Human liver regeneration following massive hepatic necrosis: Two distinct patterns

Dezső, Katalin and Nagy, Péter and Paku, Sándor (2019) Human liver regeneration following massive hepatic necrosis: Two distinct patterns. JOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY, 34. pp. 1-11. ISSN 0815-9319 (print); 1440-1746 (online)

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Massive hepatic necrosis is a rare but often fatal complication of various liver injuries. Nevertheless, some patients can survive by spontaneous hepatic regeneration. It is known that surviving hepatocytes and/or progenitor cells can participate in this process but the mechanism of hepatic recovery is vague.We examined 13 explanted human livers removed for acute liver failure. Combined immunohistochemistry, digital image analysis, and three-dimensional reconstruction of serial sections were applied.Two patterns of regeneration could be distinguished. In livers with centrilobular necrosis, the surviving injured periportal hepatocytes started to proliferate and arrange into acinar structures and expressed α-fetoprotein. If the injury wiped out almost all hepatocytes, large areas of parenchymal loss were invaded by an intense ductular reaction. The cells at the distal pole of the ductules differentiated into hepatocytes and formed foci organized by the branches of the portal vein. The expanding foci often containing complete portal triads were arranged around surviving central veins. Their fusion eventually could be an attempt to re-establish the hepatic lobules.Regeneration of human livers following massive hepatic necrosis can occur in two ways-either through proliferation of α-fetoprotein-positive acinary-arranged hepatocytes or through ductular progenitor cells, with the latter being less efficient. Further investigation of these regenerative pathways may help identify biomarkers for likelihood of complete regeneration and hence have therapeutic implications.

Item Type: Article
Uncontrolled Keywords: 3D reconstruction, α-fetoprotein, foci, fulminant liver failure, portal vein
Subjects: R Medicine / orvostudomány > RC Internal medicine / belgyógyászat
Depositing User: MTMT SWORD
Date Deposited: 18 Sep 2019 13:30
Last Modified: 18 Sep 2019 13:30

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