[Liver regeneration after hepatectomy]

Abstract

It is well known that the normal liver has enormous regenerative capacity. Despite years of effort by numerous investigators, there is still uncertainty about the signals of liver regeneration. Computed tomography (CT) is the most useful tool because it accurately measures human liver volume. Comparing the differences in regeneration after major resection of normal and injured livers, normal livers reached plateau levels within 1 to 2 months regardless of the extent of resection, whereas regeneration was retarded in injured liver. Human liver regeneration is influenced by the extent of resection. In biliary cancer, liver regeneration terminates when the liver has regained about three-quarters of its original size in about 1 year. The clinical significance of the observation that liver regeneration is an incomplete process is unclear. However, the strong correlation observed between body surface area and regenerated liver volume suggests that liver regeneration is a process of restoration of the liver to a volume suitable for body size. In living related-donor liver transplantation there is a tendency for the size of the transplanted liver to converge to the standard liver volume, regardless of whether the initial liver-graft volume was smaller or larger than the standard liver volume.