Influence of portosystemic shunt on liver regeneration after hepatic resection in pigs.
OBJECTIVE
The minimal amount of liver mass necessary for regeneration is still a matter of debate. The aim of the study was to analyze liver regeneration factors after extended resection with or without portosystemic shunt.


METHODS
An extended left hemihepatectomy was performed in 25 domestic pigs, in 15 cases after a portosystemic H-shunt. The expression of Ki-67, VEGF, TGF-alpha, FGF, and CK-7 was analyzed in paraffin-embedded tissue sections.


RESULTS
The volume of the remnant liver increased about 2.5-fold at the end of the first week after resection. With 19 cells/10 Glisson fields versus 4/10, Ki-67-expression was significantly higher in the H-shunt group. VEGF- and CK-7-expressions were significantly higher in the control group. No significant change was found in FGF-expression. The expression of TGF-alpha was higher, but not significantly, in the control group.


CONCLUSIONS
The expression of Ki-67, and therefore hepatocyte regeneration, was increased in the shunt group. The expression of CK-7 on biliary epithelium and the expression of VEGF, however, were stronger in the control group.
Ladurner
R
R
Department of General, Visceral and Transplant Surgery, University Hospital Tübingen, Hoppe-Seyler-Str. 3, 72076 Tübingen, Germany. ruth.ladurner@med.uni-tuebingen.de
Schenk
M
M
Margreiter
R
R
Offner
F
F
Königsrainer
A
A
D000818:Animals; D005260:Female; D005346:Fibroblast Growth Factors / Q000378:metabolism; D006498:Hepatectomy; D053552:Keratin-7 / Q000378:metabolism; D019394:Ki-67 Antigen / Q000378:metabolism; D008099:Liver / Q000378:metabolism; D008115:Liver Regeneration; D008297:Male; D011170:Portasystemic Shunt, Surgical; D013552:Swine; D016211:Transforming Growth Factor alpha / Q000378:metabolism; D042461:Vascular Endothelial Growth Factor A / Q000378:metabolism
D053552:Keratin-7; D019394:Ki-67 Antigen; D016211:Transforming Growth Factor alpha; D042461:Vascular Endothelial Growth Factor A; D005346:Fibroblast Growth Factors