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Erschienen in: Journal of Gastrointestinal Surgery 3/2013

01.03.2013 | Review Article

New Paradigms in Post-hepatectomy Liver Failure

verfasst von: Nicolas Golse, Petru O. Bucur, René Adam, Denis Castaing, Antonio Sa Cunha, Eric Vibert

Erschienen in: Journal of Gastrointestinal Surgery | Ausgabe 3/2013

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Abstract

Introduction

Liver failure after hepatectomy remains the most feared postoperative complication. Many risk factors are already known, related to patient’s comorbidities, underlying liver disease, received treatments and type of resection. Preoperative assessment of functional liver reserve must be a priority for the surgeon.

Methods

Physiopathology of post-hepatectomy liver failure is not comparable to fulminant liver failure. Liver regeneration is an early phenomenon whose cellular mechanisms are beginning to be elucidated and allowing most of the time to quickly recover a functional organ. In some cases, microscopic and macroscopic disorganization appears. The hepatocyte hyperproliferation and the asynchronism between hepatocytes and non-hepatocyte cells mitosis probably play a major role in this pathogenesis.

Results

Many peri- or intra-operative techniques try to prevent the occurrence of this potentially lethal complication, but a better understanding of involved mechanisms might help to completely avoid it, or even to extend the possibilities of resection.

Conclusion

Future prevention and management may include pharmacological slowing of proliferation, drug or physical modulation of portal flow to reduce shear–stress, stem cells or immortalized hepatocytes injection, and liver bioreactors. Everything must be done to avoid the need for transplantation, which remains today the most efficient treatment of liver failure.
Literatur
1.
Zurück zum Zitat Rahbari NN, Garden OJ, Padbury R, et al. Posthepatectomy liver failure: a definition and grading by the International Study Group of Liver Surgery (ISGLS). Surgery. 2011;149(5):713–724.PubMedCrossRef Rahbari NN, Garden OJ, Padbury R, et al. Posthepatectomy liver failure: a definition and grading by the International Study Group of Liver Surgery (ISGLS). Surgery. 2011;149(5):713–724.PubMedCrossRef
2.
Zurück zum Zitat Balzan S, Belghiti J, Farges O, et al. The “50–50 criteria” on postoperative day 5: an accurate predictor of liver failure and death after hepatectomy. Ann Surg. 2005;242(6):824–8, discussion 828–9.PubMedCrossRef Balzan S, Belghiti J, Farges O, et al. The “50–50 criteria” on postoperative day 5: an accurate predictor of liver failure and death after hepatectomy. Ann Surg. 2005;242(6):824–8, discussion 828–9.PubMedCrossRef
3.
Zurück zum Zitat Mullen JT, Ribero D, Reddy SK, et al. Hepatic insufficiency and mortality in 1,059 noncirrhotic patients undergoing major hepatectomy. J Am Coll Surg. 2007;204(5):854–862.PubMedCrossRef Mullen JT, Ribero D, Reddy SK, et al. Hepatic insufficiency and mortality in 1,059 noncirrhotic patients undergoing major hepatectomy. J Am Coll Surg. 2007;204(5):854–862.PubMedCrossRef
4.
Zurück zum Zitat Shawcross D, Jalan R. The pathophysiologic basis of hepatic encephalopathy: central role for ammonia and inflammation. Cell. Mol. Life Sci. 2005;62(19–20):2295–2304.PubMedCrossRef Shawcross D, Jalan R. The pathophysiologic basis of hepatic encephalopathy: central role for ammonia and inflammation. Cell. Mol. Life Sci. 2005;62(19–20):2295–2304.PubMedCrossRef
5.
Zurück zum Zitat Rivers E, Nguyen B, Havstad S, et al. Early goal-directed therapy in the treatment of severe sepsis and septic shock. N Engl J Med. 2001;345(19):1368–1377.PubMedCrossRef Rivers E, Nguyen B, Havstad S, et al. Early goal-directed therapy in the treatment of severe sepsis and septic shock. N Engl J Med. 2001;345(19):1368–1377.PubMedCrossRef
6.
Zurück zum Zitat Sun H-C, Qin L-X, Wang L, et al. Risk factors for postoperative complications after liver resection. HBPD INT. 2005;4(3):370–374.PubMed Sun H-C, Qin L-X, Wang L, et al. Risk factors for postoperative complications after liver resection. HBPD INT. 2005;4(3):370–374.PubMed
7.
Zurück zum Zitat Virani S, Michaelson JS, Hutter MM, et al. Morbidity and mortality after liver resection: results of the patient safety in surgery study. J Am Coll Surg. 2007;204(6):1284–1292.PubMedCrossRef Virani S, Michaelson JS, Hutter MM, et al. Morbidity and mortality after liver resection: results of the patient safety in surgery study. J Am Coll Surg. 2007;204(6):1284–1292.PubMedCrossRef
8.
Zurück zum Zitat House MG, Ito H, Gönen M, et al. Survival after hepatic resection for metastatic colorectal cancer: trends in outcomes for 1,600 patients during two decades at a single institution. J Am Coll Surg. 2010;210(5):744–52, 752–5.PubMedCrossRef House MG, Ito H, Gönen M, et al. Survival after hepatic resection for metastatic colorectal cancer: trends in outcomes for 1,600 patients during two decades at a single institution. J Am Coll Surg. 2010;210(5):744–52, 752–5.PubMedCrossRef
9.
Zurück zum Zitat Hammond JS, Guha IN, Beckingham IJ, Lobo DN. Prediction, prevention and management of postresection liver failure. Br J Surg. 2011;98(9):1188–1200.PubMedCrossRef Hammond JS, Guha IN, Beckingham IJ, Lobo DN. Prediction, prevention and management of postresection liver failure. Br J Surg. 2011;98(9):1188–1200.PubMedCrossRef
10.
Zurück zum Zitat Little SA, Jarnagin WR, DeMatteo RP, Blumgart LH, Fong Y. Diabetes is associated with increased perioperative mortality but equivalent long-term outcome after hepatic resection for colorectal cancer. J Gastrointest Surg. 2002;6(1):88–94.PubMedCrossRef Little SA, Jarnagin WR, DeMatteo RP, Blumgart LH, Fong Y. Diabetes is associated with increased perioperative mortality but equivalent long-term outcome after hepatic resection for colorectal cancer. J Gastrointest Surg. 2002;6(1):88–94.PubMedCrossRef
11.
12.
Zurück zum Zitat Cucchetti A, Cescon M, Ercolani G, Di Gioia P, Peri E, Pinna AD. Safety of hepatic resection in overweight and obese patients with cirrhosis. Br J Surg. 2011;98(8):1147–1154.PubMedCrossRef Cucchetti A, Cescon M, Ercolani G, Di Gioia P, Peri E, Pinna AD. Safety of hepatic resection in overweight and obese patients with cirrhosis. Br J Surg. 2011;98(8):1147–1154.PubMedCrossRef
13.
Zurück zum Zitat Santibañes E, Alvarez FA, Ardiles V. How to avoid postoperative liver failure: a novel method. World J Surg. 2011;36(1):125–128.CrossRef Santibañes E, Alvarez FA, Ardiles V. How to avoid postoperative liver failure: a novel method. World J Surg. 2011;36(1):125–128.CrossRef
14.
Zurück zum Zitat Breitenstein S, Apestegui C, Petrowsky H, Clavien P-A. “State of the art” in liver resection and living donor liver transplantation: a worldwide survey of 100 liver centers. World J Surg. 2009;33(4):797–803.PubMedCrossRef Breitenstein S, Apestegui C, Petrowsky H, Clavien P-A. “State of the art” in liver resection and living donor liver transplantation: a worldwide survey of 100 liver centers. World J Surg. 2009;33(4):797–803.PubMedCrossRef
15.
Zurück zum Zitat Kishi Y, Abdalla EK, Chun YS, et al. Three hundred and one consecutive extended right hepatectomies. Transactions of the Meeting of the American Surgical Association. 2009;127:171–179.CrossRef Kishi Y, Abdalla EK, Chun YS, et al. Three hundred and one consecutive extended right hepatectomies. Transactions of the Meeting of the American Surgical Association. 2009;127:171–179.CrossRef
16.
Zurück zum Zitat Truant S, Oberlin O, Sergent G, et al. Remnant liver volume to body weight ratio ≥0.5%: a new cut-off to estimate postoperative risks after extended resection in noncirrhotic liver. J Am Coll Surg. 2007;204(1):22–33.PubMedCrossRef Truant S, Oberlin O, Sergent G, et al. Remnant liver volume to body weight ratio ≥0.5%: a new cut-off to estimate postoperative risks after extended resection in noncirrhotic liver. J Am Coll Surg. 2007;204(1):22–33.PubMedCrossRef
17.
Zurück zum Zitat Li C, Mi K, Wen T-F, Yan L-N, Li B. Safety of patients with a graft to body weight ratio less than 0.8% in living donor liver transplantation using right hepatic lobe without middle hepatic vein. Hepatogastroenterology. 2012;59(114):469–472.PubMedCrossRef Li C, Mi K, Wen T-F, Yan L-N, Li B. Safety of patients with a graft to body weight ratio less than 0.8% in living donor liver transplantation using right hepatic lobe without middle hepatic vein. Hepatogastroenterology. 2012;59(114):469–472.PubMedCrossRef
18.
Zurück zum Zitat Hemming AW, Scudamore CH, Shackleton CR, Pudek M, Erb SR. Indocyanine green clearance as a predictor of successful hepatic resection in cirrhotic patients. Am J Surg. 1992;163(5):515–518.PubMedCrossRef Hemming AW, Scudamore CH, Shackleton CR, Pudek M, Erb SR. Indocyanine green clearance as a predictor of successful hepatic resection in cirrhotic patients. Am J Surg. 1992;163(5):515–518.PubMedCrossRef
19.
Zurück zum Zitat Yamanaka N, Okamoto E, Kawamura E, et al. Dynamics of normal and injured human liver regeneration after hepatectomy as assessed on the basis of computed tomography and liver function. Hepatology. 1993;18(1):79–85.PubMedCrossRef Yamanaka N, Okamoto E, Kawamura E, et al. Dynamics of normal and injured human liver regeneration after hepatectomy as assessed on the basis of computed tomography and liver function. Hepatology. 1993;18(1):79–85.PubMedCrossRef
20.
Zurück zum Zitat Cucchetti A, Ercolani G, Vivarelli M, et al. Is portal hypertension a contraindication to hepatic resection? Ann Surg. 2009;250(6):922–928.PubMedCrossRef Cucchetti A, Ercolani G, Vivarelli M, et al. Is portal hypertension a contraindication to hepatic resection? Ann Surg. 2009;250(6):922–928.PubMedCrossRef
21.
Zurück zum Zitat Capussotti L, Ferrero A, Viganò L, Muratore A, Polastri R, Bouzari H. Portal Hypertension: contraindication to liver surgery? World J Surg. 2006;30(6):992–999.PubMedCrossRef Capussotti L, Ferrero A, Viganò L, Muratore A, Polastri R, Bouzari H. Portal Hypertension: contraindication to liver surgery? World J Surg. 2006;30(6):992–999.PubMedCrossRef
22.
Zurück zum Zitat Cucchetti A, Ercolani G, Vivarelli M, et al. Impact of model for end-stage liver disease (MELD) score on prognosis after hepatectomy for hepatocellular carcinoma on cirrhosis. Liver Transpl. 2006;12(6):966–971.PubMedCrossRef Cucchetti A, Ercolani G, Vivarelli M, et al. Impact of model for end-stage liver disease (MELD) score on prognosis after hepatectomy for hepatocellular carcinoma on cirrhosis. Liver Transpl. 2006;12(6):966–971.PubMedCrossRef
23.
Zurück zum Zitat Scheingraber S, Richter S, Igna D, Flesch S, Kopp B, Schilling MK. Indocyanine green disappearance rate is the most useful marker for liver resection. Hepatogastroenterology. 2008;55(85):1394–1399.PubMed Scheingraber S, Richter S, Igna D, Flesch S, Kopp B, Schilling MK. Indocyanine green disappearance rate is the most useful marker for liver resection. Hepatogastroenterology. 2008;55(85):1394–1399.PubMed
24.
Zurück zum Zitat Makuuchi M, Kokudo N, Arii S, et al. Development of evidence-based clinical guidelines for the diagnosis and treatment of hepatocellular carcinoma in Japan. Hepatol Res. 2008;38(1):37–51.PubMedCrossRef Makuuchi M, Kokudo N, Arii S, et al. Development of evidence-based clinical guidelines for the diagnosis and treatment of hepatocellular carcinoma in Japan. Hepatol Res. 2008;38(1):37–51.PubMedCrossRef
25.
Zurück zum Zitat Stockmann M, Lock JF, Riecke B, et al. Prediction of postoperative outcome after hepatectomy with a new bedside test for maximal liver function capacity. Ann Surg. 2009;250(1):119–125.PubMedCrossRef Stockmann M, Lock JF, Riecke B, et al. Prediction of postoperative outcome after hepatectomy with a new bedside test for maximal liver function capacity. Ann Surg. 2009;250(1):119–125.PubMedCrossRef
26.
Zurück zum Zitat Bruix J, Castells A, Bosch J, et al. Surgical resection of hepatocellular carcinoma in cirrhotic patients: prognostic value of preoperative portal pressure. Gastroenterology. 1996;111(4):1018–1022.PubMedCrossRef Bruix J, Castells A, Bosch J, et al. Surgical resection of hepatocellular carcinoma in cirrhotic patients: prognostic value of preoperative portal pressure. Gastroenterology. 1996;111(4):1018–1022.PubMedCrossRef
27.
Zurück zum Zitat Lim C, Farges O. Portal vein occlusion before major hepatectomy in patients with colorectal liver metastases: rationale, indications, technical aspects, complications and outcome. J Visc Surg. 2012. Lim C, Farges O. Portal vein occlusion before major hepatectomy in patients with colorectal liver metastases: rationale, indications, technical aspects, complications and outcome. J Visc Surg. 2012.
28.
Zurück zum Zitat Farges O, Belghiti J, Kianmanesh R, et al. Portal vein embolization before right hepatectomy: prospective clinical trial. Ann Surg. 2003;237(2):208–217.PubMed Farges O, Belghiti J, Kianmanesh R, et al. Portal vein embolization before right hepatectomy: prospective clinical trial. Ann Surg. 2003;237(2):208–217.PubMed
29.
Zurück zum Zitat Makuuchi M, Kosuge T, Takayama T, et al. Surgery for small liver cancers. Semin Surg Oncol. 1993;9(4):298–304.PubMedCrossRef Makuuchi M, Kosuge T, Takayama T, et al. Surgery for small liver cancers. Semin Surg Oncol. 1993;9(4):298–304.PubMedCrossRef
30.
Zurück zum Zitat Seyama Y, Kokudo N. Assessment of liver function for safe hepatic resection. Hepatology Research. 2009;39(2):107–116.PubMedCrossRef Seyama Y, Kokudo N. Assessment of liver function for safe hepatic resection. Hepatology Research. 2009;39(2):107–116.PubMedCrossRef
31.
Zurück zum Zitat Das BC, Isaji S, Kawarada Y. Analysis of 100 consecutive hepatectomies: risk factors in patients with liver cirrhosis or obstructive jaundice. World J Surg. 2001;25(3):266–273.PubMedCrossRef Das BC, Isaji S, Kawarada Y. Analysis of 100 consecutive hepatectomies: risk factors in patients with liver cirrhosis or obstructive jaundice. World J Surg. 2001;25(3):266–273.PubMedCrossRef
32.
Zurück zum Zitat Makino H, Shimizu H, Ito H, et al. Changes in growth factor and cytokine expression in biliary obstructed rat liver and their relationship with delayed liver regeneration after partial hepatectomy. World J Gastroenterol. 2006;12(13):2053–2059.PubMed Makino H, Shimizu H, Ito H, et al. Changes in growth factor and cytokine expression in biliary obstructed rat liver and their relationship with delayed liver regeneration after partial hepatectomy. World J Gastroenterol. 2006;12(13):2053–2059.PubMed
33.
Zurück zum Zitat Nakano K, Chijiiwa K, Tanaka M. Lower activity of CCAAT/enhancer-binding protein and expression of cyclin E, but not cyclin D1, activating protein-1 and p21(WAF1), after partial hepatectomy in obstructive jaundice. Biochemical and Biophysical Research Communications. 2001;280(3):640–645.PubMedCrossRef Nakano K, Chijiiwa K, Tanaka M. Lower activity of CCAAT/enhancer-binding protein and expression of cyclin E, but not cyclin D1, activating protein-1 and p21(WAF1), after partial hepatectomy in obstructive jaundice. Biochemical and Biophysical Research Communications. 2001;280(3):640–645.PubMedCrossRef
34.
Zurück zum Zitat Sano T, Ajiki T, Takeyama Y, Kuroda Y. Internal biliary drainage improves decreased number of gut mucosal T lymphocytes and MAdCAM-1 expression in jaundiced rats. Surgery. 2004;136(3):693–699.PubMedCrossRef Sano T, Ajiki T, Takeyama Y, Kuroda Y. Internal biliary drainage improves decreased number of gut mucosal T lymphocytes and MAdCAM-1 expression in jaundiced rats. Surgery. 2004;136(3):693–699.PubMedCrossRef
35.
Zurück zum Zitat Kamiya S, Nagino M, Kanazawa H, et al. The value of bile replacement during external biliary drainage: an analysis of intestinal permeability, integrity, and microflora. Ann Surg. 2004;239(4):510–517.PubMedCrossRef Kamiya S, Nagino M, Kanazawa H, et al. The value of bile replacement during external biliary drainage: an analysis of intestinal permeability, integrity, and microflora. Ann Surg. 2004;239(4):510–517.PubMedCrossRef
36.
Zurück zum Zitat Iyomasa S, Terasaki M, Kuriki H, et al. Decrease in regeneration capacity of rat liver after external biliary drainage. Eur Surg Res. 1992;24(5):265–272.PubMedCrossRef Iyomasa S, Terasaki M, Kuriki H, et al. Decrease in regeneration capacity of rat liver after external biliary drainage. Eur Surg Res. 1992;24(5):265–272.PubMedCrossRef
37.
Zurück zum Zitat Seifalian AM, Piasecki C, Agarwal A, Davidson BR. The effect of graded steatosis on flow in the hepatic parenchymal microcirculation. Transplantation. 1999;68(6):780–784.PubMedCrossRef Seifalian AM, Piasecki C, Agarwal A, Davidson BR. The effect of graded steatosis on flow in the hepatic parenchymal microcirculation. Transplantation. 1999;68(6):780–784.PubMedCrossRef
38.
Zurück zum Zitat Serafín A, Roselló-Catafau J, Prats N, Xaus C, Gelpí E, Peralta C. Ischemic preconditioning increases the tolerance of Fatty liver to hepatic ischemia–reperfusion injury in the rat. Am J Pathol. 2002;161(2):587–601.PubMedCrossRef Serafín A, Roselló-Catafau J, Prats N, Xaus C, Gelpí E, Peralta C. Ischemic preconditioning increases the tolerance of Fatty liver to hepatic ischemia–reperfusion injury in the rat. Am J Pathol. 2002;161(2):587–601.PubMedCrossRef
39.
Zurück zum Zitat Rubbia-Brandt L, Mentha G, Terris B. Sinusoidal obstruction syndrome is a major feature of hepatic lesions associated with oxaliplatin neoadjuvant chemotherapy for liver colorectal metastases. J Am Coll Surg. 2006;202(1):199–200.PubMedCrossRef Rubbia-Brandt L, Mentha G, Terris B. Sinusoidal obstruction syndrome is a major feature of hepatic lesions associated with oxaliplatin neoadjuvant chemotherapy for liver colorectal metastases. J Am Coll Surg. 2006;202(1):199–200.PubMedCrossRef
40.
Zurück zum Zitat Fong Y, Bentrem DJ. CASH (Chemotherapy-Associated Steatohepatitis) costs. Ann Surg. 2006;243(1):8–9.PubMedCrossRef Fong Y, Bentrem DJ. CASH (Chemotherapy-Associated Steatohepatitis) costs. Ann Surg. 2006;243(1):8–9.PubMedCrossRef
41.
Zurück zum Zitat Rubbia-Brandt L. Hepatic lesions induced by systemic chemotherapy for digestive cancer. Ann Pathol. 2010;30(6):421–425.PubMedCrossRef Rubbia-Brandt L. Hepatic lesions induced by systemic chemotherapy for digestive cancer. Ann Pathol. 2010;30(6):421–425.PubMedCrossRef
42.
Zurück zum Zitat Soubrane O, Brouquet A, Zalinski S, et al. Predicting high grade lesions of sinusoidal obstruction syndrome related to oxaliplatin-based chemotherapy for colorectal liver metastases: correlation with post-hepatectomy outcome. Ann Surg. 2010;251(3):454–460.PubMedCrossRef Soubrane O, Brouquet A, Zalinski S, et al. Predicting high grade lesions of sinusoidal obstruction syndrome related to oxaliplatin-based chemotherapy for colorectal liver metastases: correlation with post-hepatectomy outcome. Ann Surg. 2010;251(3):454–460.PubMedCrossRef
43.
Zurück zum Zitat Overman MJ, Maru DM, Charnsangavej C, et al. Oxaliplatin-mediated increase in spleen size as a biomarker for the development of hepatic sinusoidal injury. J Clin Oncol. 2010;28(15):2549–2555.PubMedCrossRef Overman MJ, Maru DM, Charnsangavej C, et al. Oxaliplatin-mediated increase in spleen size as a biomarker for the development of hepatic sinusoidal injury. J Clin Oncol. 2010;28(15):2549–2555.PubMedCrossRef
44.
Zurück zum Zitat Aloia T, Sebagh M, Plasse M, et al. Liver histology and surgical outcomes after preoperative chemotherapy with fluorouracil plus oxaliplatin in colorectal cancer liver metastases. J Clin Oncol. 2006;24(31):4983–4990.PubMedCrossRef Aloia T, Sebagh M, Plasse M, et al. Liver histology and surgical outcomes after preoperative chemotherapy with fluorouracil plus oxaliplatin in colorectal cancer liver metastases. J Clin Oncol. 2006;24(31):4983–4990.PubMedCrossRef
45.
Zurück zum Zitat Karoui M, Penna C, Amin-Hashem M, et al. influence of preoperative chemotherapy on the risk of major hepatectomy for colorectal liver metastases. Ann Surg. 2006;243(1):1–7.PubMedCrossRef Karoui M, Penna C, Amin-Hashem M, et al. influence of preoperative chemotherapy on the risk of major hepatectomy for colorectal liver metastases. Ann Surg. 2006;243(1):1–7.PubMedCrossRef
46.
Zurück zum Zitat Soriano PA, Liu N, Castillo E, et al. Oxaliplatin but not irinotecan impairs posthepatectomy liver regeneration in a murine model. International Journal of Hepatology. 2011;2011:1–6.CrossRef Soriano PA, Liu N, Castillo E, et al. Oxaliplatin but not irinotecan impairs posthepatectomy liver regeneration in a murine model. International Journal of Hepatology. 2011;2011:1–6.CrossRef
47.
Zurück zum Zitat Schiffer E, Frossard J-L, Rubbia-Brandt L, Mentha G, Pastor CM. Hepatic regeneration is decreased in a rat model of sinusoidal obstruction syndrome. J Surg Oncol. 2009;99(7):439–446.PubMedCrossRef Schiffer E, Frossard J-L, Rubbia-Brandt L, Mentha G, Pastor CM. Hepatic regeneration is decreased in a rat model of sinusoidal obstruction syndrome. J Surg Oncol. 2009;99(7):439–446.PubMedCrossRef
48.
Zurück zum Zitat Nafidi O, Désy D, Létourneau R, et al. Hypertrophy of the non-embolized liver after chemotherapy. HPB (Oxford). 2009;11(2):103–107.CrossRef Nafidi O, Désy D, Létourneau R, et al. Hypertrophy of the non-embolized liver after chemotherapy. HPB (Oxford). 2009;11(2):103–107.CrossRef
49.
Zurück zum Zitat Vauthey JN. chemotherapy regimen predicts steatohepatitis and an increase in 90-day mortality after surgery for hepatic colorectal metastases. Journal of Clinical Oncology. 2006;24(13):2065–2072.PubMedCrossRef Vauthey JN. chemotherapy regimen predicts steatohepatitis and an increase in 90-day mortality after surgery for hepatic colorectal metastases. Journal of Clinical Oncology. 2006;24(13):2065–2072.PubMedCrossRef
50.
Zurück zum Zitat Hora C, Romanque P, Dufour J-FF. Effect of sorafenib on murine liver regeneration. Hepatology. 2011;53(2):577–586.PubMedCrossRef Hora C, Romanque P, Dufour J-FF. Effect of sorafenib on murine liver regeneration. Hepatology. 2011;53(2):577–586.PubMedCrossRef
51.
Zurück zum Zitat Van Cutsem E, Köhne C-H, Hitre E, et al. Cetuximab and chemotherapy as initial treatment for metastatic colorectal cancer. N Engl J Med. 2009;360(14):1408–1417.PubMedCrossRef Van Cutsem E, Köhne C-H, Hitre E, et al. Cetuximab and chemotherapy as initial treatment for metastatic colorectal cancer. N Engl J Med. 2009;360(14):1408–1417.PubMedCrossRef
52.
Zurück zum Zitat Zorzi D, Chun YS, Madoff DC, Abdalla EK, Vauthey J-N. Chemotherapy with bevacizumab does not affect liver regeneration after portal vein embolization in the treatment of colorectal liver metastases. Ann Surg Oncol. 2008;15(10):2765–2772.PubMedCrossRef Zorzi D, Chun YS, Madoff DC, Abdalla EK, Vauthey J-N. Chemotherapy with bevacizumab does not affect liver regeneration after portal vein embolization in the treatment of colorectal liver metastases. Ann Surg Oncol. 2008;15(10):2765–2772.PubMedCrossRef
53.
Zurück zum Zitat Klinger M, Eipeldauer S, Hacker S, et al. Bevacizumab protects against sinusoidal obstruction syndrome and does not increase response rate in neoadjuvant XELOX/FOLFOX therapy of colorectal cancer liver metastases. Eur J Surg Oncol. 2009;35(5):515–520.PubMedCrossRef Klinger M, Eipeldauer S, Hacker S, et al. Bevacizumab protects against sinusoidal obstruction syndrome and does not increase response rate in neoadjuvant XELOX/FOLFOX therapy of colorectal cancer liver metastases. Eur J Surg Oncol. 2009;35(5):515–520.PubMedCrossRef
54.
Zurück zum Zitat Rice GC, Leiberman DP, Mathie RT, Ryan CJ, Harper AM, Blumgart LH. Liver tissue blood flow measured by 85Kr clearance in the anaesthetized rat before and after partial hepatectomy. Br J Exp Pathol. 1977;58(3):243–250.PubMed Rice GC, Leiberman DP, Mathie RT, Ryan CJ, Harper AM, Blumgart LH. Liver tissue blood flow measured by 85Kr clearance in the anaesthetized rat before and after partial hepatectomy. Br J Exp Pathol. 1977;58(3):243–250.PubMed
55.
Zurück zum Zitat Schoen JM, Wang HH, Minuk GY, Lautt WW. Shear stress-induced nitric oxide release triggers the liver regeneration cascade. Nitric Oxide. 2001;5(5):453–464.PubMedCrossRef Schoen JM, Wang HH, Minuk GY, Lautt WW. Shear stress-induced nitric oxide release triggers the liver regeneration cascade. Nitric Oxide. 2001;5(5):453–464.PubMedCrossRef
56.
Zurück zum Zitat Cantré D, Schuett H, Hildebrandt A, et al. Nitric oxide reduces organ injury and enhances regeneration of reduced-size livers by increasing hepatic arterial flow. Br J Surg. 2008;95(6):785–792.PubMedCrossRef Cantré D, Schuett H, Hildebrandt A, et al. Nitric oxide reduces organ injury and enhances regeneration of reduced-size livers by increasing hepatic arterial flow. Br J Surg. 2008;95(6):785–792.PubMedCrossRef
57.
Zurück zum Zitat Fausto N. Involvement of the innate immune system in liver regeneration and injury. J Hepatol. 2006;45(3):347–349.PubMedCrossRef Fausto N. Involvement of the innate immune system in liver regeneration and injury. J Hepatol. 2006;45(3):347–349.PubMedCrossRef
58.
Zurück zum Zitat Mortensen KE, Conley LN, Nygaard I, et al. Increased sinusoidal flow is not the primary stimulus to liver regeneration. Comp Hepatol. 2010;9:2.PubMedCrossRef Mortensen KE, Conley LN, Nygaard I, et al. Increased sinusoidal flow is not the primary stimulus to liver regeneration. Comp Hepatol. 2010;9:2.PubMedCrossRef
59.
Zurück zum Zitat Di Domenico S, Santori G, Traverso N, et al. Early effects of portal flow modulation after extended liver resection in rat. Dig Liver Dis. 2011;43(10):814–822.PubMedCrossRef Di Domenico S, Santori G, Traverso N, et al. Early effects of portal flow modulation after extended liver resection in rat. Dig Liver Dis. 2011;43(10):814–822.PubMedCrossRef
61.
Zurück zum Zitat Tu Z, Bozorgzadeh A, Pierce RH, Kurtis J, Crispe IN, Orloff MS. TLR-dependent cross talk between human Kupffer cells and NK cells. J. Exp. Med. 2008;205(1):233–244.PubMedCrossRef Tu Z, Bozorgzadeh A, Pierce RH, Kurtis J, Crispe IN, Orloff MS. TLR-dependent cross talk between human Kupffer cells and NK cells. J. Exp. Med. 2008;205(1):233–244.PubMedCrossRef
62.
Zurück zum Zitat Jin X, Zimmers TA, Perez EA, Pierce RH, Zhang Z, Koniaris LG. Paradoxical effects of short- and long-term interleukin-6 exposure on liver injury and repair. Hepatology. 2006;43(3):474–484.PubMedCrossRef Jin X, Zimmers TA, Perez EA, Pierce RH, Zhang Z, Koniaris LG. Paradoxical effects of short- and long-term interleukin-6 exposure on liver injury and repair. Hepatology. 2006;43(3):474–484.PubMedCrossRef
63.
Zurück zum Zitat Ryan CJ, Guest J, Harper AM, Blumgart LH. Liver blood flow measurements in the portacavally transposed rat before and after partial hepatectomy. Br J Exp Pathol. 1978;59(2):111–115.PubMed Ryan CJ, Guest J, Harper AM, Blumgart LH. Liver blood flow measurements in the portacavally transposed rat before and after partial hepatectomy. Br J Exp Pathol. 1978;59(2):111–115.PubMed
64.
Zurück zum Zitat Ding B-S, Nolan DJ, Butler JM, et al. Inductive angiocrine signals from sinusoidal endothelium are required for liver regeneration. Nature. 2010;468(7321):310–315.PubMedCrossRef Ding B-S, Nolan DJ, Butler JM, et al. Inductive angiocrine signals from sinusoidal endothelium are required for liver regeneration. Nature. 2010;468(7321):310–315.PubMedCrossRef
65.
Zurück zum Zitat Matsumoto K, Yoshitomi H, Rossant J, Zaret KS. Liver organogenesis promoted by endothelial cells prior to vascular function. Science. 2001;294(5542):559–563.PubMedCrossRef Matsumoto K, Yoshitomi H, Rossant J, Zaret KS. Liver organogenesis promoted by endothelial cells prior to vascular function. Science. 2001;294(5542):559–563.PubMedCrossRef
66.
Zurück zum Zitat LeCouter J, Moritz DR, Li B, et al. Angiogenesis-independent endothelial protection of liver: role of VEGFR-1. Science. 2003;299(5608):890–893.PubMedCrossRef LeCouter J, Moritz DR, Li B, et al. Angiogenesis-independent endothelial protection of liver: role of VEGFR-1. Science. 2003;299(5608):890–893.PubMedCrossRef
67.
Zurück zum Zitat Hoehme S, Brulport M, Bauer A, et al. Prediction and validation of cell alignment along microvessels as order principle to restore tissue architecture in liver regeneration. Proceedings of the National Academy of Sciences. 2010;107(23):10371–10376.CrossRef Hoehme S, Brulport M, Bauer A, et al. Prediction and validation of cell alignment along microvessels as order principle to restore tissue architecture in liver regeneration. Proceedings of the National Academy of Sciences. 2010;107(23):10371–10376.CrossRef
68.
Zurück zum Zitat Myronovych A, Murata S, Chiba M, et al. Role of platelets on liver regeneration after 90% hepatectomy in mice. J Hepatol. 2008;49(3):363–372.PubMedCrossRef Myronovych A, Murata S, Chiba M, et al. Role of platelets on liver regeneration after 90% hepatectomy in mice. J Hepatol. 2008;49(3):363–372.PubMedCrossRef
69.
Zurück zum Zitat Lesurtel M, Graf R, Aleil B, et al. Platelet-derived serotonin mediates liver regeneration. Science. 2006;312(5770):104–107.PubMedCrossRef Lesurtel M, Graf R, Aleil B, et al. Platelet-derived serotonin mediates liver regeneration. Science. 2006;312(5770):104–107.PubMedCrossRef
70.
Zurück zum Zitat Kawasaki T, Murata S, Takahashi K, et al. Activation of human liver sinusoidal endothelial cell by human platelets induces hepatocyte proliferation. J Hepatol. 2010;53(4):648–654.PubMedCrossRef Kawasaki T, Murata S, Takahashi K, et al. Activation of human liver sinusoidal endothelial cell by human platelets induces hepatocyte proliferation. J Hepatol. 2010;53(4):648–654.PubMedCrossRef
71.
Zurück zum Zitat Tian Y, Graf R, El-Badry AM, et al. Activation of serotonin receptor-2B rescues small-for-size liver graft failure in mice. Hepatology. 2011;53(1):253–262.PubMedCrossRef Tian Y, Graf R, El-Badry AM, et al. Activation of serotonin receptor-2B rescues small-for-size liver graft failure in mice. Hepatology. 2011;53(1):253–262.PubMedCrossRef
72.
Zurück zum Zitat Taub R. Liver regeneration: from myth to mechanism. Nat. Rev. Mol. Cell Biol. 2004;5(10):836–847.PubMedCrossRef Taub R. Liver regeneration: from myth to mechanism. Nat. Rev. Mol. Cell Biol. 2004;5(10):836–847.PubMedCrossRef
73.
Zurück zum Zitat Sakamoto T, Liu Z, Murase N, et al. Mitosis and apoptosis in the liver of interleukin-6-deficient mice after partial hepatectomy. Hepatology. 1999;29(2):403–411.PubMedCrossRef Sakamoto T, Liu Z, Murase N, et al. Mitosis and apoptosis in the liver of interleukin-6-deficient mice after partial hepatectomy. Hepatology. 1999;29(2):403–411.PubMedCrossRef
74.
Zurück zum Zitat Wack K. Sinusoidal ultrastructure evaluated during the revascularization of regenerating rat liver. Hepatology. 2001;33(2):363–378.PubMedCrossRef Wack K. Sinusoidal ultrastructure evaluated during the revascularization of regenerating rat liver. Hepatology. 2001;33(2):363–378.PubMedCrossRef
75.
Zurück zum Zitat Mars WM, Kim TH, Stolz DB, Liu ML, Michalopoulos GK. Presence of urokinase in serum-free primary rat hepatocyte cultures and its role in activating hepatocyte growth factor. Cancer Res. 1996;56(12):2837–2843.PubMed Mars WM, Kim TH, Stolz DB, Liu ML, Michalopoulos GK. Presence of urokinase in serum-free primary rat hepatocyte cultures and its role in activating hepatocyte growth factor. Cancer Res. 1996;56(12):2837–2843.PubMed
76.
Zurück zum Zitat Nagasue N, Yukaya H, Ogawa Y, Kohno H, Nakamura T. Human liver regeneration after major hepatic resection. A study of normal liver and livers with chronic hepatitis and cirrhosis. Ann Surg. 1987;206(1):30–39.PubMedCrossRef Nagasue N, Yukaya H, Ogawa Y, Kohno H, Nakamura T. Human liver regeneration after major hepatic resection. A study of normal liver and livers with chronic hepatitis and cirrhosis. Ann Surg. 1987;206(1):30–39.PubMedCrossRef
77.
Zurück zum Zitat Kahn D, van Hoorn-Hickman R, Terblanche J. Liver blood flow after partial hepatectomy in the pig. J Surg Res. 1984;37(4):290–294.PubMedCrossRef Kahn D, van Hoorn-Hickman R, Terblanche J. Liver blood flow after partial hepatectomy in the pig. J Surg Res. 1984;37(4):290–294.PubMedCrossRef
78.
Zurück zum Zitat Yamazaki O, Sakai K, Kinoshita H, et al. Measurement of the portal blood flow in man by continuous local thermodilution method: II. Portal hemodynamics before and after hepatectomy. Nihon Geka Gakkai Zasshi. 1986;87(7):743–753.PubMed Yamazaki O, Sakai K, Kinoshita H, et al. Measurement of the portal blood flow in man by continuous local thermodilution method: II. Portal hemodynamics before and after hepatectomy. Nihon Geka Gakkai Zasshi. 1986;87(7):743–753.PubMed
79.
Zurück zum Zitat Lin PW. Hemodynamic changes after hepatectomy in rats studied with radioactive microspheres. J. Formos. Med. Assoc. 1990;89(3):177–181.PubMed Lin PW. Hemodynamic changes after hepatectomy in rats studied with radioactive microspheres. J. Formos. Med. Assoc. 1990;89(3):177–181.PubMed
80.
Zurück zum Zitat Eipel C, Abshagen K, Ritter J, Cantré D, Menger MD, Vollmar B. Splenectomy improves survival by increasing arterial blood supply in a rat model of reduced-size liver. Transpl Int. 2010;23(10):998–1007.PubMedCrossRef Eipel C, Abshagen K, Ritter J, Cantré D, Menger MD, Vollmar B. Splenectomy improves survival by increasing arterial blood supply in a rat model of reduced-size liver. Transpl Int. 2010;23(10):998–1007.PubMedCrossRef
81.
Zurück zum Zitat Simon-Santamaria J, Malovic I, Warren A, et al. Age-related changes in scavenger receptor-mediated endocytosis in rat liver sinusoidal endothelial cells. The Journals of Gerontology Series A: Biological Sciences and Medical Sciences. 2010;65A(9):951–960.CrossRef Simon-Santamaria J, Malovic I, Warren A, et al. Age-related changes in scavenger receptor-mediated endocytosis in rat liver sinusoidal endothelial cells. The Journals of Gerontology Series A: Biological Sciences and Medical Sciences. 2010;65A(9):951–960.CrossRef
82.
Zurück zum Zitat Le Couteur DG, Warren A, Cogger VC, et al. Old age and the hepatic sinusoid. Anat Rec. 2008;291(6):672–683.CrossRef Le Couteur DG, Warren A, Cogger VC, et al. Old age and the hepatic sinusoid. Anat Rec. 2008;291(6):672–683.CrossRef
83.
Zurück zum Zitat Panis Y, McMullan DM, Emond JC. Progressive necrosis after hepatectomy and the pathophysiology of liver failure after massive resection. Surgery. 1997;121(2):142–149.PubMedCrossRef Panis Y, McMullan DM, Emond JC. Progressive necrosis after hepatectomy and the pathophysiology of liver failure after massive resection. Surgery. 1997;121(2):142–149.PubMedCrossRef
84.
Zurück zum Zitat Ninomiya M, Shirabe K, Terashi T, et al. Deceleration of regenerative response improves the outcome of rat with massive hepatectomy. Am J Transplant. 2010;10(7):1580–1587.PubMedCrossRef Ninomiya M, Shirabe K, Terashi T, et al. Deceleration of regenerative response improves the outcome of rat with massive hepatectomy. Am J Transplant. 2010;10(7):1580–1587.PubMedCrossRef
85.
Zurück zum Zitat Cai SR, Motoyama K, Shen KJ, Kennedy SC, Flye MW, Ponder KP. Lovastatin decreases mortality and improves liver functions in fulminant hepatic failure from 90% partial hepatectomy in rats. J Hepatol. 2000;32(1):67–77.PubMedCrossRef Cai SR, Motoyama K, Shen KJ, Kennedy SC, Flye MW, Ponder KP. Lovastatin decreases mortality and improves liver functions in fulminant hepatic failure from 90% partial hepatectomy in rats. J Hepatol. 2000;32(1):67–77.PubMedCrossRef
86.
Zurück zum Zitat Xue F, Takahara T, Yata Y, et al. Hepatocyte growth factor gene therapy accelerates regeneration in cirrhotic mouse livers after hepatectomy. Gut. 2003;52(5):694–700.PubMedCrossRef Xue F, Takahara T, Yata Y, et al. Hepatocyte growth factor gene therapy accelerates regeneration in cirrhotic mouse livers after hepatectomy. Gut. 2003;52(5):694–700.PubMedCrossRef
87.
Zurück zum Zitat Sakata H, Takayama H, Sharp R, Rubin JS, Merlino G, LaRochelle WJ. Hepatocyte growth factor/scatter factor overexpression induces growth, abnormal development, and tumor formation in transgenic mouse livers. Cell Growth Differ. 1996;7(11):1513–1523.PubMed Sakata H, Takayama H, Sharp R, Rubin JS, Merlino G, LaRochelle WJ. Hepatocyte growth factor/scatter factor overexpression induces growth, abnormal development, and tumor formation in transgenic mouse livers. Cell Growth Differ. 1996;7(11):1513–1523.PubMed
88.
Zurück zum Zitat Petrowsky H, Breitenstein S, Slankamenac K, et al. Effects of pentoxifylline on liver regeneration. Ann Surg. 2010;252(5):813–822.PubMedCrossRef Petrowsky H, Breitenstein S, Slankamenac K, et al. Effects of pentoxifylline on liver regeneration. Ann Surg. 2010;252(5):813–822.PubMedCrossRef
89.
Zurück zum Zitat Belghiti J, Liddo G, Raut V, et al. “Inherent limitations” in donors: control matched study of consequences following a right hepatectomy for living donation and benign liver lesions. Ann Surg. 2012;255(3):528–533.PubMedCrossRef Belghiti J, Liddo G, Raut V, et al. “Inherent limitations” in donors: control matched study of consequences following a right hepatectomy for living donation and benign liver lesions. Ann Surg. 2012;255(3):528–533.PubMedCrossRef
90.
Zurück zum Zitat Yigitler C, Farges O, Kianmanesh R, Regimbeau J-M, Abdalla EK, Belghiti J. The small remnant liver after major liver resection: how common and how relevant? Liver Transpl. 2003;9(9):S18–25.PubMedCrossRef Yigitler C, Farges O, Kianmanesh R, Regimbeau J-M, Abdalla EK, Belghiti J. The small remnant liver after major liver resection: how common and how relevant? Liver Transpl. 2003;9(9):S18–25.PubMedCrossRef
91.
Zurück zum Zitat Hemming AW, Reed AI, Howard RJ, et al. Preoperative portal vein embolization for extended hepatectomy. Ann Surg. 2003;237(5):686–91; discussion 691–3.PubMed Hemming AW, Reed AI, Howard RJ, et al. Preoperative portal vein embolization for extended hepatectomy. Ann Surg. 2003;237(5):686–91; discussion 691–3.PubMed
92.
Zurück zum Zitat Capussotti L, Muratore A, Baracchi F, et al. Portal vein ligation as an efficient method of increasing the future liver remnant volume in the surgical treatment of colorectal metastases. Arch Surg. 2008;143(10):978–82; discussion 982.PubMedCrossRef Capussotti L, Muratore A, Baracchi F, et al. Portal vein ligation as an efficient method of increasing the future liver remnant volume in the surgical treatment of colorectal metastases. Arch Surg. 2008;143(10):978–82; discussion 982.PubMedCrossRef
93.
Zurück zum Zitat Ribero D, Abdalla EK, Madoff DC, Donadon M, Loyer EM, Vauthey JN. Portal vein embolization before major hepatectomy and its effects on regeneration, resectability and outcome. Br J Surg. 2007;94(11):1386–1394.PubMedCrossRef Ribero D, Abdalla EK, Madoff DC, Donadon M, Loyer EM, Vauthey JN. Portal vein embolization before major hepatectomy and its effects on regeneration, resectability and outcome. Br J Surg. 2007;94(11):1386–1394.PubMedCrossRef
94.
Zurück zum Zitat de Graaf W, van Lienden KP, van den Esschert JW, Bennink RJ, van Gulik TM. Increase in future remnant liver function after preoperative portal vein embolization. Br J Surg. 2011;98(6):825–834.PubMedCrossRef de Graaf W, van Lienden KP, van den Esschert JW, Bennink RJ, van Gulik TM. Increase in future remnant liver function after preoperative portal vein embolization. Br J Surg. 2011;98(6):825–834.PubMedCrossRef
95.
Zurück zum Zitat de Graaf W, van den Esschert JW, van Lienden KP, van Gulik TM. Induction of tumor growth after preoperative portal vein embolization: is it a real problem? Ann Surg Oncol. 2009;16(2):423–430.PubMedCrossRef de Graaf W, van den Esschert JW, van Lienden KP, van Gulik TM. Induction of tumor growth after preoperative portal vein embolization: is it a real problem? Ann Surg Oncol. 2009;16(2):423–430.PubMedCrossRef
96.
Zurück zum Zitat Yoo H, Kim JH, Ko G-Y, et al. sequential transcatheter arterial chemoembolization and portal vein embolization versus portal vein embolization only before major hepatectomy for patients with hepatocellular carcinoma. Ann Surg Oncol. 2010;18(5):1251–1257.PubMedCrossRef Yoo H, Kim JH, Ko G-Y, et al. sequential transcatheter arterial chemoembolization and portal vein embolization versus portal vein embolization only before major hepatectomy for patients with hepatocellular carcinoma. Ann Surg Oncol. 2010;18(5):1251–1257.PubMedCrossRef
97.
Zurück zum Zitat Ogata S, Belghiti J, Farges O, Varma D, Sibert A, Vilgrain V. Sequential arterial and portal vein embolizations before right hepatectomy in patients with cirrhosis and hepatocellular carcinoma. Br J Surg. 2006;93(9):1091–1098.PubMedCrossRef Ogata S, Belghiti J, Farges O, Varma D, Sibert A, Vilgrain V. Sequential arterial and portal vein embolizations before right hepatectomy in patients with cirrhosis and hepatocellular carcinoma. Br J Surg. 2006;93(9):1091–1098.PubMedCrossRef
98.
Zurück zum Zitat Hwang S, Lee S-G, Ko G-Y, et al. Sequential preoperative ipsilateral hepatic vein embolization after portal vein embolization to induce further liver regeneration in patients with hepatobiliary malignancy. Ann Surg. 2009;249(4):608–616.PubMedCrossRef Hwang S, Lee S-G, Ko G-Y, et al. Sequential preoperative ipsilateral hepatic vein embolization after portal vein embolization to induce further liver regeneration in patients with hepatobiliary malignancy. Ann Surg. 2009;249(4):608–616.PubMedCrossRef
99.
Zurück zum Zitat Gruttadauria S, Gridelli B. Sequential preoperative ipsilateral portal and arterial embolization in patients with liver tumors: is it really the best approach? World J Surg. 2007;31(12):2427–2428.PubMedCrossRef Gruttadauria S, Gridelli B. Sequential preoperative ipsilateral portal and arterial embolization in patients with liver tumors: is it really the best approach? World J Surg. 2007;31(12):2427–2428.PubMedCrossRef
100.
Zurück zum Zitat Adam R, Laurent A, Azoulay D, Castaing D, Bismuth H. Two-stage hepatectomy: a planned strategy to treat irresectable liver tumors. Ann Surg. 2000;232(6):777–785.PubMedCrossRef Adam R, Laurent A, Azoulay D, Castaing D, Bismuth H. Two-stage hepatectomy: a planned strategy to treat irresectable liver tumors. Ann Surg. 2000;232(6):777–785.PubMedCrossRef
101.
Zurück zum Zitat Kokudo N, Tada K, Seki M, et al. Proliferative activity of intrahepatic colorectal metastases after preoperative hemihepatic portal vein embolization. Hepatology. 2001;34(2):267–272.PubMedCrossRef Kokudo N, Tada K, Seki M, et al. Proliferative activity of intrahepatic colorectal metastases after preoperative hemihepatic portal vein embolization. Hepatology. 2001;34(2):267–272.PubMedCrossRef
102.
Zurück zum Zitat Heinrich S, Jochum W, Graf R, Clavien P-A. Portal vein ligation and partial hepatectomy differentially influence growth of intrahepatic metastasis and liver regeneration in mice. J Hepatol. 2006;45(1):35–42.PubMedCrossRef Heinrich S, Jochum W, Graf R, Clavien P-A. Portal vein ligation and partial hepatectomy differentially influence growth of intrahepatic metastasis and liver regeneration in mice. J Hepatol. 2006;45(1):35–42.PubMedCrossRef
103.
Zurück zum Zitat Torzilli G, Procopio F, Donadon M, Del Fabbro D, Cimino M, Montorsi M. Safety of intermittent Pringle maneuver cumulative time exceeding 120 minutes in liver resection: a further step in favor of the “radical but conservative” policy. Ann Surg. 2012;255(2):270–280.PubMedCrossRef Torzilli G, Procopio F, Donadon M, Del Fabbro D, Cimino M, Montorsi M. Safety of intermittent Pringle maneuver cumulative time exceeding 120 minutes in liver resection: a further step in favor of the “radical but conservative” policy. Ann Surg. 2012;255(2):270–280.PubMedCrossRef
104.
Zurück zum Zitat Schnitzbauer AA, Lang SA, Goessmann H, et al. Right portal vein ligation combined with in situ splitting induces rapid left lateral liver lobe hypertrophy enabling 2-staged extended right hepatic resection in small-for-size settings. Ann Surg. 2012;255(3):405–414.PubMedCrossRef Schnitzbauer AA, Lang SA, Goessmann H, et al. Right portal vein ligation combined with in situ splitting induces rapid left lateral liver lobe hypertrophy enabling 2-staged extended right hepatic resection in small-for-size settings. Ann Surg. 2012;255(3):405–414.PubMedCrossRef
105.
Zurück zum Zitat Clavien PA, Barkun J, de Oliveira ML, et al. The Clavien–Dindo classification of surgical complications: five-year experience. Ann Surg. 2009;250(2):187–196.PubMedCrossRef Clavien PA, Barkun J, de Oliveira ML, et al. The Clavien–Dindo classification of surgical complications: five-year experience. Ann Surg. 2009;250(2):187–196.PubMedCrossRef
106.
Zurück zum Zitat Mise Y, Hasegawa K, Satou S, et al. Venous reconstruction based on virtual liver resection to avoid congestion in the liver remnant. Br J Surg. 2011;98(12):1742–1751.PubMedCrossRef Mise Y, Hasegawa K, Satou S, et al. Venous reconstruction based on virtual liver resection to avoid congestion in the liver remnant. Br J Surg. 2011;98(12):1742–1751.PubMedCrossRef
107.
Zurück zum Zitat Ogata S, Kianmanesh R, Belghiti J. Doppler assessment after right hepatectomy confirms the need to fix the remnant left liver in the anatomical position. Br J Surg. 2005;92(5):592–595.PubMedCrossRef Ogata S, Kianmanesh R, Belghiti J. Doppler assessment after right hepatectomy confirms the need to fix the remnant left liver in the anatomical position. Br J Surg. 2005;92(5):592–595.PubMedCrossRef
108.
Zurück zum Zitat Sano K, Makuuchi M, Miki K, et al. Evaluation of hepatic venous congestion: proposed indication criteria for hepatic vein reconstruction. Ann Surg. 2002;236(2):241–247.PubMedCrossRef Sano K, Makuuchi M, Miki K, et al. Evaluation of hepatic venous congestion: proposed indication criteria for hepatic vein reconstruction. Ann Surg. 2002;236(2):241–247.PubMedCrossRef
109.
Zurück zum Zitat Scatton O, Plasse M, Dondero F, Vilgrain V, Sauvanet A, Belghiti J. Impact of localized congestion related to venous deprivation after hepatectomy. Surgery. 2008;143(4):483–489.PubMedCrossRef Scatton O, Plasse M, Dondero F, Vilgrain V, Sauvanet A, Belghiti J. Impact of localized congestion related to venous deprivation after hepatectomy. Surgery. 2008;143(4):483–489.PubMedCrossRef
110.
Zurück zum Zitat Akamatsu N, Sugawara Y, Kaneko J, et al. Effects of middle hepatic vein reconstruction on right liver graft regeneration. Transplantation. 2003;76(5):832–837.PubMedCrossRef Akamatsu N, Sugawara Y, Kaneko J, et al. Effects of middle hepatic vein reconstruction on right liver graft regeneration. Transplantation. 2003;76(5):832–837.PubMedCrossRef
111.
Zurück zum Zitat Hoti E, Salloum C, Azoulay D. Hepatic resection with in situ hypothermic perfusion is superior to other resection techniques. Dig Surg. 2011;28(2):94–99.PubMedCrossRef Hoti E, Salloum C, Azoulay D. Hepatic resection with in situ hypothermic perfusion is superior to other resection techniques. Dig Surg. 2011;28(2):94–99.PubMedCrossRef
112.
Zurück zum Zitat Azoulay D, Eshkenazy R, Andreani P, et al. In situ hypothermic perfusion of the liver versus standard total vascular exclusion for complex liver resection. Ann Surg. 2005;241(2):277–285.PubMedCrossRef Azoulay D, Eshkenazy R, Andreani P, et al. In situ hypothermic perfusion of the liver versus standard total vascular exclusion for complex liver resection. Ann Surg. 2005;241(2):277–285.PubMedCrossRef
113.
Zurück zum Zitat Yoshizumi T, Taketomi A, Soejima Y, et al. The beneficial role of simultaneous splenectomy in living donor liver transplantation in patients with small-for-size graft. Transpl Int. 2008;21(9):833–842.PubMedCrossRef Yoshizumi T, Taketomi A, Soejima Y, et al. The beneficial role of simultaneous splenectomy in living donor liver transplantation in patients with small-for-size graft. Transpl Int. 2008;21(9):833–842.PubMedCrossRef
114.
Zurück zum Zitat Troisi R, Cammu G, Militerno G, et al. Modulation of portal graft inflow: a necessity in adult living-donor liver transplantation? Ann Surg. 2003;237(3):429–436.PubMed Troisi R, Cammu G, Militerno G, et al. Modulation of portal graft inflow: a necessity in adult living-donor liver transplantation? Ann Surg. 2003;237(3):429–436.PubMed
115.
Zurück zum Zitat Tucker ON, Heaton N. The “small for size” liver syndrome. Curr Opin Crit Care. 2005;11(2):150–155.PubMedCrossRef Tucker ON, Heaton N. The “small for size” liver syndrome. Curr Opin Crit Care. 2005;11(2):150–155.PubMedCrossRef
116.
Zurück zum Zitat Sugawara Y, Yamamoto J, Shimada K, et al. Splenectomy in patients with hepatocellular carcinoma and hypersplenism. J Am Coll Surg. 2000;190(4):446–450.PubMedCrossRef Sugawara Y, Yamamoto J, Shimada K, et al. Splenectomy in patients with hepatocellular carcinoma and hypersplenism. J Am Coll Surg. 2000;190(4):446–450.PubMedCrossRef
117.
Zurück zum Zitat Arakawa Y, Shimada M, Uchiyama H, et al. Beneficial effects of splenectomy on massive hepatectomy model in rats. Hepatol Res. 2009;39(4):391–397.PubMedCrossRef Arakawa Y, Shimada M, Uchiyama H, et al. Beneficial effects of splenectomy on massive hepatectomy model in rats. Hepatol Res. 2009;39(4):391–397.PubMedCrossRef
118.
Zurück zum Zitat Ito K, Ozasa H, Horikawa S. Effects of prior splenectomy on remnant liver after partial hepatectomy with Pringle maneuver in rats. Liver Int. 2005;25(2):438–444.PubMedCrossRef Ito K, Ozasa H, Horikawa S. Effects of prior splenectomy on remnant liver after partial hepatectomy with Pringle maneuver in rats. Liver Int. 2005;25(2):438–444.PubMedCrossRef
119.
Zurück zum Zitat Ito K, Ozasa H, Yoneya R, Horikawa S. Splenectomy ameliorates hepatic ischemia and reperfusion injury mediated by heme oxygenase-1 induction in the rat. Liver. 2002;22(6):467–473.PubMedCrossRef Ito K, Ozasa H, Yoneya R, Horikawa S. Splenectomy ameliorates hepatic ischemia and reperfusion injury mediated by heme oxygenase-1 induction in the rat. Liver. 2002;22(6):467–473.PubMedCrossRef
120.
Zurück zum Zitat Ren Y-S, Qian N-S, Tang Y, et al. Beneficial effects of splenectomy on liver regeneration in a rat model of massive hepatectomy. HBPD Int. 2012;11(1):60–65.PubMed Ren Y-S, Qian N-S, Tang Y, et al. Beneficial effects of splenectomy on liver regeneration in a rat model of massive hepatectomy. HBPD Int. 2012;11(1):60–65.PubMed
121.
Zurück zum Zitat Sato Y, Kobayashi T, Nakatsuka H, et al. Splenic arterial ligation prevents liver injury after a major hepatectomy by a reduction of surplus portal hypertension in hepatocellular carcinoma patients with cirrhosis. Hepatogastroenterology. 2001;48(39):831–835.PubMed Sato Y, Kobayashi T, Nakatsuka H, et al. Splenic arterial ligation prevents liver injury after a major hepatectomy by a reduction of surplus portal hypertension in hepatocellular carcinoma patients with cirrhosis. Hepatogastroenterology. 2001;48(39):831–835.PubMed
122.
Zurück zum Zitat Mogl MT, Nüssler NC, Presser SJ, et al. Evolving experience with prevention and treatment of splenic artery syndrome after orthotopic liver transplantation. Transpl Int. 2010;23(8):831–841.PubMedCrossRef Mogl MT, Nüssler NC, Presser SJ, et al. Evolving experience with prevention and treatment of splenic artery syndrome after orthotopic liver transplantation. Transpl Int. 2010;23(8):831–841.PubMedCrossRef
123.
Zurück zum Zitat Wang H, Ohkohchi N, Enomoto Y, et al. Effect of portocaval shunt on residual extreme small liver after extended hepatectomy in porcine. World J Surg. 2006;30(11):2014–2022.PubMedCrossRef Wang H, Ohkohchi N, Enomoto Y, et al. Effect of portocaval shunt on residual extreme small liver after extended hepatectomy in porcine. World J Surg. 2006;30(11):2014–2022.PubMedCrossRef
124.
Zurück zum Zitat Iida T, Yagi S, Taniguchi K, Hori T, Uemoto S. Improvement of morphological changes after 70% hepatectomy with portocaval shunt: preclinical study in porcine model. Journal of Surgical Research. 2007;143(2):238–246.PubMedCrossRef Iida T, Yagi S, Taniguchi K, Hori T, Uemoto S. Improvement of morphological changes after 70% hepatectomy with portocaval shunt: preclinical study in porcine model. Journal of Surgical Research. 2007;143(2):238–246.PubMedCrossRef
125.
Zurück zum Zitat Xu X, Man K, Zheng SS, et al. Attenuation of acute phase shear stress by somatostatin improves small-for-size liver graft survival. Liver Transpl. 2006;12(4):621–627.PubMedCrossRef Xu X, Man K, Zheng SS, et al. Attenuation of acute phase shear stress by somatostatin improves small-for-size liver graft survival. Liver Transpl. 2006;12(4):621–627.PubMedCrossRef
126.
Zurück zum Zitat van de Kerkhove M-P, de Jong KP, Rijken AM, de Pont A-CJM, van Gulik TM. MARS treatment in posthepatectomy liver failure. Liver Int. 2003;23 Suppl 3:44–51.PubMedCrossRef van de Kerkhove M-P, de Jong KP, Rijken AM, de Pont A-CJM, van Gulik TM. MARS treatment in posthepatectomy liver failure. Liver Int. 2003;23 Suppl 3:44–51.PubMedCrossRef
127.
Zurück zum Zitat Rittler P, Ketscher C, Inthorn D, Jauch K-W, Hartl WH. Use of the molecular adsorbent recycling system in the treatment of postoperative hepatic failure and septic multiple organ dysfunction—preliminary results. Liver Int. 2004;24(2):136–141.PubMedCrossRef Rittler P, Ketscher C, Inthorn D, Jauch K-W, Hartl WH. Use of the molecular adsorbent recycling system in the treatment of postoperative hepatic failure and septic multiple organ dysfunction—preliminary results. Liver Int. 2004;24(2):136–141.PubMedCrossRef
128.
Zurück zum Zitat Consensus conference: Indications for Liver Transplantation, January 19 and 20, 2005, Lyon-Palais Des Congrès: text of recommendations (long version). Vol 12. 2006:998–1011. Consensus conference: Indications for Liver Transplantation, January 19 and 20, 2005, Lyon-Palais Des Congrès: text of recommendations (long version). Vol 12. 2006:998–1011.
129.
Zurück zum Zitat Uskudar O, Raja K, Schiano TD, Fiel MI, del Rio Martin J, Chang C. Liver Transplantation is possible in some patients with liver metastasis of colon cancer. Transplant Proc. 2011;43(5):2070–2074.PubMedCrossRef Uskudar O, Raja K, Schiano TD, Fiel MI, del Rio Martin J, Chang C. Liver Transplantation is possible in some patients with liver metastasis of colon cancer. Transplant Proc. 2011;43(5):2070–2074.PubMedCrossRef
130.
Zurück zum Zitat Minato M, Houssin D, Demma I, et al. Transplantation of hepatocytes for treatment of surgically induced acute hepatic failure in the rat. Eur Surg Res. 1984;16(3):162–169.PubMedCrossRef Minato M, Houssin D, Demma I, et al. Transplantation of hepatocytes for treatment of surgically induced acute hepatic failure in the rat. Eur Surg Res. 1984;16(3):162–169.PubMedCrossRef
131.
Zurück zum Zitat Kobayashi N. Prevention of acute liver failure in rats with reversibly immortalized human hepatocytes. Science. 2000;287(5456):1258–1262.PubMedCrossRef Kobayashi N. Prevention of acute liver failure in rats with reversibly immortalized human hepatocytes. Science. 2000;287(5456):1258–1262.PubMedCrossRef
132.
Zurück zum Zitat Chen Y, Li J, Liu X, Zhao W, Wang Y, Wang X. Transplantation of immortalized human fetal hepatocytes prevents acute liver failure in 90% hepatectomized mice. Transplant Proc. 2010;42(5):1907–1914.PubMedCrossRef Chen Y, Li J, Liu X, Zhao W, Wang Y, Wang X. Transplantation of immortalized human fetal hepatocytes prevents acute liver failure in 90% hepatectomized mice. Transplant Proc. 2010;42(5):1907–1914.PubMedCrossRef
133.
Zurück zum Zitat Arkadopoulos N, Kostopanagiotou G, Nastos C, et al. Reversal of experimental posthepatectomy liver failure in pigs: a new application of hepatocyte bioreactors. Artif Organs. 2011;35(1):29–36.PubMedCrossRef Arkadopoulos N, Kostopanagiotou G, Nastos C, et al. Reversal of experimental posthepatectomy liver failure in pigs: a new application of hepatocyte bioreactors. Artif Organs. 2011;35(1):29–36.PubMedCrossRef
134.
Zurück zum Zitat Furst G, Schulte am Esch J, Poll LW, et al. Portal vein embolization and autologous CD133+ bone marrow stem cells for liver regeneration: initial experience. Radiology. 2007;243(1):171–179.PubMedCrossRef Furst G, Schulte am Esch J, Poll LW, et al. Portal vein embolization and autologous CD133+ bone marrow stem cells for liver regeneration: initial experience. Radiology. 2007;243(1):171–179.PubMedCrossRef
135.
Zurück zum Zitat Esch JSA, Schmelzle M, Fürst G, et al. Infusion of CD133+ bone marrow-derived stem cells after selective portal vein embolization enhances functional hepatic reserves after extended right hepatectomy. Ann Surg. 2012;255(1):79–85.CrossRef Esch JSA, Schmelzle M, Fürst G, et al. Infusion of CD133+ bone marrow-derived stem cells after selective portal vein embolization enhances functional hepatic reserves after extended right hepatectomy. Ann Surg. 2012;255(1):79–85.CrossRef
136.
Zurück zum Zitat Yamanaka K, Hatano E, Narita M, et al. Olprinone attenuates excessive shear stress through up-regulation of endothelial nitric oxide synthase in a rat excessive hepatectomy model. Liver Transpl. 2011;17(1):60–69.PubMedCrossRef Yamanaka K, Hatano E, Narita M, et al. Olprinone attenuates excessive shear stress through up-regulation of endothelial nitric oxide synthase in a rat excessive hepatectomy model. Liver Transpl. 2011;17(1):60–69.PubMedCrossRef
137.
Zurück zum Zitat Figueras J, Valls C, Rafecas A, Fabregat J, Ramos E, Jaurrieta E. Resection rate and effect of postoperative chemotherapy on survival after surgery for colorectal liver metastases. Br J Surg. 2001;88(7):980–985.PubMedCrossRef Figueras J, Valls C, Rafecas A, Fabregat J, Ramos E, Jaurrieta E. Resection rate and effect of postoperative chemotherapy on survival after surgery for colorectal liver metastases. Br J Surg. 2001;88(7):980–985.PubMedCrossRef
138.
Zurück zum Zitat Finch RJB, Malik HZ, Hamady ZZR, et al. Effect of type of resection on outcome of hepatic resection for colorectal metastases. Br J Surg. 2007;94(10):1242–1248.PubMedCrossRef Finch RJB, Malik HZ, Hamady ZZR, et al. Effect of type of resection on outcome of hepatic resection for colorectal metastases. Br J Surg. 2007;94(10):1242–1248.PubMedCrossRef
139.
Zurück zum Zitat Tamandl D, Gruenberger B, Herberger B, et al. Selective resection of colorectal liver metastases. European Journal of Surgical Oncology (EJSO). 2007;33(2):174–182.CrossRef Tamandl D, Gruenberger B, Herberger B, et al. Selective resection of colorectal liver metastases. European Journal of Surgical Oncology (EJSO). 2007;33(2):174–182.CrossRef
140.
Zurück zum Zitat Gold JS, Are C, Kornprat P, et al. Increased use of parenchymal-sparing surgery for bilateral liver metastases from colorectal cancer is associated with improved mortality without change in oncologic outcome. Ann Surg. 2008;247(1):109–117.PubMedCrossRef Gold JS, Are C, Kornprat P, et al. Increased use of parenchymal-sparing surgery for bilateral liver metastases from colorectal cancer is associated with improved mortality without change in oncologic outcome. Ann Surg. 2008;247(1):109–117.PubMedCrossRef
141.
Zurück zum Zitat Karanjia ND, Lordan JT, Quiney N, Fawcett WJ, Worthington TR, Remington J. A comparison of right and extended right hepatectomy with all other hepatic resections for colorectal liver metastases: a ten-year study. European Journal of Surgical Oncology. 2009;35(1):65–70.PubMedCrossRef Karanjia ND, Lordan JT, Quiney N, Fawcett WJ, Worthington TR, Remington J. A comparison of right and extended right hepatectomy with all other hepatic resections for colorectal liver metastases: a ten-year study. European Journal of Surgical Oncology. 2009;35(1):65–70.PubMedCrossRef
142.
Zurück zum Zitat Kesmodel SB, Ellis LM, Lin E, et al. Preoperative bevacizumab does not significantly increase postoperative complication rates in patients undergoing hepatic surgery for colorectal cancer liver metastases. J Clin Oncol. 2008;26(32):5254–5260.PubMedCrossRef Kesmodel SB, Ellis LM, Lin E, et al. Preoperative bevacizumab does not significantly increase postoperative complication rates in patients undergoing hepatic surgery for colorectal cancer liver metastases. J Clin Oncol. 2008;26(32):5254–5260.PubMedCrossRef
143.
Zurück zum Zitat Mehta NN, Ravikumar R, Coldham CA, et al. Effect of preoperative chemotherapy on liver resection for colorectal liver metastases. European Journal of Surgical Oncology (EJSO). 2008;34(7):782–786.CrossRef Mehta NN, Ravikumar R, Coldham CA, et al. Effect of preoperative chemotherapy on liver resection for colorectal liver metastases. European Journal of Surgical Oncology (EJSO). 2008;34(7):782–786.CrossRef
144.
Zurück zum Zitat Schiesser M, Chen JWC, Maddern GJ, Padbury RTA. Perioperative morbidity affects long-term survival in patients following liver resection for colorectal metastases. J Gastrointest Surg. 2008;12(6):1054–1060.PubMedCrossRef Schiesser M, Chen JWC, Maddern GJ, Padbury RTA. Perioperative morbidity affects long-term survival in patients following liver resection for colorectal metastases. J Gastrointest Surg. 2008;12(6):1054–1060.PubMedCrossRef
145.
Zurück zum Zitat Welsh FKS, Tekkis PP, O'Rourke T, John TG, Rees M. Quantification of risk of a positive (R1) resection margin following hepatic resection for metastatic colorectal cancer: an aid to clinical decision-making. Surg Oncol. 2008;17(1):3–13.PubMedCrossRef Welsh FKS, Tekkis PP, O'Rourke T, John TG, Rees M. Quantification of risk of a positive (R1) resection margin following hepatic resection for metastatic colorectal cancer: an aid to clinical decision-making. Surg Oncol. 2008;17(1):3–13.PubMedCrossRef
146.
Zurück zum Zitat Konopke R, Kersting S, Bunk A, et al. Colorectal liver metastasis surgery: analysis of risk factors predicting postoperative complications in relation to the extent of resection. Int J Colorectal Dis. 2009;24(6):687–697.PubMedCrossRef Konopke R, Kersting S, Bunk A, et al. Colorectal liver metastasis surgery: analysis of risk factors predicting postoperative complications in relation to the extent of resection. Int J Colorectal Dis. 2009;24(6):687–697.PubMedCrossRef
147.
Zurück zum Zitat Fong Y, Sun RL, Jarnagin W, Blumgart LH. An analysis of 412 cases of hepatocellular carcinoma at a Western center. Ann Surg. 1999;229(6):790–9; discussion 799–800.PubMedCrossRef Fong Y, Sun RL, Jarnagin W, Blumgart LH. An analysis of 412 cases of hepatocellular carcinoma at a Western center. Ann Surg. 1999;229(6):790–9; discussion 799–800.PubMedCrossRef
148.
Zurück zum Zitat Midorikawa Y, Kubota K, Takayama T, et al. A comparative study of postoperative complications after hepatectomy in patients with and without chronic liver disease. Surgery. 1999;126(3):484–491.PubMedCrossRef Midorikawa Y, Kubota K, Takayama T, et al. A comparative study of postoperative complications after hepatectomy in patients with and without chronic liver disease. Surgery. 1999;126(3):484–491.PubMedCrossRef
149.
Zurück zum Zitat Poon RT-P, Fan S-T, Lo CM, et al. Extended hepatic resection for hepatocellular carcinoma in patients with cirrhosis: is it justified? Ann Surg. 2002;236(5):602–611.PubMedCrossRef Poon RT-P, Fan S-T, Lo CM, et al. Extended hepatic resection for hepatocellular carcinoma in patients with cirrhosis: is it justified? Ann Surg. 2002;236(5):602–611.PubMedCrossRef
150.
Zurück zum Zitat Hsu K-Y, Chau G-Y, Lui W-Y, Tsay S-H, King K-L, Wu C-W. Predicting morbidity and mortality after hepatic resection in patients with hepatocellular carcinoma: the role of Model for End-Stage Liver Disease score. World J Surg. 2009;33(11):2412–2419.PubMedCrossRef Hsu K-Y, Chau G-Y, Lui W-Y, Tsay S-H, King K-L, Wu C-W. Predicting morbidity and mortality after hepatic resection in patients with hepatocellular carcinoma: the role of Model for End-Stage Liver Disease score. World J Surg. 2009;33(11):2412–2419.PubMedCrossRef
151.
Zurück zum Zitat Choi GH, Park JY, Hwang HK, et al. Predictive factors for long-term survival in patients with clinically significant portal hypertension following resection of hepatocellular carcinoma. Liver Int. 2011;31(4):485–493.PubMedCrossRef Choi GH, Park JY, Hwang HK, et al. Predictive factors for long-term survival in patients with clinically significant portal hypertension following resection of hepatocellular carcinoma. Liver Int. 2011;31(4):485–493.PubMedCrossRef
152.
Zurück zum Zitat Ruzzenente A. Hepatocellular carcinoma in cirrhotic patients with portal hypertension: is liver resection always contraindicated? World J Gastroenterol. 2011;17(46):5083.PubMedCrossRef Ruzzenente A. Hepatocellular carcinoma in cirrhotic patients with portal hypertension: is liver resection always contraindicated? World J Gastroenterol. 2011;17(46):5083.PubMedCrossRef
Metadaten
Titel
New Paradigms in Post-hepatectomy Liver Failure
verfasst von
Nicolas Golse
Petru O. Bucur
René Adam
Denis Castaing
Antonio Sa Cunha
Eric Vibert
Publikationsdatum
01.03.2013
Verlag
Springer-Verlag
Erschienen in
Journal of Gastrointestinal Surgery / Ausgabe 3/2013
Print ISSN: 1091-255X
Elektronische ISSN: 1873-4626
DOI
https://doi.org/10.1007/s11605-012-2048-6

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