Syngeneic living-donor liver transplantation for hemangioendothelioma: a clinical model for studying liver regeneration.
A 22-year-old Caucasian patient underwent living-donor liver transplantation (LDLT) for hepatic hemangioendothelioma in a healthy liver. The organ donor was his monozygotic twin brother. Surgery was uneventful in both donor and recipient, who received the same postoperative treatment (i.e. no immunosuppression for the recipient). Although both donor and recipient achieved a full liver function recovery, the volume of the recipient's graft increased much more than the donor's residual liver in the first postoperative month (1.6-fold vs. 1.2-fold). This different growth rate correlated with growth hormone (GH)/insulin growth factor (IGF) axis dynamics: the donor had significantly lower insulin-like growth factor 1 (IGF-1), insulin-like growth factor 2 (IGF-2) and insulin-like growth factor binding protein 3 (IGFBP-3) values than the recipient on postoperative days (POD) 3-30, although they had similar GH values. Other potential regenerative factors, e.g. tumor necrosis alpha, interleukin 6 (IL-6), insulin and C peptide did not correlate with liver regeneration rate. The particular endocrine picture of the graft may be explained by a modified GH-hepatocyte interaction due to cold ischemia during preservation resulting in a higher IGF production. Whether this is a potential molecular tool by means of which transplanted partial livers promote their regeneration remains to be seen in a larger number of patients.
Cillo
Umberto
U
Clinica Chirurgica I, Dipartimento di Chirurgia Generale e Trapianti d'organo, University of Padua, School of Medicine, Padova, Italy.
Vitale
Alessandro
A
Brolese
Alberto
A
Zanus
Giacomo
G
Bassanello
Marco
M
Montin
Umberto
U
D'Amico
Francesco
F
Ciarleglio
Francesco Antonio
FA
Iurilli
Vincenzo
V
Carraro
Paolo
P
Grigoletto
Francesco
F
Plebani
Mario
M
D'Amico
Davide Francesco
DF
D000328:Adult; D002096:C-Peptide / Q000097:blood; D004200:Diseases in Twins; D013006:Growth Hormone / Q000378:metabolism; D006390:Hemangioendothelioma / Q000628:therapy*; D022781:Hepatocytes / Q000378:metabolism; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D018972:Insulin-Like Growth Factor Binding Protein 3 / Q000097:blood; D007334:Insulin-Like Growth Factor I / Q000096:biosynthesis; D007335:Insulin-Like Growth Factor II / Q000096:biosynthesis; D015850:Interleukin-6 / Q000097:blood; D007700:Kinetics; D008099:Liver / Q000473:pathology; D008113:Liver Neoplasms / Q000628:therapy*; D008115:Liver Regeneration; D016031:Liver Transplantation; D019520:Living Donors; D008297:Male; D015233:Models, Statistical; D013002:Somatomedins / Q000378:metabolism; D013997:Time Factors; D014185:Transplantation, Isogeneic / Q000379:methods*; D014409:Tumor Necrosis Factor-alpha / Q000096:biosynthesis; D014430:Twins, Monozygotic
D002096:C-Peptide; D007166:Immunosuppressive Agents; D018972:Insulin-Like Growth Factor Binding Protein 3; D015850:Interleukin-6; D013002:Somatomedins; D014409:Tumor Necrosis Factor-alpha; D007334:Insulin-Like Growth Factor I; D007335:Insulin-Like Growth Factor II; D013006:Growth Hormone