Liver resection as a stimulation of its regeneration in chronic diseases

Abstract

Annotation. Uncertainty of measures for the treatment of liver cirrhosis and hepatocellular carcinoma necessitates the development of new treatments for patients. The analysis of the specialized scientific literature for generalization of the given mechanisms of regeneration of a liver at chronic liver diseases and use in clinical practice of modern medical actions is carried out. The search of specialized scientific literature for the period from 2012 to 2022 to identify problematic issues of liver regeneration after different volumes of its resection in chronic liver disease and the disclosure of mechanisms that inhibit or directly stimulate liver regeneration. It has been established that the liver has sufficient regenerative potential, capable of regeneration after 75% removal of its volume in humans and up to 90% in some models of rodents, which allows it to withstand various types of damage, including physical injuries, infections, inflammation, direct toxicity and immunological disorders. Liver regeneration after resection is achieved in different ways depending on the size of the liver resection. Regeneration after resection of a third of the liver is achieved mainly by hypertrophy with a small number of cell divisions. Resection of 70% of the liver volume is accompanied by regeneration in the form of hyperplasia due to hepatocyte proliferation. Increased hepatocyte growth factor in sinusoidal endothelial cells of the liver stimulates liver regeneration. Regression of fibrosis is possible due to the elimination of pathophysiological causes, as well as the elimination of activated myofibroblasts, which leads to the resorption of scar tissue. In the future, it is advisable to investigate and test in practice innovative technologies to stimulate liver regeneration in non-alcoholic fatty liver disease.