Exploring the Enhanced Liver Regeneration Patterns Following ALPPS Versus Selective Portal Vein Ligation in an Experimental Model
Cancer Reports, vol. 8, pp. e70221
Abstract
ABSTRACT Background Associating liver partition and portal vein ligation (PVL) for staged hepatectomy (ALPPS) and selective PV embolization (PVE) are important clinical strategies in liver surgery. Even though it has been demonstrated that ALPPS induces a more rapid and expressed hypertrophy than PVL/PVE, this phenomenon is still not well understood. Aim In the present study, we aimed to characterize enhanced regeneration patterns in a rat model. Methods Male Wistar rats were used ( n = 84; 220–250 g). Selective PVL and ALPPS were achieved using microsurgical techniques (RML‐regenerating/LML‐non‐regenerating). Parameters of liver regeneration, microcirculation, hepatocyte morphology, hepatocellular injury, and activation status of certain protein kinases involved in liver regeneration were investigated. Results Right median lobe (RMLs) in the ALPPS group exhibited a more significant and rapid hypertrophy compared to PVL (regeneration ratio, 1.669 ± 0.155 vs. 1.980 ± 0.189, p = 0.009, PVL vs. ALPPS). ALPPS led to a more prominent hepatocellular injury. Hypertrophy was associated with increased microcirculation of the RML and a prominent increase of hepatocellular size (300.43 ± 31.92 μm 2 vs. 374.48 ± 58.34 μm 2 , PVL vs. ALPPS) and morphology. There was an early pAkt/Akt activation after surgery which was significantly higher in ALPPS (5 ± 2 vs. 9.7 ± 3 RQ‐fold‐change, p = 0.0087, PVL vs. ALPPS). Conclusions Our results suggest that the enhanced regeneration in ALPPS is associated with characteristic changes in liver microcirculation, cell division, hepatocyte morphology, and activation of pAkt/Akt.
Authors 13
-
Dóra Krisztina Tihanyi Aachen Institute for Laboratory Animal Science and Experimental Surgery Faculty of Medicine
Semmelweis University · RWTH Aachen University
Affiliation as printed
Department of Surgery, Transplantation and Gastroenterology, Hepato‐Pancreatico‐Biliary Surgical Research Center Semmelweis University Budapest Hungary
Doctoral School of Clinical Medicine Semmelweis University Budapest Hungary
Institute for Laboratory Animal Science and Experimental Surgery, Faculty of Medicine RWTH Aachen University Aachen Germany
Doctoral School of Clinical Medicine, Semmelweis University, Budapest, Hungary
Institute for Laboratory Animal Science and Experimental Surgery, Faculty of Medicine, RWTH Aachen University, Aachen, Germany
-
Affiliation as printed
Department of Surgery, Transplantation and Gastroenterology, Hepato‐Pancreatico‐Biliary Surgical Research Center Semmelweis University Budapest Hungary
Department of Surgery, Transplantation and Gastroenterology, Hepato-Pancreatico-Biliary Surgical Research Center, Semmelweis University, Budapest, Hungary
-
Affiliation as printed
Department of Surgery, Transplantation and Gastroenterology, Hepato‐Pancreatico‐Biliary Surgical Research Center Semmelweis University Budapest Hungary
Department of Surgery, Transplantation and Gastroenterology, Hepato-Pancreatico-Biliary Surgical Research Center, Semmelweis University, Budapest, Hungary
-
Charité - Universitätsmedizin Berlin
Affiliation as printed
Department of Surgery Campus Charité Mitte|Campus Virchow‐Klinikum–Charité‐Universitätsmedizin Berlin Germany
-
Lisa Ernst Aachen Institute for Laboratory Animal Science and Experimental Surgery Faculty of Medicine
Affiliation as printed
Institute for Laboratory Animal Science and Experimental Surgery, Faculty of Medicine RWTH Aachen University Aachen Germany
Institute for Laboratory Animal Science and Experimental Surgery, Faculty of Medicine, RWTH Aachen University, Aachen, Germany
-
Universitätsklinikum Aachen · RWTH Aachen University
Affiliation as printed
Department of Surgery and Transplantation University Hospital RWTH Aachen Aachen Germany
Department of Surgery and Transplantation, University Hospital RWTH Aachen, Aachen, Germany
-
Universitätsklinikum Aachen · RWTH Aachen University
Affiliation as printed
Department of Anesthesiology, Medical Faculty University Hospital RWTH Aachen Aachen Germany
Department of Anesthesiology, Medical Faculty, University Hospital RWTH Aachen, Aachen, Germany
-
Heidelberg University · University Hospital Heidelberg
Affiliation as printed
Department of General, Viszeral and Transplantation Surgery University Hospital Heidelberg Heidelberg Germany
Department of General, Viszeral and Transplantation Surgery, University Hospital Heidelberg, Heidelberg, Germany
-
Heidelberg University · University Hospital Heidelberg
Affiliation as printed
Department of General, Viszeral and Transplantation Surgery University Hospital Heidelberg Heidelberg Germany
Department of General, Viszeral and Transplantation Surgery, University Hospital Heidelberg, Heidelberg, Germany
-
Heidelberg University · University Hospital Heidelberg
Affiliation as printed
Department of General, Viszeral and Transplantation Surgery University Hospital Heidelberg Heidelberg Germany
Department of General, Viszeral and Transplantation Surgery, University Hospital Heidelberg, Heidelberg, Germany
-
Heidelberg University · University Hospital Heidelberg
Affiliation as printed
Department of General, Viszeral and Transplantation Surgery University Hospital Heidelberg Heidelberg Germany
Department of General, Viszeral and Transplantation Surgery, University Hospital Heidelberg, Heidelberg, Germany
-
Rene Hany Tolba Aachen Institute for Laboratory Animal Science and Experimental Surgery Faculty of Medicine
Affiliation as printed
Institute for Laboratory Animal Science and Experimental Surgery, Faculty of Medicine RWTH Aachen University Aachen Germany
Institute for Laboratory Animal Science and Experimental Surgery, Faculty of Medicine, RWTH Aachen University, Aachen, Germany
-
Zoltán Czigány corresponding Aachen Institute for Laboratory Animal Science and Experimental Surgery Faculty of Medicine
Heidelberg University · University Hospital Heidelberg · RWTH Aachen University
Affiliation as printed
Department of General, Viszeral and Transplantation Surgery University Hospital Heidelberg Heidelberg Germany
Institute for Laboratory Animal Science and Experimental Surgery, Faculty of Medicine RWTH Aachen University Aachen Germany
Department of General, Viszeral and Transplantation Surgery, University Hospital Heidelberg, Heidelberg, Germany
Institute for Laboratory Animal Science and Experimental Surgery, Faculty of Medicine, RWTH Aachen University, Aachen, Germany
Cited by 0 stored of 0
No patents citing this paper on Lens.org (checked 2026-10-06).