Open AccessSupportive Hepatocyte Transplantation after Partial Hepatectomy Enhances Liver Regeneration in a Preclinical Pig Model
Author(s) -
Felix Oldhafer,
EvaMaria Wittauer,
Oliver Beetz,
Clara A. Weigle,
Lion Sieg,
Hendrik Eismann,
Peter Braubach,
Michael Bock,
Danny Jonigk,
Kai Johanning,
Florian W. R. Vondran
Publication year - 2021
Publication title -
european surgical research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.658
H-Index - 46
eISSN - 1421-9921
pISSN - 0014-312X
DOI - 10.1159/000516690
Subject(s) - hepatectomy , medicine , liver regeneration , liver transplantation , liver function , hepatocyte , liver function tests , transplantation , surgery , urology , gastroenterology , regeneration (biology) , resection , biology , biochemistry , in vitro , microbiology and biotechnology
Background: Hepatocyte transplantation (HTx) is regarded as a potential treatment modality for various liver diseases including acute liver failure. We developed a preclinical pig model to evaluate if HTx could safely support recovery from liver function impairment after partial hepatectomy. Methods: Pigs underwent partial hepatectomy with reduction of the liver volume by 50% to induce a transient but significant impairment of liver function. Thereafter, 2 protocols for HTx were evaluated and compared to a control group receiving liver resection only (group 1, n = 5). Portal pressure-controlled HTx was performed either immediately after surgery (group 2, n = 6) or 3 days postoperatively (group 3, n = 5). In all cases, liver regeneration was monitored by conventional laboratory tests and the novel noninvasive maximum liver function capacity (LiMAx) test with a follow-up of 4 weeks. Results: Partial hepatectomy significantly impaired liver function according to conventional liver function tests as well as LiMAx in all groups. A mean of 4.10 ± 1.1 × 10 8 and 3.82 ± 0.7 × 10 8 hepatocytes were transplanted in groups 2 and 3, respectively. All animals remained stable with respect to vital parameters during and after HTx. The animals in group 2 showed enhanced liver regeneration as observed by mean postoperative LiMAx values (621.5 vs. 331.3 μg/kg/h on postoperative day 7; p < 0.001) whereas HTx in group 3 led to a significant increase in mean liver-specific coagulation factor VII (112.2 vs. 54.0% on postoperative day 7; p = 0.003) compared to controls (group 1), respectively. In both experimental groups, thrombotic material was observed in the portal veins and pulmonary arteries on histology, despite the absence of clinical symptoms. Conclusion: HTx can be performed safely and effectively immediately after a partial (50%) hepatectomy as well as 3 days postoperatively, with comparable results regarding the enhancement of liver function and regeneration.