Acceleration of Remnant Liver Regeneration After Hepatectomy

Abstract

Objective: Remnant liver tissue is essential for the surgery of primary liver tumors, metastasectomy, or donor hepatectomy. We aimed to determine whether an effective supportive treatment can improve the safety of donors with insufficient remnants and expand the donor pool in countries where LDLT is performed intensively. Therefore, our study investigated the effects of various substance extracts on the regenerative capacity of residual liver tissue following hepatectomy.
Methods: Rats of equal age and approximately equal weight were grouped into 6 groups: Sham, Genabilic acid, Silymarin+curcumin, Ganoderma lucidum, Mixture containing group B vitamins, amino acids, l-carnitine, and sugars, and Phenoxy-2-methyl-2-propionic acid. Subjects' mTOR, insulin, nesfatin, and leptin levels were checked. PCNA was performed for regeneration control, and immunohistochemistry for Ki-67, mTOR, VEGF, FGF, HGF, and Calpain-10 was performed on the liver.
Results: In comparisons between the Sham group and the other groups, there were significant differences for insulin in group 4 (p=0.041) and for nesfatin in group 3 (p<0.001). The other markers were similar. PCNA, Ki-67, mTOR, and Calpain-10 differed significantly across all groups (p < 0.001). It was also significantly different with respect to VEGF, FGF, and HGF compared with the other groups, except for group 4.
Conclusions: It was determined that the silymarin-curcumin was more successful in suppressing hunger hormones. Since liver regeneration with fibrosis is undesirable, although Ganoderma lucidum is thought not to affect FGF levels, it may promote healthier regenerative tissue; however, this has not been demonstrated by immunostaining.

Keywords

• Hepatectomy
• Liver regeneration
• Supplements

Supporting Institution

All authors (Şencan Acar, Hüseyin Çakıroğlu, Erdem Çokluk, Özcan Budak, Murat Coşkun, Ahmet Tarık Eminler) declare that this study has been supported by the Turkish Association for the Study of the Liver (TASL).

Project Number

19/28

Ethical Statement

The study was approved by the Local Ethics Committee of Animal Experiments of Sakarya University (07.08.2019/28).

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