Morine Yuji, Tsuchida Kunihiro, Sugino Hiromu, Takamura Kazuto, Tashiro Seiki, Shimada Mitsuo
Digestive Surgery, School of Medicine The University of Tokushima, Tokushima, Japan.
Hepatogastroenterology. 2007 Jun;54(76):1216-21.
BACKGROUND/AIMS: We performed a long-term assessment of liver regeneration with or without PVL after massive hepatectomy in similar sized remnant livers to evaluate effects of regenerating livers preactivated by PVL following massive hepatectomy.
Rats were randomly divided into two groups, PVL-88%Hx and sham 88%Hx. As the initial operation, PVL or sham operation was performed by ligation of the portal vein of the left and median lobes or a similar manipulation without ligation, respectively. Four days after PVL, the volume of the posterior caudate lobe (5%) increased approximately two-fold (12%) and was the same size as the whole caudate lobe (12%) in the sham animals. Subsequently, 88%Hx was performed in the two groups.
Survival rates were not significantly different between the two groups. Relative liver weight in PVL-88%Hx group was significantly higher up to 24hr, but after 48hr no significant difference was evident between the two groups. PCNA LI in sham-89%Hx group was significantly higher than that in PVL-88%Hx group after 48hr. The mRNA expression levels of activin A and ActRIIA were significantly higher in PVL-88%Hx group than in sham-88% group at 72 hr.
The regenerating liver preactivated by PVL is restricted late-phase liver regeneration after massive hepatectomy.
背景/目的：我们对在相似大小的残余肝脏中行大规模肝切除术后有或无门静脉结扎（PVL）的肝脏再生进行了长期评估，以评价大规模肝切除术后经PVL预激活的再生肝脏的效果。
将大鼠随机分为两组，即PVL - 88%肝切除组和假手术88%肝切除组。作为初始手术，分别通过结扎左叶和中叶门静脉或进行类似的不结扎操作来实施PVL或假手术。PVL术后4天，尾状叶后叶（5%）的体积增加了约两倍（12%），与假手术动物的整个尾状叶（12%）大小相同。随后，对两组进行88%肝切除术。
两组的生存率无显著差异。PVL - 88%肝切除组的相对肝脏重量在24小时内显著更高，但48小时后两组之间无明显差异。48小时后，假手术 - 89%肝切除组的增殖细胞核抗原标记指数（PCNA LI）显著高于PVL - 88%肝切除组。在72小时时，PVL - 88%肝切除组中激活素A和激活素受体IIA（ActRIIA）的mRNA表达水平显著高于假手术 - 88%组。
PVL预激活的再生肝脏在大规模肝切除术后会限制后期肝脏再生。
