[Mechanism of liver failure after hepatectomy].
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.
Togo
Shinji
S
Department of Gastroenterological Surgery, Yokohama City University Graduate School of Medicine, Yokohama, Japan.
Kubota
Toru
T
Matsuo
Kenichi
K
Shimizu
Tetsuya
T
Momiyama
Nobuyoshi
N
Takeda
Kazuhisa
K
Tanaka
Kuniya
K
Endo
Itaru
I
Sekido
Hitoshi
H
Shimada
Hiroshi
H
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
D016207:Cytokines; C508960:TGFB1 protein, human; D016212:Transforming Growth Factor beta; D053773:Transforming Growth Factor beta1; D002154:Calpain; D002118:Calcium