title: The impact of hepatic steatosis on liver regeneration after partial hepatectomy.
abstract: OBJECTIVE
  Experimental studies in animals have suggested that liver regeneration is impaired in steatotic livers. However, few studies have focused on the impact of steatosis in patients undergoing partial hepatectomy (PH). This study aims to determine the role of steatosis on liver regeneration in humans following PH.
  
  
  METHODS
  Eighty-eight patients undergoing PH were included in this study. All patients underwent CT-scanning of the liver preoperatively and 7 days after surgery. Additional CT-scans were performed 6 months post-operatively. Preoperative and post-operative volumes of the total liver (TLV), future liver remnant (FLR) and liver remnant (LR) were measured on CT-scans. Regeneration indices (RI) were calculated at 7 days and 6 months using the formula: (Volume LR-Volume FLR)/Volume FLR × 100%. Based on histological examination of the resected part of the liver, patients were classified into three groups: (1) no steatosis, (2) mild steatosis (1-29%) and (3) moderate-to-severe steatosis (≥30%).
  
  
  RESULTS
  The early RI (at day 7) was 40%, 24% and 20% for patients in group 1, 2 and 3 respectively. Late RI (at 6 months) was 81% for group 1, 44% for group 2 and 22% for group 3 (P = 0.019). At 7 days, the LR represented 79%, 80% and 79% of the TLV for groups 1-3. At 6 months, this was 93%, 92% and 79% respectively.
  
  
  CONCLUSIONS
  Although early RI after PH did not differ in patients with or without steatosis, the late RI in patients with moderate-to-severe steatosis was lower, suggesting that late liver regeneration is impaired in these patients.
authors: Department of Radiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands. p.g.kele@rad.umcg.nl
authors: Petra G
authors: PG
authors: Kele
authors: Eric J
authors: EJ
authors: van der Jagt
authors: Annette S H
authors: AS
authors: Gouw
authors: Ton
authors: T
authors: Lisman
authors: Robert J
authors: RJ
authors: Porte
authors: Marieke T
authors: MT
authors: de Boer
mesh_terms: D000410:Alanine Transaminase / Q000097:blood; D001219:Aspartate Aminotransferases / Q000097:blood; D001663:Bilirubin; D054893:Cone-Beam Computed Tomography; D005234:Fatty Liver / Q000503:physiopathology*; D006498:Hepatectomy; D006801:Humans; D008115:Liver Regeneration / Q000502:physiology*; D009929:Organ Size; D011517:Prothrombin Time; D012189:Retrospective Studies; D018709:Statistics, Nonparametric; D014057:Tomography, X-Ray Computed
chemical_list: D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase; D001663:Bilirubin