Small liver graft regenerates through immediate increase of HGF and IL-6--possible involvement of sinusoidal tensile/shear stress in small liver graft.
OBJECTIVE
The mechanisms whereby grafts in the recipients can be primed for regeneration following living donor liver transplantation (LDLT) are poorly understood. The present study was designed to understand the mechanism for posttransplant regeneration in small-for-size liver graft.


METHODS
Out of LDLT cases, we examined patients with end-stage liver cirrhosis and subsequent transplantation. A total of 16 patients were divided into 2 groups, group L (large graft) and group S (small graft). We examined the serum biochemical markers and cytokines preoperatively and postoperatively. We also carried out hemodynamic analysis by measuring the portal and arterial peak velocity.


RESULTS
The differences in ages, preoperative biochemical markers and MELD score between the two groups were not statistically significant. Though differences in the preoperative levels of IL-6, sIL-6R and HGF were not significant between the two groups, IL-6 and HGF levels in group S significantly increased postoperatively. Immediate and significant increase of Vp max was also observed in group S. Two weeks after LDLT, the regeneration rate in group S was significantly higher than that in group L.


CONCLUSIONS
These findings may allow us to speculate that immediate increase of portal pressure, reflecting sinusoidal tensile/shear stress, accelerates liver regeneration through immediate induction of IL-6 and HGF.
Oyama
Takanori
T
Department of Gastroenterological Surgery, Okayama University Graduate School of Medicine and Dentistry, 2-5-1 Shikata, Okayama 700-8558, Japan.
Sadamori
Hiroshi
H
Matsukawa
Hiroyoshi
H
Murata
Hiroshi
H
Umeda
Yuzou
Y
Watanabe
Yasuhiro
Y
Ozaki
Michitaka
M
Iwagaki
Hiromi
H
Tanaka
Noriaki
N
Yagi
Takahito
T
D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D005260:Female; D017228:Hepatocyte Growth Factor / Q000032:analysis*; D006801:Humans; D007223:Infant; D015850:Interleukin-6 / Q000032:analysis*; D008103:Liver Cirrhosis / Q000601:surgery; D008115:Liver Regeneration / Q000502:physiology*; D016031:Liver Transplantation / Q000502:physiology*; D008297:Male; D008875:Middle Aged; D017082:Portal Pressure / Q000502:physiology; D033081:Shear Strength; D013718:Tensile Strength
C066855:HGF protein, human; D015850:Interleukin-6; D017228:Hepatocyte Growth Factor