-annulated cyclohexenone–tropone rearrangement of p-QMs and TosMIC: de novo synthesis of pyrrolotropones with anti-cancer activity

2021 ◽  
Author(s):  
Chuan-Hua Qu ◽  
Gui-Ting Song ◽  
Jiu-Hong Huang ◽  
Run Huang ◽  
Yuan Chen ◽  
...  
Keyword(s):  
Biological Activity ◽  
De Novo ◽  
Ring Expansion ◽  
De Novo Synthesis ◽  
Anti Cancer ◽  
Cancer Activity

TosMIC causes ring expansion of p-QMs: highly substituted pyrrolotropones are rapidly assembled in a domino process mediated by DBU. The utility of the method was highlighted by follow-up transformation and biological activity identification.

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