Portal venous velocity affects liver regeneration after right lobe living donor hepatectomy

Hou, Chen-Tai; Chen, Yao‐Li; Lin, Chia-Cheng; Chou, Chen‐Te; Lin, Kuo‐Hua; Lin, Ping‐Yi; Hsu, Ya-Lan; Chen, Chia‐Bang; Lin, Hui-Chuan; Ko, Chih‐Jan; Wang, Suhan; Weng, Li‐Chueh; Hsieh, Ching‐Chuan

doi:10.1371/journal.pone.0204163

Cited by 8 publications

(6 citation statements)

References 28 publications

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“…Therefore, portal blood flow is among the most crucial factors needed to launch the liver regeneration process. 45 After PH, hemodynamic changes in the portal vein (not affecting hepatic arteries) elevate the portal contribution per unit of liver tissue. The increased portal contribution increases the availability of growth factors and cytokines from the intestine and pancreas.…”

Section: Role Of Insulin In Liver Regeneration After Inhibiting Portal Blood Flowmentioning

confidence: 99%

Hormonal Contribution to Liver Regeneration

Rmilah

Zhou

Nyberg

2020

Mayo Clinic Proceedings: Innovations, Quality & Outcomes

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An understanding of the molecular basis of liver regeneration will open new horizons for the development of novel therapies for chronic liver failure. Such therapies would solve the drawbacks associated with liver transplant, including the shortage of donor organs, long waitlist time, high medical costs, and lifelong use of immunosuppressive agents. Regeneration after partial hepatectomy has been studied in animal models, particularly fumarylacetoacetate hydrolaseedeficient (FAH À/À ) mice and pigs. The process of regeneration is distinctive, complex, and well coordinated, and it depends on the interplay among several signaling pathways (eg, nuclear factor kb, Notch, Hippo), cytokines (eg, tumor necrosis factor a, interleukin 6), and growth factors (eg, hepatocyte growth factor, epidermal growth factor, vascular endothelial growth factor), and other components. Furthermore, endocrinal hormones (eg, norepinephrine, growth hormone, insulin, thyroid hormones) also can influence the aforementioned pathways and factors. We believe that these endocrinal hormones are important hepatic mitogens that strongly induce and accelerate hepatocyte proliferation (regeneration) by directly and indirectly triggering the activity of the involved signaling pathways, cytokines, growth factors, and transcription factors. The subsequent induction of cyclins and associated cyclin-dependent kinase complexes allow hepatocytes to enter the cell cycle. In this review article, we comprehensively summarize the current knowledge regarding the roles and mechanisms of these hormones in liver regeneration. Articles used for this review were identified by searching MEDLINE and EMBASE databases from inception through June 1, 2019.

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Section: Role Of Insulin In Liver Regeneration After Inhibiting Portal Blood Flowmentioning

confidence: 99%

Hormonal Contribution to Liver Regeneration

Rmilah

Zhou

Nyberg

2020

Mayo Clinic Proceedings: Innovations, Quality & Outcomes

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“…Several studies have been conducted to identify factors that may influence liver regeneration after donor hepatectomy [8,9,13]. The incidence of postoperative major complications after liver donation in older donors was significantly higher than that of younger donors [3].…”

Section: Discussionmentioning

confidence: 99%

“…However, the rate of liver regeneration varies from individual to individual, even with similar types of resections considered for each living donor. Older age, male sex, high body mass index (BMI), preoperative alanine aminotransferase (ALT), and the presence of moderate or severe steatosis, have been reported to have a significant negative impact on postoperative liver regeneration in previous studies [8,9]. Therefore, it would be very important to identify the clinical factors related to liver regeneration, especially in living donors with a RTVR < 30%, to prevent postoperative liver insufficiency causing catastrophic events.…”

Section: Introductionmentioning

confidence: 99%

Clinical Factors Affecting the Rate of Liver Regeneration in Living Donors after Right Hepatectomy

Kim,

Suh,

Lee

et al. 2024

JPM

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Sufficient liver regeneration after a right hepatectomy is important in living donors for preventing postoperative hepatic insufficiency; however, it differs for each living donor so we investigated the clinical factors affecting the rate of liver regeneration after hepatic resection. This retrospective case–control study investigated fifty-four living donors who underwent a right hepatectomy from July 2015 to March 2023. Patients were classified into 2 groups by the remnant/total volume ratio (RTVR): Group A (RTVR < 30%, n = 9) and Group B (RTVR ≥ 30%, n = 45). The peak postoperative level of total bilirubin was more elevated in Group A than in Group B (3.0 ± 1.1 mg/dL vs. 2.3 ± 0.8 mg/dL, p = 0.046); however, no patients had hepatic insufficiency or major complications. The rates of residual liver volume (RLV) growth at Postoperative Week 1 (89.1 ± 26.2% vs. 53.5 ± 23.7%, p < 0.001) were significantly greater in Group A, and its significant predictors were RTVR (β = −0.478, p < 0.001, variance inflation factor (VIF) = 1.188) and intraoperative blood loss (β = 0.247, p = 0.038, VIF = 1.182). In conclusion, as the RLV decreases, compensatory liver regeneration after hepatic resection becomes more prominent, resulting in comparable operative outcomes. Further studies are required to investigate the relationship between hematopoiesis and the rate of liver regeneration.

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“…In the treatment of patients after major liver resection, branched-chain amino acids with parenteral nutrition promotes hepatocyte proliferation and improves liver regeneration and function [12][13][14]. In living donor after hepatectomy studies, significant rapid regeneration was observed in small-RLV groups, in males, and in younger patients [6][7][8]15]. However, there was no significant difference in regeneration when comparing mild steatosis and no steatosis groups and when comparing right-lobe hepatectomy and left-lobe hepatectomy groups [6,10].…”

Section: Discussionmentioning

confidence: 99%

Clinical Outcome of Residual Liver Volume and Hepatic Steatosis After Right-Lobe Living-Donor Hepatectomy

et al. 2020

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Departmental sources Background:We examine how residual liver volume (RLV) and hepatic steatosis (HS) of living liver donors affect the regeneration process and clinical outcomes. Material/Methods:We longitudinally studied 58 donors who underwent right-lobe hepatectomy during the period February 2014 to February 2015 at a single medical institution. The patients were classified based on RLV (30-35%, 35-40%, 40-50%) subgroups and HS (<10%, 10-30%, 30-50%) subgroups. Clinical parameters such as clinical outcome, liver volumetric recovery (LVR,%) rate and remnant left-liver (RLL,%) growth rate were collected for analysis. Results:The clinical features of postoperative peak total bilirubin (p=.024) were significant in the 3 RLV subgroups. Body mass index (p=.017), preoperative alanine transaminase (p<.001), and pleural effusion (p=.038) were significant in the 3 HS subgroups. The LVR rate and RLL growth rate equations showed significant variation in regeneration among the 3 RLV subgroups. The LVR rate and RLL growth rate equations did not show significant variation in regeneration among the 3 HS subgroups. Conclusions:Hyperbilirubinemia was a risk factor in the small-RLV group, and a large amount of pleural effusion was a risk factor in the steatosis 30-50% group. Hepatic steatosis subgroups did not show significantly different degrees of regeneration. The safety of living donors was a major concern while we compiled the extended living-donor criteria presented in this paper.

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Portal venous velocity affects liver regeneration after right lobe living donor hepatectomy

Cited by 8 publications

References 28 publications

Hormonal Contribution to Liver Regeneration

Hormonal Contribution to Liver Regeneration

Clinical Factors Affecting the Rate of Liver Regeneration in Living Donors after Right Hepatectomy

Clinical Outcome of Residual Liver Volume and Hepatic Steatosis After Right-Lobe Living-Donor Hepatectomy

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