Intrahepatic Size Regulation in a Surgical Model: Liver Resection-Induced Liver Regeneration Counteracts the Local Atrophy following Simultaneous Portal Vein Ligation

2016 ◽  
Vol 57 (1-2) ◽  
pp. 125-137 ◽  
Author(s):  
Weiwei Wei ◽  
Tianjiao Zhang ◽  
Haoshu Fang ◽  
Olaf Dirsch ◽  
Andrea Schenk ◽  
...  
Keyword(s):  
Liver Regeneration ◽  
Liver Weight ◽  
Caudate Lobe ◽  
Hepatocyte Proliferation ◽  
Portal Vein Ligation ◽  
Portal Flow ◽  
Liver Lobe ◽  
Size Regulation ◽  
Right Lobe ◽  
The Right

Background/Aim: Liver size regulation is based on the balance between hepatic regeneration and atrophy. To achieve a better understanding of intrahepatic size regulation, we explored the size regulation of a portally deprived liver lobe on a liver subjected to concurrent portal vein ligation (PVL) and partial hepatectomy (PHx). Materials and Methods: Using a surgical rat model consisting of right PVL (rPVL) plus 70% PHx, we evaluated the size regulation of liver lobes 1, 2, 3, and 7 days after the operation in terms of liver weight and hepatocyte proliferation. Portal hyperperfusion was confirmed by measuring portal flow. The portal vascular tree was visualized by injection of a contrast agent followed by CT imaging of explanted livers. Control groups consisted of 70% PHx, rPVL, and sham operation. Results: The size of the ligated right lobe increased to 1.4-fold on postoperative day 7 when subjected to rPVL + 70% PHx. The right lobe increased to 3-fold when subjected to 70% PHx alone and decreased to 0.3-fold when subjected to rPVL only. The small but significant increase in liver weight after the combined procedure was accompanied by a low proliferative response. In contrast, hepatocyte proliferation was undetectable in the right lobe undergoing atrophy after PVL only. The caudate lobe in the rPVL + 70% PHx group increased to 4.6-fold, which is significantly more than in the other groups. This increase in liver weight was paralleled by persisting portal hyperperfusion and a prolonged proliferative phase of 3 days. Conclusions: A discontinued portal blood supply does not always result in atrophy of the ligated lobe. The concurrent regenerative stimulus induced by 70% PHx seemed to counteract the local atrophy after a simultaneously performed rPVL, leading to a low but prolonged regenerative response of the portally deprived liver lobe. This observation supports the conclusion that portal flow is not necessary for liver regeneration. The persisting portal hyperperfusion may be crucial for the specific kinetics of prolonged liver regeneration after rPVL + 70% PHx in the portally supplied caudate lobe. Both observations deserve more attention regarding the underlying mechanism in further studies.

scholarly journals The center of the human porta hepatis

Medicina ◽  
2008 ◽  
Vol 44 (9) ◽  
pp. 694
Author(s):  
Saulius Rutkauskas ◽  
Vytautas Gedrimas ◽  
Tomas Čičinskas ◽  
Aurimas Savulis ◽  
Algidas Basevičius
Keyword(s):  
Vena Cava ◽  
Caudate Lobe ◽  
Left Lobe ◽  
Porta Hepatis ◽  
Liver Lobe ◽  
Anatomical Structures ◽  
Liver Surface ◽  
Right Lobe ◽  
Human Livers ◽  
The Right

Majority of interventional procedures are made at the porta hepatis, which has a different location on the visceral surface of the liver. Objective. To describe the location of the porta hepatis in respect of the borders of the visceral surface and separate lobes of the liver. Material and methods. Sixty-four human livers were obtained at autopsy (mean age, 45 years). We chose the point of the crossing of longitudinal and transversal lines of the porta hepatis, which was considered as center of the porta hepatis. The distances from the center of the porta hepatis to the border of the visceral surface every 10 degrees with protractor and ruler and the angles of anatomical structures were measured. Additionally, the borders of lobes were assessed. Results. We found that center of the porta hepatis is located approximately 11.6±2.8 cm from the border of the visceral liver surface. The location of center of the porta hepatis was 11.6±1.1 cm from the border of left lobe, 9.7±1.5 cm from the border of quadrate lobe, 12.3±1.2 cm from the border of right lobe, and 7.4±1.0 cm from the border of caudate lobe. All distances were statistically significant (P<0.05). An angle of the fissure for round ligament was 50.5°, of the fossa of gallbladder – 102°, of the groove of vena cava inferior – 266°, and of the fissure for ligamentum venosum – 293°. The borders of the right, left, quadrate, and caudate liver lobe covered 45.6%, 32.6%, 14.3%, and 7.5% of the perimeter of visceral surface border, respectively. Conclusions. The center of the porta hepatis can help to characterize precisely the position of the porta hepatis on the visceral surface of the liver.

scholarly journals Morphometric Liver Study in Adults

2021 ◽  
Vol 9 (3.2) ◽  
pp. 8054-8058
Author(s):  
Seye C ◽  
◽  
Ndoye JM ◽  
Wade R ◽  
Mar NB ◽  
...  
Keyword(s):  
Sickle Cell ◽  
Liver Weight ◽  
Left Lobe ◽  
Transverse Diameter ◽  
Key Words Liver ◽  
Adult Liver ◽  
Right Lobe ◽  
Post Traumatic ◽  
The Subject ◽  
The Right

Background: The aim is to study the dimensions of the adult liver in Senegal in order to contribute to the data of the manufacture of a peri-hepatic prosthesis wrapping in the therapeutic means of post-traumatic hemorrhagic lesions of the liver. Materials and methods: This study involved 50 livers of anatomical subjects with an average age of 38 years. We have noted some biometric parameters. On the livers collected, we measured the weight and some dimensions. Results: The intermediate morphotype predomined with 48% of cases. The dorso-petal position of the liver was observed in 84% of the subjects. There was no correlation between the morphotype of the subjects and the orientation of the visceral face of the liver. The average liver weight was 1410 g. The average transverse diameter was 25.77cm while the antero-posterior diameter of the right lobe was 16 cm. The sagittal circumference of the liver in the sickle cell ligament was significantly lower than those measured at the right and left lobes. The sagittal circumferences of the liver in the Breviligneous subject were lower than those of the intermediate and long morphotype subjects. Conclusion: The choke zone between the two lobes of the liver in the sickle cell ligament is a mooring point for the peri-hepatic wrapping prosthesis. However, this can only be segmental for each right and left lobe. The morphotype of the subject, however, affects the weight, thickness and sagittal circumferences of the liver, which are essential for the dimensions of a peri-hepatic prosthesis. KEY WORDS: Liver morphometric, peri-hepatic prosthesis.

Ultrasonographic examination of liver and spleen of normal adult spiti horses and Himalayan Hill mules of India

2017 ◽  
Author(s):  
Uiase Bin Farooq ◽  
Adarsh Kumar ◽  
Rajni Chaudhary
Keyword(s):  
Blood Vessels ◽  
Abdominal Cavity ◽  
Left Lobe ◽  
Dynamic Parameters ◽  
Liver Lobe ◽  
Abdominal Ultrasonography ◽  
Ultrasonographic Examination ◽  
Splenic Parenchyma ◽  
Right Lobe ◽  
The Right

The main objective of this study was to develop baseline topographical data of landmarks for locating liver and spleen and to generate sonographic calliper measurements along with dynamic parameters of these organs. Abdominal ultrasonography was performed on 50 native adult (Spiti horses and Himalayan hill mules) healthy unsedated equines of either sex. The thickness, character and echo-architecture of liver and spleen were recorded. In horses, the right lobe of liver was found from 8th to 15th intercostal space (ICS) and left lobe from 6th to 11th (±1) ICS, while in mules the right liver lobe was found between 6th to 15th (±1) ICS and left lobe between 6th to 9th (±1) ICS. The liver was recognized by its branching vasculature and architecture was found relatively homogenous. In addition ventral edges were distinctly sharp. Spleen was found from 8th to 17th ICS both in horses as well as in mules. The splenic parenchyma was homogenously granular in appearance with few blood vessels and most echogenic organ in the abdominal cavity of equines. The only measurement that was reliably obtained was the central thickness or depth of the spleen, which varied from 41.4 to 68.4 mm (Mean± SE= 50.84±4.61 mm) in horses and 37.9 to 51.6 mm (Mean± SE = 42.76±2.34 mm) in mules. Therefore detailed ultrasonographic examination of liver and spleen helped us to compile baseline data, which will be helpful in management of the affections of liver and spleen in future.

Liver Regeneration and Venous Collateral Formation in the Right Lobe Living-Donor Remnant

2013 ◽  
Vol 95 (2) ◽  
pp. 353-360 ◽  
Author(s):  
Hiroto Kayashima ◽  
Ken Shirabe ◽  
Kazutoyo Morita ◽  
Naotaka Hashimoto ◽  
Toru Ikegami ◽  
...  
Keyword(s):  
Liver Regeneration ◽  
Living Donor ◽  
Right Lobe ◽  
The Right ◽  
Collateral Formation

scholarly journals Case Report: Robotic ALPPS Procedure for Hepatocellular Carcinoma in the Right Lobe of the Liver

2021 ◽  
Vol 8 ◽  
Author(s):  
Evgeny Solomonov ◽  
Itamar Tzadok ◽  
Salomon Stemmer ◽  
Seema Biswas
Keyword(s):  
Hepatocellular Carcinoma ◽  
Operative Procedure ◽  
Portal Vein Ligation ◽  
Liver Malignancy ◽  
Liver Remnant ◽  
First Case ◽  
Right Lobe ◽  
Surgical Recovery ◽  
The Right ◽  
Macrovesicular Steatosis

Introduction: Associating liver partition with portal vein ligation for staged hepatectomy (ALPPS) is a surgical procedure for liver malignancy where the volume of the liver remnant is estimated to be too small. We present the first case of two-stage robotic ALPPS procedure, illustrating the steps and advantages of robotic surgery.Materials and Methods: A 68-year-old man with morbid obesity (BMI 40), portal fibrosis, macrovesicular steatosis, and poor liver function underwent robotic ALPPS for hepatocellular carcinoma in the right lobe of the liver (segments 5, 7, and 8). A video presentation (https://youtu.be/M50Gumf-4pw) of the operative procedure is accompanied by explanation in the text with embedded corresponding video time points.Results: Both stages of the procedure were performed robotically, with negligible blood loss, and rapid surgical recovery. The patient died 3 years later.Discussion: Robotic ALPPS offers reduced morbidity in major liver surgery for malignancy and may extend survival in meticulously selected patients.

scholarly journals Vascular reconstruction and outcomes of 220 adult-to-adult right lobe living donor liver transplantations

2018 ◽  
Vol 46 (6) ◽  
pp. 598-608 ◽  
Author(s):  
S. E. Voskanyan ◽  
A. I. Artemyev ◽  
A. I. Sushkov ◽  
I. Yu. Kolyshev ◽  
V. S. Rudakov ◽  
...  
Keyword(s):  
Liver Transplantation ◽  
Postoperative Complications ◽  
Portal Vein ◽  
Living Donor ◽  
Vascular Reconstruction ◽  
Donor Liver ◽  
Liver Lobe ◽  
Liver Transplantations ◽  
Right Lobe ◽  
The Right

Rationale: Adult-to-adult right lobe living donor liver transplantation is a  viable alternative to whole liver transplantation from a  deceased donor. The key aspect of the surgical procedure is the restoration of adequate graft blood flow and maintenance of sufficient volume of well vascularized parenchyma in the donor. Specific features of vascular anatomy in the donor and the recipient can be eventual cause for significant technical difficulties during transplantation. They can also increase the risk of complications and deteriorate graft functioning.Aim: To identify the incidence of various types of afferent and efferent vascularization of right lobe of the liver, potential techniques of vascular reconstructive procedures, rates and types of postoperative complications, as well as immediate surgical results.Materials and methods: We retrospectively analyzed the data on 220 right lobe liver transplantations adult patients, consecutively performed from 2010 to 2017 in one center. Specific characteristics of liver vascularization in donors and recipients were determined by pre-operative computed tomography and intra-operatively. The information on the types of vascular reconstruction, complications and results of surgical procedures was obtained from patients' medical files.Results: The following variants of blood supply to the right liver lobe were seen most frequently: portal vein trifurcation 22%, shortened trunk of the right portal vein branch 13%, supplementary v. hepatica from SgVIII with a diameter of > 5 mm 22%, supplementary lower right v. hepatica 17%, isolated venous outflow from all right lobe segments 2%, two arteries 2%. In addition, 17% of the recipients had portal vein thrombosis and 1% portal vein fibrosis. During the follow-up all donors remained alive. The rate of surgical complications was 12.5%, among them bile pocket or biloma 8.5%, intra-abdominal bleeding 2.5%, wound complications 1.5%. The rate of early post-operative complications in the recipients was 31.5%, with 4.5% of them being vascular and 15.5% biliary. The 6-months and 4-years survival of the recipients (Kaplan-Meier) was 98% and 95%, respectively.Conclusion: Immediate and longterm survival of the recipients of living donor right lobe live grafts, as well as absence of fatalities among their donors, confirm high effectiveness and expedience of this type of intervention. The observed anatomic variety of blood supply to the right liver lobe stipulates stringent requirements to the quality of preoperative diagnostics, deliberate donor selection, thorough planning of the procedure and high qualification of the surgical team. A  relatively high rate of postoperative complications warrants the necessity of an intensive diagnostic monitoring in the early post-operative period and active strategies of their correction.

Loss of NF-κB activation in Kupffer cell-depleted mice impairs liver regeneration after partial hepatectomy

2007 ◽  
Vol 292 (6) ◽  
pp. G1570-G1577 ◽  
Author(s):  
Kerstin Abshagen ◽  
Christian Eipel ◽  
Jörg C. Kalff ◽  
Michael D. Menger ◽  
Brigitte Vollmar
Keyword(s):  
Liver Regeneration ◽  
Liver Weight ◽  
Cyclin B1 ◽  
Binding Activity ◽  
Hepatocyte Proliferation ◽  
Cell Nuclei ◽  
Dna Binding Activity ◽  
Liver Sinusoids ◽  
Tnf Α

Kupffer cells (KCs) are located in the liver sinusoids adjacent to hepatocytes and are capable of producing important growth-regulating mediators that exert both stimulatory and inhibitory influences on hepatocyte proliferation by paracrine mechanisms. To elucidate the overall effect of KC depletion on liver regeneration, mice were selectively and long-standing depleted of KCs by liposome-encapsulated dichloromethylene diphosphonate. Using in vivo fluorescence microscopy, immunohistochemistry, Western blot analysis, and NF-κB transcription factor DNA binding activity and cytokine assays, we analyzed livers of KC-depleted and KC-competent mice at days 3, 5, and 8 after partial (i.e., 68%) hepatectomy (PH). Selective KC elimination delayed cell proliferation, as indicated by significantly reduced PCNA and cyclin B1 protein expression in liver tissue at day 3 after PH. This was associated with a lower liver weight at day 8 upon PH. Resection-associated activation of NF-κB with translocation into parenchymal and nonparenchymal cell nuclei was diminished in livers of KC-depleted mice, primarily at day 3 after PH. KC-depleted mice further lacked the resection-induced rise in TNF-α and IL-6 serum concentrations. These findings imply that KCs play a stimulatory role in liver regeneration, mainly by activating NF-κB with influence on the cell cycle and by enhancing expression of the proliferative cytokines TNF-α and IL-6.

scholarly journals Regulation of liver regeneration and hepatocarcinogenesis by suppressor of cytokine signaling 3

2007 ◽  
Vol 205 (1) ◽  
pp. 91-103 ◽  
Author(s):  
Kimberly J. Riehle ◽  
Jean S. Campbell ◽  
Ryan S. McMahan ◽  
Melissa M. Johnson ◽  
Richard P. Beyer ◽  
...  
Keyword(s):  
Liver Regeneration ◽  
Liver Weight ◽  
Cell Types ◽  
Hepatocyte Proliferation ◽  
Cytokine Signaling ◽  
Suppressor Of Cytokine Signaling ◽  
Cytokine Activation ◽  
Stat3 Phosphorylation ◽  
Multiple Cell

Suppressor of cytokine signaling 3 (SOCS3) down-regulates several signaling pathways in multiple cell types, and previous data suggest that SOCS3 may shut off cytokine activation at the early stages of liver regeneration (Campbell, J.S., L. Prichard, F. Schaper, J. Schmitz, A. Stephenson-Famy, M.E. Rosenfeld, G.M. Argast, P.C. Heinrich, and N. Fausto. 2001.J. Clin. Invest. 107:1285–1292). We developed Socs3 hepatocyte-specific knockout (Socs3 h-KO) mice to directly study the role of SOCS3 during liver regeneration after a two-thirds partial hepatectomy (PH). Socs3 h-KO mice demonstrate marked enhancement of DNA replication and liver weight restoration after PH in comparison with littermate controls. Without SOCS3, signal transducer and activator of transcription 3 (STAT3) phosphorylation is prolonged, and activation of the mitogenic extracellular signal-regulated kinase 1/2 (ERK1/2) is enhanced after PH. In vitro, we show that SOCS3 deficiency enhances hepatocyte proliferation in association with enhanced STAT3 and ERK activation after epidermal growth factor or interleukin 6 stimulation. Microarray analyses show that SOCS3 modulates a distinct set of genes, which fall into diverse physiological categories, after PH. Using a model of chemical-induced carcinogenesis, we found that Socs3 h-KO mice develop hepatocellular carcinoma at an accelerated rate. By acting on cytokines and multiple proliferative pathways, SOCS3 modulates both physiological and neoplastic proliferative processes in the liver and may act as a tumor suppressor.

scholarly journals Unaltered Liver Regeneration in Post-Cholestatic Rats Treated with the FXR Agonist Obeticholic Acid

Biomolecules ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. 260
Author(s):  
Lianne R. de Haan ◽  
Joanne Verheij ◽  
Rowan F. van Golen ◽  
Verena Horneffer-van der Sluis ◽  
Matthew R. Lewis ◽  
...  
Keyword(s):  
Liver Regeneration ◽  
Bile Flow ◽  
Liver Weight ◽  
Farnesoid X Receptor ◽  
Hepatocyte Proliferation ◽  
Obeticholic Acid ◽  
Liver Growth ◽  
Beneficial Effects ◽  
Duct Ligation ◽  
Human Validation

In a previous study, obeticholic acid (OCA) increased liver growth before partial hepatectomy (PHx) in rats through the bile acid receptor farnesoid X-receptor (FXR). In that model, OCA was administered during obstructive cholestasis. However, patients normally undergo PHx several days after biliary drainage. The effects of OCA on liver regeneration were therefore studied in post-cholestatic Wistar rats. Rats underwent sham surgery or reversible bile duct ligation (rBDL), which was relieved after 7 days. PHx was performed one day after restoration of bile flow. Rats received 10 mg/kg OCA per day or were fed vehicle from restoration of bile flow until sacrifice 5 days after PHx. Liver regeneration was comparable between cholestatic and non-cholestatic livers in PHx-subjected rats, which paralleled liver regeneration a human validation cohort. OCA treatment induced ileal Fgf15 mRNA expression but did not enhance post-PHx hepatocyte proliferation through FXR/SHP signaling. OCA treatment neither increased mitosis rates nor recovery of liver weight after PHx but accelerated liver regrowth in rats that had not been subjected to rBDL. OCA did not increase biliary injury. Conclusively, OCA does not induce liver regeneration in post-cholestatic rats and does not exacerbate biliary damage that results from cholestasis. This study challenges the previously reported beneficial effects of OCA in liver regeneration in cholestatic rats.

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