Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
Gewählte Publikation:
Kelm, M.
Induction of Liver Hypertrophy for Major Liver Resections
Humanmedizin; [ Diplomarbeit ] Graz Medical University; 2015. pp.
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- Autor*innen der Med Uni Graz:
- Betreuer*innen:
- Mischinger Hans-Jörg
- Altmetrics:
- Abstract:
- Background: Portal vein embolization (PVE) is well established in cases of functional inoperable liver tumors to induce preoperative liver hypertrophy. Nevertheless, retrospective studies show that liver hypertrophy induced by PVE is inadequate in some cases. Further methods are necessary to improve its effect. Methods: 23 patients who had undergone PVE were evaluated retrospectively. In an experimental study Wistar-rats received portal branch ligation (PBL). In addition some animals received a single subcutaneous application of either rhHGF (10µg/kg) or a combination of rhHGF/EGF/serotonin (5µg/kg; 0.2mg/kg; 1mg/kg). After ten days rat livers were removed and examined macro- and microscopically. Blood and hormone values were evaluated as well. Results: 15 out of 23 patients reached operability through PVE and underwent hemihepatectomy afterwards (58%). For the other patients PVE was inadequate because of insufficient hypertrophy or fast tumor proliferation. In the experimental part, absolute volume of the FLR (future liver remnant) increased in a median by 5.3g (43%) after usual PBL in comparison to the control group. In animals with additional rhHGF or rhHGF/EGF/serotonin application the absolute volume of the FLR showed an increased median of 6.8g and 4.7g which corresponds to a relative volume increase of 45.7% and 47.5%. Discussion: The retrospective part showed that PVE can be inadequate in some cases. In the experimental study, portal branch ligation with additional subcutaneous rhHGF injection showed a considerable greater volume increase of the FLR in comparison to single PBL. Therefore, an additional hormone injection may be able to be a new approach to induce a stronger preoperative liver hypertrophy.