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Frontiers of Medicine ; (4): 495-505, 2021.
Article in English | WPRIM | ID: wpr-888737


On the basis of real-world clinical data, the study aimed to explore the effect and mechanisms of the treatment plan of "traditional Chinese medicine (TCM) regulating liver regeneration." A total of 457 patients with HBV-related liver failure were retrospectively collected. The patients were divided into three groups: the modern medicine control group (MMC group), patients treated with routine medical treatment; the control group combining traditional Chinese and Western medicine (CTW), patients treated with routine medical treatment plus the common TCM formula; and the treatment group of "TCM regulating liver regeneration" (RLR), patients treated with both routine medical treatment and the special TCM formula of RLR. After 8 weeks of treatment, the mortality of patients in the RLR group (12.31%) was significantly lower than those in the MMC (50%) and CTW (29.11%) groups. Total bilirubin level significantly decreased and albumin increased in the RLR group when compared with the MMC and CTW groups (P < 0.05). In addition, there were significant differences in the expression of several cytokines related to liver regeneration in the RLR group compared with the MMC group. RLR treatment can decrease jaundice, improve liver function, and significantly reduce the mortality in patients with HBV-related liver failure. The mechanism may be related to the role of RLR treatment in influencing cytokines related to liver regeneration.

Drugs, Chinese Herbal/therapeutic use , Hepatitis B/drug therapy , Humans , Liver Failure , Liver Regeneration , Medicine, Chinese Traditional , Retrospective Studies
Chinese Journal of Surgery ; (12): 835-840, 2020.
Article in Chinese | WPRIM | ID: wpr-878273


Associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) can speed up the regeneration of future liver remnant (FLR) in short period of time, and offer a chance for surgical resection for patients without sufficient FLR. However, ALPPS still remains controversy due to its high perioperative morbidity and mortality, as well as the uncertain long-term oncological benefits. How to solve these problems is the key to ensure the safety of surgery.This article focus on the indication selection, liver function reserve evaluation and timing to perform the second stage surgery, surgical mode evolution and comparison with portal venous embolization/portal venous ligation+two-stage hepatectomy.

Embolization, Therapeutic , Hepatectomy/methods , Humans , Ligation , Liver/surgery , Liver Neoplasms/surgery , Liver Regeneration , Portal Vein/surgery , Treatment Outcome
Article in Chinese | WPRIM | ID: wpr-828067


This study aimed to investigate whether psoralen can aggravate hepatotoxicity induced by carbon tetrachloride(CCl_4) by inducing hepatocyte cycle arrest and delaying liver regeneration. Female C57 BL/6 mice aged 6-8 weeks were randomly divided into control group, model group(CCl_4 group), combined group(CCl_4+PSO group) and psoralen group(PSO group). CCl_4 group and CCl_4+PSO group were given CCl_4 intraperitoneally at a dose of 100 μL·kg~(-1) once; olive oil of the same volume was given to control group and PSO group intraperitoneally; 12 h, 36 h and 60 h after CCl_4 injection, PSO group and CCl_4+PSO group were administrated with PSO intragastrically at a dose of 200 mg·kg~(-1); 0.5% CMC-Na of the same volume was administrated to control group and PSO group intragastrically. The weight of mice was recorded every day. Serum alanine aminotransferase(ALT) and aspartate aminotransferase(AST) were measured at 36 h, 60 h and 84 h after CCl_4 injection. Mice were sacrificed after collection of the last serum samples. Liver samples were collected, and liver weight was recorded. Histopathological and morphological changes of liver were observed by haematoxylin and eosin staining. The mRNA levels of HGF, TGF-β, TNF-α, p53 and p21 in liver were detected by RT-qPCR. Western blot was used to detect the levels of cell cycle-related proteins. According to the results, significant increase of serum ALT and AST and centrilobular necrosis with massive inflammatory cell infiltration were observed in CCl_4+PSO group. After PSO administration in CCl_4 model, the mRNA levels of HGF(hepatocyte growth factor) and TNF-α were reduced, while the mRNA expressions of TGF-β, p53 and p21 was up-regulated. The expression of PCNA(proliferating cell nuclear antigen) was significantly increased in CCl_4 and CCl_4+PSO group, while the relative protein level in CCl_4+PSO group was slightly lower than that in CCl_4 group. Compared with control and CCl_4 group, the expression of p27(cyclic dependent kinase inhibitor protein p27) was prominently increased in CCl_4+PSO group. These results indicated that hepatotoxicity induced by CCl_4 could be aggravated by intraperitoneal administration with PSO, and the repair process of liver could be delayed. The preliminary mechanism may be related to the inhibition of PCNA and regulation of some cell cycle-associated protein by psoralen, in which the significant up-regulation of p27, p53 and p21 may play important roles.

Alanine Transaminase , Animals , Aspartate Aminotransferases , Carbon Tetrachloride , Chemical and Drug Induced Liver Injury , Female , Ficusin , Liver , Liver Regeneration , Mice
ABCD arq. bras. cir. dig ; 33(1): e1484, 2020. tab, graf
Article in English | LILACS | ID: biblio-1088501


ABSTRACT Background: Hepatectomies promote considerable amount of blood loss and the need to administrate blood products, which are directly linked to higher morbimortality rates. The blood-conserving hepatectomy (BCH) is a modification of the selective vascular occlusion technique. It could be a surgical maneuver in order to avoid or to reduce the blood products utilization in the perioperative period. Aim: To evaluate in rats the BCH effects on the hematocrit (HT) variation, hemoglobin serum concentration (HB), and on liver regeneration. Methods: Twelve Wistar rats were divided into two groups: control (n=6) and intervention (n=6). The ones in the control group had their livers partially removed according to the Higgins and Anderson technique, while the rats in the treatment group were submitted to BCH technique. HT and HB levels were measured at day D0, D1 and D7. The rate between the liver and rat weights was calculated in D0 and D7. Liver regeneration was quantitatively and qualitatively evaluated. Results: The HT and HB levels were lower in the control group as of D1 onwards, reaching an 18% gap at D7 (p=0.01 and p=0.008, respectively); BCH resulted in the preservation of HT and HB levels to the intervention group rats. BCH did not alter liver regeneration in rats. Conclusion: The BCH led to beneficial effects over the postoperative HT and serum HB levels with no setbacks to liver regeneration. These data are the necessary proof of evidence for translational research into the surgical practice.

RESUMO Racional: As hepatectomias compreendem considerável perda sanguínea e utilização de hemoderivados, o que diretamente estão relacionados com maior morbimortalidade. A hepatectomia hemoconservadora (HH) é modificação da técnica de oclusão vascular seletiva em hepatectomia. Ela pode ser alternativa cirúrgica para evitar ou diminuir o uso de hemoderivados no perioperatório. Objetivo: Avaliar os efeitos da HH sobre o volume globular (VG), concentração de hemoglobina (HB) e sobre a regeneração hepática em ratos. Métodos: Dois grupos de ratos Wistar foram constituídos: controle (n=6) e intervenção (n=6). Os do grupo controle foram submetidos à hepatectomia parcial de Higgins e Anderson e os do grupo Intervenção à HH. VG e HB foram medidos nos dias D0, D1 e D7. A relação peso do fígado/peso do rato foi calculada em D0 e D7. A regeneração hepática foi analisada qualitativamente e quantitativamente. Resultados: Houve diminuição dos níveis de VG e HB nos ratos do grupo controle a partir de D1, atingindo decréscimo de 18% em D7 (p=0,01 e p=0,008 respectivamente); a HH permitiu a manutenção dos níveis de VG e HB nos ratos do grupo intervenção. A HH não alterou a regeneração hepática. Conclusão: HH resultou em níveis maiores de VG e HB pós-operatórios sem alterar a regeneração hepática. Pode-se considerar estes dados como a prova necessária para a translação à pesquisa clinicocirúrgica.

Animals , Male , Rats , Veins/physiology , Hepatectomy/methods , Liver/surgery , Liver/blood supply , Liver Regeneration , Portal Vein/surgery , Postoperative Period , Blood Volume/physiology , Hepatic Veno-Occlusive Disease/physiopathology , Hemoglobins/analysis , Rats, Wistar , Hematocrit
Acta cir. bras ; 34(11): e201901103, Nov. 2019. tab, graf
Article in English | LILACS | ID: biblio-1054680


Abstract Purpose: To evaluate liver regeneration after selective ligation of portal vein and hepatic artery by 3D Computed Tomography in an experimental model. Methods: Sixteen Wistar rats were randomized into four equal groups: Group I- control (sham), Group II- isolated selective ligation of the hepatic artery, Group III- isolated selective ligation of the portal vein and Group IV- combined ligation of portal vein and hepatic artery. Before procedure and five days after a 3D CT Scan was performed to analyze the hypertrophy, weight and function of the remnant liver. Results: The largest regeneration rate and increase of weight in the hypertrophied lobe was detected in group IV, the first with an average of 3.99 (p=0.006) and the last varying from 6.10g to 9.64g (p=0.01). However, total liver weight and the R1 ratio (Hypertrophied Lobe Weight/Total Liver Weight) was higher in group III (P<0.001) when compared with groups I, II and IV and showed no difference between them. The immunohistochemical examination with PCNA also found higher percentages with statistical significance differences in rats of groups III and IV. It was possible to confirm a strong correlation between hypertrophied lobe weight and its imaging volumetric study. Liver function tests only showed a significant difference in serum gamma-glutamyltransferase and phosphorous. Conclusion: There is a largest liver regeneration after combined ligation of portal vein and hepatic artery and this evidence may improve the knowledge of surgical treatment of liver injuries, with a translational impact in anima nobile.

Animals , Male , Portal Vein/surgery , Hepatic Artery/surgery , Liver/diagnostic imaging , Liver Regeneration/physiology , Organ Size/physiology , Immunohistochemistry , Random Allocation , Tomography, X-Ray Computed/methods , Reproducibility of Results , Treatment Outcome , Rats, Wistar , Imaging, Three-Dimensional/methods , Hepatomegaly/physiopathology , Hepatomegaly/diagnostic imaging , Ligation , Liver/blood supply , Liver/pathology
Chinese Medical Journal ; (24): 311-318, 2019.
Article in English | WPRIM | ID: wpr-774849


BACKGROUND@#The clinical trials emerged centromere protein E inhibitor GSK923295 as a promising anticancer drug, but its function in hepatocellular carcinoma (HCC) remain needs to be fully elucidated, especially as chemotherapy after hepatectomy for liver tumors. We aimed to describe anti-HCC activities of GSK923295 and compare its antiproliferative effects on liver regeneration after partial hepatectomy (PH).@*METHODS@#All subjects were randomized to treatment with either vehicle or GSK923295. Antitumor activity of GSK923295 was assessed by xenograft growth assays. The C57BL/6 mice were subjected to 70% PH and the proliferation was calculated by liver coefficient, further confirmed by immunohistochemistry. The proliferation and cell cycle analysis of liver cell AML12 and HCC cells LM3, HUH7, and HepG2 were investigated using the cell counting kit-8 assay and Flow Cytometry. The chromosome misalignment and segregation in AML12 cells were visualized by immunofluorescence.@*RESULTS@#Treatment with GSK923295 induced antiproliferation in HCC cell lines. It also caused delay on HCC tumor growth instead of regression both in a HCC cell line xenograft model and patient-derived tumor xenograft model. With microarray analysis, CENtromere Protein E was gradually increased in mouse liver after PH. Exposure of liver cells to GSK923295 resulted in delay on a cell cycle in mitosis with a phenotype of misaligned chromosomes and chromosomes clustered. In 70% PH mouse model, GSK923295 treatment also remarkably reduced liver regeneration in later stage, in parallel with the mitotic marker phospho-histone H3 elevation.@*CONCLUSION@#The anticancer drug GSK923295 causes a significant delay on HCC tumor growth and liver regeneration after PH in later stage.

Animals , Antineoplastic Agents , Therapeutic Uses , Blotting, Western , Bridged Bicyclo Compounds, Heterocyclic , Therapeutic Uses , Carcinoma, Hepatocellular , Drug Therapy , General Surgery , Cell Cycle , Cell Proliferation , Chromosomal Proteins, Non-Histone , Electrophoresis, Polyacrylamide Gel , Female , Fluorescent Antibody Technique , Humans , Immunohistochemistry , Liver Neoplasms , Drug Therapy , General Surgery , Liver Regeneration , Physiology , Mice , Mice, Inbred C57BL , Real-Time Polymerase Chain Reaction , Sarcosine , Therapeutic Uses , Xenograft Model Antitumor Assays
Acta cir. bras ; 34(6): e201900606, 2019. graf
Article in English | LILACS | ID: biblio-1019270


Abstract Purpose To investigate the effects of pine needle extract (PNE) on the expression of proliferating cell nuclear antigen (PCNA) and Ki-67 during liver regeneration induced by 70% partial hepatectomy (PH) in rat. Methods Forty-eight male rats (SD, 7 weeks) had surgery (70% PH). They were randomly divided into two groups. PH + PNE group was only provided PNE diluted in water (10%) for drinking and PH group was provided water from 5 days before surgery to the time of sacrifice. PNE was made by pressing and filtering. Animals were sacrificed at 12h, 24h, 36h, 60h, 84h, 168h after PH, respectively. The expressions of PCNA and Ki-67 were determined as proliferation indices. Results Immunohistochemistry turned out to increase the expression of PCNA and Ki-67. PCNA expression of PH+PNE group increased up to twice of that of PH group. Western blot also seemed to increase the PCNA expression. These results indicated the promotion of cell proliferation in liver tissue and hepatic regeneration. Conclusions Pine needle extract stimulates the expression of some mitotic proteins during liver regeneration induced by 70% PH in rats. It suggests that administration of pine needle extract could accelerate the liver regeneration after partial hepatectomy.

Animals , Male , Rats , Plant Extracts/pharmacology , Proliferating Cell Nuclear Antigen/drug effects , Ki-67 Antigen/adverse effects , Pinus/chemistry , Hepatectomy/methods , Liver Regeneration/drug effects , Time Factors , Rats, Sprague-Dawley , Proliferating Cell Nuclear Antigen/metabolism , Ki-67 Antigen/metabolism , Cell Proliferation , Mitotic Index
Repert. med. cir ; 28(3): 152-156, 2019.
Article in Spanish | LILACS, COLNAL | ID: biblio-1046821


La regeneración hepática ha sido uno de los procesos más estudiados en la medicina al ser el hígado un órgano altamente importante y complejo del organismo, asiento de múltiples enfermedades y expuesto por su ubicación anatómica a los traumatismos. El trasplante hepático se ha convertido en uno de los procedimientos más frecuentes en la trasplantología de órganos, por lo que el conocimiento de los aspectos básicos de esta técnica terapéutica y el estudio de los mecanismos histológicos y fisiológicos vinculados con la regeneración hepática es fundamental para lograr un resultado satisfactorio. Se realizó un estudio exploratorio de la bibliografía vinculada con el tema, con el objetivo de exponer aspectos esenciales y actualizados vinculados a las modificaciones fisiológicas y la respuesta orgánica ante el trasplante hepático, además de algunas características clínicas prácticas en este procedimiento.

Liver regeneration has been the focus of intense study in medicine given the liver is a very important and complex organ, affected by multiple illnesses and vulnerable for injury due to its fixed position. Liver transplantation has become one of the most frequent transplantation procedures, thus, knowledge on the basic aspects of this therapeutic technique and the study of the histological and physiological mechanisms linked to liver regeneration is critical to achieve a satisfactory outcome. An exploratory research of the bibliography on this topic was conducted aiming to expose essential and updated aspects related to the physiological modifications and immune response after liver transplantation, and some practical clinical features of this procedure.

Humans , Liver Regeneration , Liver Transplantation
Article in English | WPRIM | ID: wpr-761899


BACKGROUND: Liver disease is one of the top causes of death globally. Although liver transplantation is a very effective treatment strategy, the shortage of available donor organs, waiting list mortality, and high costs of surgery remain huge problems. Stem cells are undifferentiated cells that can differentiate into a variety of cell types. Scientists are exploring the possibilities of generating hepatocytes from stem cells as an alternative for the treatment of liver diseases. METHODS: In this review, we summarized the updated researches in the field of stem cell-based therapies for liver diseases as well as the current challenges and future expectations for a successful cell-based liver therapy. RESULTS: Several cell types have been investigated for liver regeneration, such as embryonic stem cells, induced pluripotent stem cells, liver stem cells, mesenchymal stem cells, and hematopoietic stem cells. In vitro and in vivo studies have demonstrated that stem cells are promising cell sources for the liver regeneration. CONCLUSION: Stem cell-based therapy could be a promising therapeutic method for patients with end-stage liver disease, which may alleviate the need for liver transplantation in the future.

Cause of Death , Embryonic Stem Cells , Hematopoietic Stem Cells , Hepatocytes , Humans , In Vitro Techniques , Induced Pluripotent Stem Cells , Liver Diseases , Liver Regeneration , Liver Transplantation , Liver , Mesenchymal Stem Cells , Methods , Mortality , Stem Cells , Tissue Donors , Waiting Lists
Rev. Assoc. Med. Bras. (1992) ; 64(9): 791-798, Sept. 2018. graf
Article in English | LILACS | ID: biblio-976857


SUMMARY OBJECTIVE To study factors affecting the liver regeneration after hepatectomy METHODS With 3D reconstitution technology, liver regeneration ability of 117 patients was analysed, and relative factors were studied. RESULTS There was no statistically difference between the volume of simulated liver resection and the actual liver resection. All livers had different degrees of regeneration after surgery. Age, gender and blood indicators had no impact on liver regeneration, while surgery time, intraoperative blood loss, blood flow blocking time and different ways of liver resection had a significant impact on liver regeneration; In addition, the patients' own pathological status, including, hepatitis and liver fibrosis all had a significant impact on liver regeneration. CONCLUSION 3D reconstitution model is a good model to calculate liver volume. Age, gender, blood indicators and biochemistry indicators have no impact on liver regeneration, but surgery indicators and patients' own pathological status have influence on liver regeneration.

RESUMO OBJETIVO Estudar os fatores que afetam a regeneração hepática após hepatectomia. MÉTODOS A capacidade de regeneração hepática de 117 pacientes foi analisada com a tecnologia de reconstituição 3D e foram estudados os fatores relacionados. RESULTADOS Não houve diferença estatística significante entre o volume de ressecção hepática simulada e a ressecção atual. Todos os fígados apresentaram diferentes graus de regeneração após cirurgia. Idade, gênero e indicadores sanguíneos não tiveram impacto na regeneração hepática, enquanto que tempo de cirurgia, perda sanguínea intraoperatória, tempo de bloqueio do fluxo sanguíneo e diferentes formas de ressecção mostraram impacto significante na regeneração do órgão. Além disso, condições patológicas dos pacientes, incluindo hepatite e fibrose hepática, tiveram impacto significante na regeneração hepática. CONCLUSÃO O modelo de reconstituição 3D é um bom modelo para calcular o volume do fígado. Idade, gênero, indicadores sanguíneos e bioquímicos não tiveram impacto na regeneração hepática, mas indicadores operatórios e condição patológica dos pacientes mostraram influência na regeneração do órgão.

Humans , Male , Female , Adult , Aged , Aged, 80 and over , Carcinoma, Hepatocellular/surgery , Hepatectomy/rehabilitation , Liver Neoplasms/surgery , Liver Regeneration/physiology , Organ Size , Risk Factors , Analysis of Variance , Blood Loss, Surgical , Treatment Outcome , Carcinoma, Hepatocellular/pathology , Carcinoma, Hepatocellular/rehabilitation , Imaging, Three-Dimensional , Tumor Burden , Operative Time , Hepatitis/pathology , Liver Cirrhosis/pathology , Liver Neoplasms/pathology , Liver Neoplasms/rehabilitation , Middle Aged , Models, Anatomic
Acta cir. bras ; 33(5): 439-445, May 2018. graf
Article in English | LILACS | ID: biblio-949344


Abstract Purpose: To investigate the effects of capsiate treatment on hepatic hyperplasia in partially hepatectomized rats. Methods: The animals were divided into a Capsiate group (CPH), a Capsiate Post-Partial Hepatectomy group (CPPH) and a Partial Hepatectomy Control group (PH). CPH and CPPH animals received 60 mg/kg/day Capsiate for 30 days. Next, the rats underwent partial hepatectomy. CPPH animals continued to receive treatment for 48 h after partial hepatectomy. Liver tissue and intracardiac blood samples were obtained 24 or 48 h after PH. Results: Capsiate treatment interfered with hepatic parameters, reducing the number of mitoses and apoptosis and increasing blood ALT and alkaline phosphatase concentrations. Conclusion: Capsiate treatment preceding hepatic surgery may compromise the initial period of postoperative recovery.

Animals , Male , Rats , Capsaicin/analogs & derivatives , Hepatectomy , Liver/enzymology , Aspartate Aminotransferases/metabolism , Capsaicin/pharmacology , Rats, Wistar , Apoptosis/drug effects , Alanine Transaminase/metabolism , Alkaline Phosphatase/metabolism , Liver/drug effects , Liver/pathology , Liver Regeneration/drug effects , Mitosis/drug effects
Acta cir. bras ; 33(2): 110-116, Feb. 2018. tab, graf
Article in English | LILACS | ID: biblio-886264


Abstract Purpose: To investigate thymoquinone, curcumin and a combination of these two drugs were effective or not at the growth of liver. Methods: Forty female Wistar-Albino rats distributed into five groups of eight rats each, control, thymoquinone, curcumin, and thymoquinone/curcumin groups. Pathological specimens were studied using the Ki-67 Proliferation Index(PI); and arginase(Arg), tissue plasminogen activator(tPA), ceruloplasmin(Cer) and nitric oxide(NO) were studied in biochemical analysis. Results: Our results showed that Ki-67 proliferation index was low in Groups 1. The proliferation coefficient was significantly higher in the Group 2 and Group 4 than in the Group 1 and Group 3.(P < 0.001 between Groups 1 and 2, 1 and 4, and 3 and 4). There was no difference between Groups 2 and 4 (P = 1). The results of the biochemical Arg, tPA and Cer test showed statistically between the Group 1 and Group 2. NO showed significant differences Group 1 and 3. Conclusions: Thymoquinone and curcumin both have known positive effects on the organism. Histological and biochemical tests showed that thymoquinone is more effective than curcumin.

Animals , Female , Rats , Liver Regeneration/drug effects , Antioxidants/pharmacology , Arginase/blood , Ceruloplasmin/analysis , Biomarkers/blood , Benzoquinones/pharmacology , Liver Transplantation , Tissue Plasminogen Activator/blood , Rats, Wistar , Ki-67 Antigen/analysis , Curcumin/pharmacology , Cell Proliferation , Hepatectomy/methods , Liver/pathology , Liver Neoplasms/surgery , Antineoplastic Agents/pharmacology , Nitric Oxide/blood
Article in English | WPRIM | ID: wpr-713273


PURPOSE: Posthepatectomy liver failure is a serious complication and considered to be caused by increased portal pressure and flow. Splanchnic vasoactive agents and propranolol are known to decrease portal pressure. The aim of this study was to identify optimal candidates with potential for clinical use among somatostatin, terlipressin, and propranolol using rats with 90% hepatectomy. METHODS: Rats were divided into 5 groups: sham operation (n = 6), control (n = 20), propranolol (n = 20), somatostatin (n = 20), and terlipressin group (n = 20). Seven-day survival rates and portal pressure change were measured, and biochemical, histologic, and molecular analyses were performed. RESULTS: Portal pressure was significantly decreased in all 3 treatment groups compared to control. All treatment groups showed a tendency of decreased liver injury markers, and somatostatin showed the most prominent effect at 24 hours postoperatively. Histologic liver injury at 24 hours was significantly decreased in propranolol and terlipressin groups (P = 0.016, respectively) and somatostatin group showed borderline significance (P = 0.056). Hepatocyte proliferation was significantly increased after 24 hours in all treatment groups. Median survival was significantly increased in terlipressin group compared to control group (P < 0.01). CONCLUSION: Terlipressin is considered as the best candidate, while somatostatin has good potential for clinical use, considering their effects on portal pressure and subsequent decrease in liver injury and increase in liver regeneration.

Animals , Hepatectomy , Hepatocytes , Liver Failure , Liver Regeneration , Liver , Portal Pressure , Propranolol , Rats , Somatostatin , Survival Rate , Vasoconstrictor Agents
Journal of Liver Cancer ; : 162-167, 2018.
Article in Korean | WPRIM | ID: wpr-765688


Although surgical resection is a curative treatment option for solitary hepatocellular carcinoma, high recurrence rate contributes to dismal long-term prognosis after curative resection. Early recurrence within 2 years after surgery is associated with intrahepatic metastasis of primary tumor. Liver regeneration after hepatic resection can accelerate tumorigenesis in remnant liver. Treatment strategies for intrahepatic recurrence after curative resection include salvage transplantation, repeated resection, local ablation, and transarterial chemoembolization (TACE). Here, we report a 51-year-old male who was presented with a single large tumor located at segment 4. The patient was initially treated with surgical resection, but intrahepatic recurrence occurred only 4 months after surgery. He achieved complete remission with repeated TACE and has survived without recurrence for 4 years so far.

Carcinogenesis , Carcinoma, Hepatocellular , Humans , Liver , Liver Regeneration , Male , Middle Aged , Neoplasm Metastasis , Prognosis , Recurrence
Frontiers of Medicine ; (4): 262-268, 2018.
Article in English | WPRIM | ID: wpr-772720


γδ T cells display unique developmental, distributional, and functional patterns and can rapidly respond to various insults and contribute to diverse diseases. Different subtypes of γδ T cells are produced in the thymus prior to their migration to peripheral tissues. γδ T cells are enriched in the liver and exhibit liver-specific features. Accumulating evidence reveals that γδ T cells play important roles in liver infection, non-alcoholic fatty liver disease, autoimmune hepatitis, liver fibrosis and cirrhosis, and liver cancer and regeneration. In this study, we review the properties of hepatic γδ T cells and summarize the roles of γδ T cells in liver diseases. We believe that determining the properties and functions of γδ T cells in liver diseases enhances our understanding of the pathogenesis of liver diseases and is useful for the design of novel γδ T cell-based therapeutic regimens for liver diseases.

Animals , Cytokines , Allergy and Immunology , Humans , Liver Diseases , Allergy and Immunology , Liver Regeneration , Allergy and Immunology , Mice , T-Lymphocytes, Regulatory , Allergy and Immunology
Article in English | WPRIM | ID: wpr-739765


Hepatectomy plays a pivotal role in the management of primary and secondary malignancies of the liver, and offers a curative option for the patient. Postoperative liver failure is a severe complication of liver resection, particularly for patients with underlying liver disease. Portal vein embolization (PVE) is a well-established preoperative technique that redirects blood flow to the anticipated remaining liver after resection in an effort to improve the functional hepatic reserve. PVE has improved the safety of hepatectomy and has extended surgical candidacy to patients who previously would have been ineligible for resection because of insufficient remnant liver volume. This article reviews the following aspects of PVE; indications, contraindications, liver volumetry, approaches, embolization agents, recent outcomes data, and areas of active research including adjunctive therapies and temporary PVE.

Hepatectomy , Humans , Liver , Liver Diseases , Liver Failure , Liver Neoplasms , Liver Regeneration , Portal Vein
Rev. Col. Bras. Cir ; 44(5): 476-481, Sept.-Oct. 2017. tab
Article in English | LILACS | ID: biblio-896617


ABSTRACT Objective: to evaluate whether colectomy, associated with 70% hepatectomy, influences liver regeneration in rats. Methods: we distributed 18 Wistar rats in three groups of six animals each. In group I (sham), we performed laparotomy; In group II, colectomy + 70% hepatectomy; In group III, only 70% hepatectomy. On the 6th postoperative day, we collected blood by cardiac puncture under anesthesia, followed by euthanasia. We performed serum dosages of aspartate aminotransferase (AST), alanine aminotransferase (ALT), albumin and alkaline phosphatase (AF), hepatocyte growth factor (HGF) and transforming growth factor-α (TGF-α). We calculated liver regeneration by the formula: liver weight ratio per 100g body weight at the time of euthanasia / liver weight preoperatively projected for 100g body weight × 100. Results: ALT and AST levels were significantly lower in group II when compared with group III (p<0.001). Albuminemia showed significantly higher levels in group II. Levels of HGF and TGF-α in group II were significantly higher than in group III. The percentage of hepatic regeneration was significantly higher in group II than in group III. Conclusion: Colectomy performed simultaneously with 70% hepatectomy had a positive influence on liver regeneration in rats. Further research is needed to reveal the molecular mechanisms of this effect and to characterize the colon influence in liver physiology.

RESUMO Objetivo: avaliar se a colectomia, associada à hepatectomia 70%, influencia a regeneração do fígado em ratos. Métodos: foram utilizados 18 ratos Wistar distribuídos em três grupos de seis animais cada. No grupo I (sham) foi realizada laparotomia; no grupo II colectomia + hepatectomia 70%; no grupo III apenas hepatectomia 70%. No sexto dia pós-operatório foi colhido sangue por punção cardíaca, sob anestesia, seguido de eutanásia. Foram realizadas dosagens séricas de aspartato aminotransferase (AST), alanina aminotransferase (ALT), albumina e fosfatase alcalina (FA), fator de crescimento de hepatócitos (HGF) e fator de crescimento transformador-α (TGF-α). A regeneração do fígado foi calculada pela fórmula: razão peso do fígado por 100g do peso corporal no momento da eutanásia/peso do fígado no pré-operatório projetado por 100g de peso corporal ×100. Resultados: Os níveis de ALT e AST foram significativamente menores no grupo II quando comparados com o grupo III (p<0,001). A albuminemia mostrou níveis significativamente mais elevados no grupo II. Os níveis de HGF e TGF-α no grupo II foram significativamente mais elevados que no grupo III. O percentual de regeneração hepática foi significativamente mais elevado no grupo II do que no grupo III. Conclusão: o estudo demonstrou que a colectomia realizada simultaneamente à hepatectomia 70% influenciou positivamente na regeneração do fígado em ratos. Pesquisas adicionais são necessárias para revelar os mecanismos moleculares deste efeito e para caracterizar a influência do cólon na fisiologia do fígado.

Animals , Male , Rats , Colectomy , Colon , Hepatectomy , Liver Regeneration , Rats, Wistar
Acta cir. bras ; 32(7): 515-522, July 2017. tab, graf
Article in English | LILACS | ID: biblio-886219


Abstract Purpose: To evaluate the effects of mesenchymal stem cells on liver regeneration in rats following a 70% hepatectomy. Methods: Forty rats were subjected to 70% hepatectomy and then ~106 mesenchymal stem cells (test group), or saline solution (control group), were infused into their livers via the portal vein. Each treatment group was divided into early and late subgroups (euthanized 3 d and 5 d following the operation, respectively). Group comparisons of Albumin, aminotransaminases (AST, ALT), and Alcaline Phosphatase (AP) levels, proliferative index (ki-67+ straining), and mitotic cell counts were conducted. Results: No significant differences in liver regeneration rate, number of mitoses, proliferative index, or serum levels of albumin, AST, or AP were observed. ALT levels were higher in the test group than in the control group (p<.05). Conclusions: Mesenchymal stem-cell therapy did not improve liver regeneration rate 3 d or 5 d after 70% hepatectomy in rats. Likewise, the therapy appeared not to affect liver function, proliferative index, or number of mitoses significantly.

Animals , Male , Rats , Mesenchymal Stem Cell Transplantation/methods , Hepatectomy/methods , Liver Regeneration , Time Factors , Rats, Wistar , Models, Animal , Cell Proliferation , Injections, Intravenous
Einstein (Säo Paulo) ; 15(2): 178-185, Apr.-June 2017. tab, graf
Article in English | LILACS | ID: biblio-891376


ABSTRACT Objective To analyze the influence of portal vein ligation in hepatic regeneration by immunohistochemical criteria. Methods Ten pigs divided into two groups of five animals underwent hepatectomy in two stages, and the groups were differentiated by ligation or not of the left portal vein tributary, which is responsible for vascularization of the left lateral and medial lobes of the pig liver. Five days after the procedure, the animals underwent liver biopsies for further analysis of histological and immunohistochemical with marker Ki67. Results The group submitted to hepatectomy with vascular ligation showed an increase of approximately 4% of hepatocytes in regeneration status, as well as a greater presence of Kupffer and inflammatory cells as compared to control. Conclusion As a result of positive cell replication observed through the Ki67 marker, we can suspect that the ligation of a tributary of the portal vein associated with liver resection promoted a greater stimulus of liver regeneration when compared to liver resection alone.

RESUMO Objetivo Analisar a influência da ligadura da tributária da veia porta no estímulo regenerativo hepático por meio de critérios imuno-histoquímicos. Métodos Dez suínos, divididos em dois grupos de cinco animais, foram submetidos à hepatectomia em dois estágios, sendo que os grupos foram diferenciados pela ligadura ou não da tributária da veia porta, responsável pela vascularização dos lobos lateral e medial esquerdos do fígado do suíno. Cinco dias após o procedimento, os animais foram reabordados para retirada de amostras hepáticas para posterior análise de histológica e imunoistoquímica com o marcador Ki67. Resultados O grupo submetido à hepatectomia com ligadura vascular apresentou incremento de 4% aproximadamente de hepatócitos em processo de regeneração, bem como grande número de células de Kupffer e células inflamatórias, quando comparado ao controle. Conclusão Em virtude da análise positiva da replicação celular observada por meio do marcador Ki67, pode-se observar que a ligadura de uma tributária da veia porta promoveu um maior estímulo de regeneração hepática, efeito observado com menor intensidade no grupo submetido apenas à ressecção hepática.

Animals , Portal Vein/surgery , Parenchymal Tissue/surgery , Hepatectomy/methods , Liver/surgery , Liver Regeneration , Swine , Random Allocation , Ki-67 Antigen/metabolism , Hepatocytes/metabolism , Models, Animal , Parenchymal Tissue/pathology , Leukocytes , Ligation/methods , Liver/pathology
ABCD arq. bras. cir. dig ; 30(2): 122-126, Apr.-June 2017. tab, graf
Article in English | LILACS | ID: biblio-885715


ABSTRACT Background: Partial hepatectomy is a surgical intervention of the liver that can trigger its regenerative process, where the residual lobes deflagrate a compensatory hyperplasia, causing its restoration almost to the original volume. Nevertheless, depending on the extent of liver damage its regeneration might be impaired. The low-power laser has been studied with beneficial results. Aim: To investigate the possible functional and mutagenic damage arising from the use of low-power laser used in liver regeneration after partial hepatectomy. Methods: Fifteen male adult Wistar rats were hepatectomizated in 70% and laser irradiated or not with dose of 70 J/cm2, 650 nm, 100 mW, directly on the remaining liver, during the perioperative period. These animals were divided into four groups: G1 (control, 7 days); G2 (laser, 7 days); G3 (control, 14 days); G4 (laser, 14 days). Were analyzed the liver weight; number of hepatocytes; deposition of collagen fibers; liver function tests: serum alanine aminotransferase, aspartate aminotransferase, alkaline phosphatase, gamma glutamyl transferase, bilirubin and micronucleus test in peripheral blood erythrocyte. Results: The liver weight was greater in G3 and G4 (p=0.001 and p=0.002) compared to other groups. The deposition of collagen fibers in G1 was statistically higher than the other groups (p=0.01). In tests of liver function and micronucleus test was not found significant differences between the studied groups. Conclusion: Low-power laser stimulation did not cause loss of liver function or mutagenic damage.

RESUMO Racional: A hepatectomia parcial é intervenção cirúrgica que pode desencadear processo regenerativo, onde os lobos residuais deflagram resposta de hiperplasia compensatória, ocasionando restauração próxima ao seu volume original. Contudo, dependendo da extensão das lesões hepáticas a regeneração pode ser prejudicada. O laser de baixa potência tem sido pesquisado com resultados benéficos no processo de regeneração hepática. Objetivo: Investigar os possíveis danos funcionais e mutagênicos decorrentes da utilização do laser de baixa potência utilizado na regeneração hepática após hepatectomia parcial. Métodos: Quinze ratos adultos Wistar foram hepatectomizados a 70%, irradiados ou não com laser, dose de 70 J/cm2, 650 nm,100 mW, de forma direta sobre o fígado remanescente, durante o período transoperatório. Os animais foram distribuídos em quatro grupos: G1 (controle, 7 dias); G2 (laser, 7 dias); G3 (controle 14 dias); G4 (laser,14 dias). Foram analisados o peso do fígado; número de hepatócitos; deposição de fibras colágenas; teste de função hepática: alanina aminotransferase, aspartato aminotransferase, fosfatase alcalina, gama glutamiltransferase, bilirrubinas e teste de micronúcleo em eritrócitos. Resultados: O peso do fígado apresentou-se aumentado nos grupos G3 e G4 (p=0,001 e p=0,002) comparados aos demais grupos. A deposição das fibras colágenas no G1 foi estatisticamente maior em relação aos demais grupos (p=0,01). Nos testes de função hepática e teste de micronúcleo não foram encontradas diferenças significativas entre os grupos. Conclusão: O laser de baixa potência não ocasionou perda de função hepática ou dano mutagênico.

Animals , Male , Rats , Low-Level Light Therapy/adverse effects , Hepatectomy/methods , Liver Regeneration/radiation effects , Rats, Wistar , Liver Regeneration/physiology , Liver Regeneration/genetics , Mutation