Abstract
BackgroundPost-hepatectomy liver failure contributes significantly to postoperative mortality after liver resection. The prediction of the individual risk for liver failure is challenging. This review aimed to provide an overview of cytokine and growth factor triggered signaling pathways involved in liver regeneration after resection.MethodsMEDLINE and Cochrane databases were searched without language restrictions for articles from the time of inception of the databases till March 2019. All studies with comparative data on the effect of cytokines and growth factors on liver regeneration in animals and humans were included.ResultsOverall 3.353 articles comprising 40 studies involving 1.498 patients and 101 animal studies were identified and met the inclusion criteria. All included trials on humans were retrospective cohort/observational studies. There was substantial heterogeneity across all included studies with respect to the analyzed cytokines and growth factors and the described endpoints.ConclusionHigh-level evidence on serial measurements of growth factors and cytokines in blood samples used to predict liver regeneration after resection is still lacking. To address the heterogeneity of patients and potential markers, high throughput serial analyses may offer a method to predict an individual’s regenerative potential in the future.
Highlights
Post-hepatectomy liver failure (PHLF) is a serious complication after liver resection and the incidence varies from 1.2 to 32% [1,2,3,4]
PHLF is defined as functional deterioration of the liver associated with an increased international normalized ratio (INR) and hyperbilirubinemia on, or after, the fifth postoperative day [1]
Noninvasive individualized identification of valid predictive and prognostic biomarkers of PHLF based on the cytokines and hepatic growth factors in the liquid-biopsy samples might be a novel approach in the peri-operative diagnosis and monitoring of regeneration on a molecular basis
Summary
Post-hepatectomy liver failure (PHLF) is a serious complication after liver resection and the incidence varies from 1.2 to 32% [1,2,3,4]. PHLF is defined as functional deterioration of the liver associated with an increased international normalized ratio (INR) and hyperbilirubinemia on, or after, the fifth postoperative day [1]. Noninvasive individualized identification of valid predictive and prognostic biomarkers of PHLF based on the cytokines and hepatic growth factors in the liquid-biopsy samples might be a novel approach in the peri-operative diagnosis and monitoring of regeneration on a molecular basis. Since liver regeneration is a well-orchestrated process controlled by various cytokines and growth factors, these might be promising targets for modulation. This review aimed to provide an overview of cytokine and growth factor triggered signaling pathways involved in liver regeneration after resection
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