scholarly journals Towards the Study of Liver Failure: Protocol for a 90% Extended Hepatectomy in Mice

2021 ◽  
Author(s):  
Maria J. Lizardo Thiebaud ◽  
Eduardo Cervantes-Alvarez ◽  
Nalu Navarro-Alvarez
Keyword(s):  
Cell Cycle ◽  
Liver Failure ◽  
Liver Regeneration ◽  
Liver Dysfunction ◽  
Surgical Procedure ◽  
Molecular Level ◽  
Liver Volume ◽  
Extended Hepatectomy

Studies have shown that extended hepatectomy mimics post-hepatectomy liver failure (PHLF) and could also be used to study other small-for-flow syndromes. Extended hepatectomy can be defined as the removal of more than 70% of liver volume. At the molecular level, there seems to be a delayed entrance to the cell cycle, and thus liver dysfunction ensues. Therefore, there is an imperious need to study the mechanisms of such delay to understand how it can be regulated. While the classical 70% hepatectomy model to study liver regeneration has been previously described thoroughly, there are no protocols describing the surgical procedure for a 90% extended hepatectomy (90% EHx). Therefore, we here describe a detailed and reproducible protocol for such model, defining specific aspects that must be considered as well as the most common complications and troubleshooting strategies.

Relationship between platelet count and hepatic failure and residual liver regeneration after hemihepatectomy in patients with hepatitis B-related primary hepatocellular carcinoma

2019 ◽  
Author(s):  
Chuhui Ye ◽  
Banghao Xu ◽  
Kaiyi Lu ◽  
Tingting Lu ◽  
Ling Zhang ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Liver Resection ◽  
Hepatitis B ◽  
Liver Failure ◽  
Liver Regeneration ◽  
Liver Volume ◽  
Primary Hepatocellular Carcinoma ◽  
Postoperative Liver Failure ◽  
Regeneration Rate ◽  
Significant Difference

Abstract Objective A retrospective analysis of the influences of platelet (PLT) counts on liver failure and liver regeneration in patients with primary hepatocellular carcinoma (HCC) provides a treatment strategy for clinical prevention and treatment of postoperative liver failure and residual liver regeneration. Method The clinical data of 111 patients with a background of hepatitis B virus infection and who underwent (expanded) half liver resection at the First Affiliated Hospital of Guangxi Medical University from June 2012 to June 2017 were collected and statistically analyzed. Results　On the basis of the International Study Group of Liver Surgery liver failure-grading standards and Dino–Clavien postoperative complication criteria, the incidence of grade B and above liver failure was 55%, and complication II level and above was 47.5% in the PLT decline group after semihepatectomy. The incidence rates in the normal group were 26.8% and 23.9%. A statistically significant difference was determined in the two groups (P1=0.003, P2 = 0.011). The average volumes of liver hyperplasia (residual liver volume (RLV)80.4 days − RLV) in the PLT decline and normal groups were 132.09 ± 61.89 cm3 and 190.89 ± 91.98c cm3, respectively; the average rates of hyperplasia ((RLV80.4days−RLV)/RLV) were 16.59%± 7.36% and 24.78% ± 10.82%. The difference between the two groups was statistically significant (PProliferation = 0.001, PProliferation rate = 0.001). Univariable and multivariable logistic regression analyses of postoperative liver failure grade and proliferation rate in patients who underwent semihepatectomy suggested that the decrease in postoperative PLT count (PLT < 125 × 109/L) might be an independent risk factor of severe posthepatectomy liver failure (PHLF) (PHLF-B or above) and residual liver regeneration rate for patients with primary HCC after half liver resection. No death occurred. Conclusions A correlation existed between PLT count and postoperative PHLF or liver regeneration. Monitoring PLT counts after liver resection may help us predict the suffering from PHLF-B or above and severe postoperative complications.

Liver Failure After Extended Hepatectomy in Mice Is Mediated by a p21-Dependent Barrier to Liver Regeneration

2012 ◽  
Vol 143 (6) ◽  
pp. 1609-1619.e4 ◽  
Author(s):  
Kuno Lehmann ◽  
Christoph Tschuor ◽  
Andreas Rickenbacher ◽  
Jae–Hwi Jang ◽  
Christian E. Oberkofler ◽  
...  
Keyword(s):  
Liver Failure ◽  
Liver Regeneration ◽  
Extended Hepatectomy

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 Auxiliary partial orthotopic liver transplantation for acute liver failure

2019 ◽  
Vol 101 (3) ◽  
pp. e71-e72
Author(s):  
M Shrivastav ◽  
A Rammohan ◽  
MS Reddy ◽  
M Rela
Keyword(s):  
Liver Transplantation ◽  
Liver Failure ◽  
Acute Liver Failure ◽  
Liver Regeneration ◽  
Orthotopic Liver Transplantation ◽  
Liver Dysfunction ◽  
Case History ◽  
Free Survival ◽  
Native Liver

Introduction Auxiliary partial orthotopic liver transplantation (APOLT) in acute liver failure acts as a bridge to native liver regeneration with potential for immunosuppression free survival. While technical concerns limit its universal acceptance, the indications in acute liver failure also need to be examined for this procedure to ultimately succeed. Case history We present the case of an eight-month-old girl with cryptogenic acute liver failure who underwent APOLT. She developed postoperative liver dysfunction, most likely owing to the persistence of the diseased native liver, ultimately leading to an orthotopic retransplantation. She remains well on follow-up review. Conclusions A tempered approach to selecting patients for APOLT (especially with regard to aetiology of acute liver failure) makes it a safe and effective alternative to orthotopic liver transplantation.

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.

scholarly journals Mesenchymal Stem Cells Transplantation following Partial Hepatectomy: A New Concept to Promote Liver Regeneration—Systematic Review of the Literature Focused on Experimental Studies in Rodent Models

2017 ◽  
Vol 2017 ◽  
pp. 1-22 ◽  
Author(s):  
Ioannis G. Papanikolaou ◽  
Charalambos Katselis ◽  
Konstantinos Apostolou ◽  
Themistoklis Feretis ◽  
Maria Lymperi ◽  
...  
Keyword(s):  
Systematic Review ◽  
Stem Cells ◽  
Mesenchymal Stem Cells ◽  
Liver Failure ◽  
Liver Regeneration ◽  
Partial Hepatectomy ◽  
Chronic Liver ◽  
Review Of The Literature ◽  
Chronic Liver Injury ◽  
Stem Cells Transplantation

Mesenchymal stem cells (MSCs) are an attractive source for regenerative medicine because they are easily accessible through minimally invasive methods and have the potential to enhance liver regeneration (LG) and improve liver function, following partial hepatectomy (PH) and acute or chronic liver injury. A systematic review of the literature was conducted for articles published up to September 1st, 2016, using the MEDLINE database. The keywords that were used in various combinations were as follows: “Mesenchymal stem cells”, “transplantation”, “stem cells”, “adipose tissue derived stem cells”, “bone marrow-derived stem cells”, “partial hepatectomy”, “acute liver failure”, “chronic liver failure”, “liver fibrosis”, “liver cirrhosis”, “rats”, “mice”, and “liver regeneration”. All introduced keywords were searched for separately in MeSH Database to control relevance and terminological accuracy and validity. A total of 41 articles were identified for potential inclusion and reviewed in detail. After a strict selection process, a total of 28 articles were excluded, leaving 13 articles to form the basis of this systematic review. MSCs transplantation promoted LG and improved liver function. Furthermore, MSCs had the ability to differentiate in hepatocyte-like cells, increase survival, and protect hepatocytes by paracrine mechanisms. MSCs transplantation may provide beneficial effects in the process of LG after PH and acute or chronic liver injury. They may represent a new therapeutic option to treat posthepatectomy acute liver failure.

Assay to detect inhibitors of liver regeneration in acute liver failure

1998 ◽  
Vol 28 ◽  
pp. 63
Author(s):  
C. Anderson ◽  
M.I. Thabrew ◽  
R.D. Hughes
Keyword(s):  
Liver Failure ◽  
Acute Liver Failure ◽  
Liver Regeneration

scholarly journals Complement System as a Target for Therapies to Control Liver Regeneration/Damage in Acute Liver Failure Induced by Viral Hepatitis

2018 ◽  
Vol 2018 ◽  
pp. 1-9 ◽  
Author(s):  
Juliana Gil Melgaço ◽  
Carlos Eduardo Veloso ◽  
Lúcio Filgueiras Pacheco-Moreira ◽  
Claudia Lamarca Vitral ◽  
Marcelo Alves Pinto
Keyword(s):  
Liver Failure ◽  
Acute Liver Failure ◽  
Liver Regeneration ◽  
Viral Hepatitis ◽  
Complement System ◽  
Immune Cell ◽  
Ex Vivo ◽  
Heat Inactivation ◽  
Plasma Samples ◽  
The Complement System

The complement system plays an important role in innate immunity inducing liver diseases as well as signaling immune cell activation in local inflammation regulating immunomodulatory effects such as liver damage and/or liver regeneration. Our aim is to evaluate the role of complement components in acute liver failure (ALF) caused by viral hepatitis, involving virus-induced ALF in human subjects using peripheral blood, samples of liver tissues, and ex vivo assays. Our findings displayed low levels of C3a in plasma samples with high frequency of C3a, C5a, and C5b/9 deposition in liver parenchyma. Meanwhile, laboratory assays using HepG2 (hepatocyte cell line) showed susceptibility to plasma samples from ALF patients impairing in vitro cell proliferation and an increase in apoptotic events submitting plasma samples to heat inactivation. In summary, our data suggest that the complement system may be involved in liver dysfunction in viral-induced acute liver failure cases using ex vivo assays. In extension to our findings, we provide insights into future studies using animal models for viral-induced ALF, as well as other associated soluble components, which need further investigation.

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