title: [Mechanism of liver failure after hepatectomy].
abstract: Liver failure after hepatectomy is caused by many factors such as excessive hepatectomy, ischemic-reperfusion injury, postoperative infection, etc. However, apoptosis of hepatocytes is the most important event in the molecular mechanism of liver failure. Liver failure after excessive hepatectomy is characterized by increased apoptosis of hepatocytes and diminished liver regeneration. The former is induced by hypercytokinemia and hyperendotoxemia, and the latter is caused by cell cycle arrest. In ischemic-reperfusion injury of the liver, the apoptosis of hepatocytes is caused by activation of the MMPT and calpain system that are induced by the intracellular accumulation of Ca. The possible mechanism of liver failure in cases with persistent infection is the inhibition of liver regeneration and the induction of apoptosis of hepatocytes due to transforming growth factor-beta 1. The knowledge of these mechanisms will lead to prompt and appropriate treatments for individual patients.
authors.affiliation: Department of Gastroenterological Surgery, Yokohama City University Graduate School of Medicine, Yokohama, Japan.
authors.forename: Shinji
authors.initials: S
authors.lastname: Togo
authors.forename: Toru
authors.initials: T
authors.lastname: Kubota
authors.forename: Kenichi
authors.initials: K
authors.lastname: Matsuo
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Shimizu
authors.forename: Nobuyoshi
authors.initials: N
authors.lastname: Momiyama
authors.forename: Kazuhisa
authors.initials: K
authors.lastname: Takeda
authors.forename: Kuniya
authors.initials: K
authors.lastname: Tanaka
authors.forename: Itaru
authors.initials: I
authors.lastname: Endo
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Sekido
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Shimada
mesh_terms: D000818:Animals; D017209:Apoptosis; D002118:Calcium / Q000378:metabolism; D002154:Calpain / Q000378:metabolism; D002463:Cell Membrane Permeability; D016207:Cytokines / Q000097:blood; D019446:Endotoxemia / Q000150:complications; D006498:Hepatectomy; D022781:Hepatocytes; D006801:Humans; D017093:Liver Failure / Q000209:etiology*; D008928:Mitochondria / Q000502:physiology; D011183:Postoperative Complications; D015427:Reperfusion Injury; D016212:Transforming Growth Factor beta / Q000502:physiology; D053773:Transforming Growth Factor beta1
chemical_list: D016207:Cytokines; C508960:TGFB1 protein, human; D016212:Transforming Growth Factor beta; D053773:Transforming Growth Factor beta1; D002154:Calpain; D002118:Calcium