The mystery of liver regeneration.
BACKGROUND
Partial hepatectomy is the strongest stimulator of hepatic regeneration. The process of initiation and the control of the final size of the regenerated liver have been the subject of research for many years. A better understanding of this process and the effect of disease may allow better selection of patients for partial hepatectomy. It may also allow an insight into the possible application of clinical stimulation of regeneration.


METHODS
Data were reviewed from the published literature using the Medline database.


RESULTS
Most knowledge comes from in vitro studies and the study of resection in the rat model. A variety of cytokines, hormones and growth factors are involved in regeneration but very few have been found capable of stimulating regeneration in vitro. The exact interactions are not known, but there is probably a cascade involving different factors at differing stages of regeneration.


CONCLUSIONS
Further in vivo research should allow greater understanding of liver regeneration, thereby providing a potential therapeutic tool in patients for whom regeneration has failed, or is likely to fail. Such research is also important in respect of liver support devices, which may inhibit liver regeneration by filtration of many of the factors involved.
University of Adelaide Department of Surgery, The Queen Elizabeth Hospital, Woodville, Adelaide, South Australia 5011, Australia.
F G
FG
Court
S A
SA
Wemyss-Holden
A R
AR
Dennison
G J
GJ
Maddern
D016207:Cytokines / Q000502:physiology; D004815:Epidermal Growth Factor / Q000502:physiology; D006133:Growth Substances / Q000502:physiology; D017228:Hepatocyte Growth Factor / Q000502:physiology; D022781:Hepatocytes / Q000502:physiology; D006801:Humans; D036341:Intercellular Signaling Peptides and Proteins; D008099:Liver / Q000033:anatomy & histology*; D008115:Liver Regeneration / Q000502:physiology*; D008934:Mitogens / Q000502:physiology; D010455:Peptides / Q000502:physiology; D016211:Transforming Growth Factor alpha / Q000502:physiology; D016212:Transforming Growth Factor beta / Q000502:physiology
D016207:Cytokines; D006133:Growth Substances; D036341:Intercellular Signaling Peptides and Proteins; D008934:Mitogens; D010455:Peptides; D016211:Transforming Growth Factor alpha; D016212:Transforming Growth Factor beta; C073456:hepatic stimulator substance; D004815:Epidermal Growth Factor; D017228:Hepatocyte Growth Factor