Factors affecting liver regeneration after right portal vein embolization.
OBJECTIVE
The factors influencing the effect of portal vein embolization performed prior to hepatectomies are not clearly understood.


METHODS
In 18 patients who underwent portal vein embolization, serum transforming growth factor-alpha levels and the nonembolized liver volume were studied after portal vein embolization. The increase in the nonembolized liver volume was compared with the change in serum transforming growth factor-alpha levels and several other clinical variables.


RESULTS
The volume of the nonembolized liver significantly increased from 430+/-114 cm3 to 521+/-113 cm3. The serum transforming growth factor-alpha levels significantly increased on the 7th day after portal vein embolization and peaked on the 18th day. The percentage increase in the nonembolized liver volume 14 days after portal vein embolization was significantly correlated with the nonembolized liver volume and the increase in the portal flow velocity, and it was independently and significantly correlated with the increase in the transforming growth factor-alpha level 14 days after portal vein embolization (r2=0.674, P=0.0014 and r=0.761, P<0.0005).


CONCLUSIONS
The increase in the transforming growth factor-alpha level 14 days after portal vein embolization was the only independent factor related to the hypertrophy of the nonembolized liver. Measurement of its serum level may be a useful indicator in the scheduling of subsequent extensive hepatectomies.
Kusaka
Koji
K
Department of Surgery, Hepato-Biliary-Pancreatic Surgery Division, Graduate School of Medicine, University of Tokyo, Japan. hab18310@syd.odn.ne.jp
Imamura
Hiroshi
H
Tomiya
Tomoaki
T
Makuuchi
Masatoshi
M
D000368:Aged; D000369:Aged, 80 and over; D001650:Bile Duct Neoplasms / Q000601:surgery*; D004621:Embolization, Therapeutic; D004797:Enzyme-Linked Immunosorbent Assay / Q000379:methods; D005260:Female; D006498:Hepatectomy; D006801:Humans; D008111:Liver Function Tests; D008113:Liver Neoplasms / Q000556:secondary / Q000601:surgery*; D008115:Liver Regeneration / Q000502:physiology*; D008297:Male; D008875:Middle Aged; D011169:Portal Vein; D011184:Postoperative Period; D016211:Transforming Growth Factor alpha / Q000097:blood*
D016211:Transforming Growth Factor alpha