Vascular Endothelial Growth Factor Improves Liver Regeneration and Survival after 90% Hepatectomy in a Rat Model of Diet-Induced Steatosis

Abstract

Background/Aims: Fatty liver disease increases the risk in major liver resection for patients. As previous studies suggested that vascular endothelial growth factor (VEGF) and erythropoietin (EPO) might improve liver regeneration in nonobese animals, we investigated their effect after subtotal hepatectomy (SH) in rats with diet-induced steatosis. Methods: Male Wistar rats were fed with fatty liver-inducing diet (FLD) or normal diet (control) for 11-12 weeks followed by 90% SH. Animals were treated either with EPO, VEGF or NaCl on postoperative days 0, 1 and 3 and sacrificed 24 h or 7 days after SH. Survival rate, liver regeneration and biochemical markers were assessed. Expression of inflammatory cytokines (TNF-α, IL-6) and apoptosis-related genes (PUMA, Bcl-2) was measured by qRT-PCR. Results: Seven-day survival after SH was significantly decreased in the FLD group compared to controls (50 vs. 100%, p < 0.05). In FLD animals, treatment with VEGF increased 7-day survival to 90% compared to only 40% in the EPO group. After surgery, blood glucose levels of VEGF but not EPO- or NaCl-treated animals remained normal. Inflammatory genes were markedly upregulated in the EPO group 24 h after SH. Conclusions: Steatosis severely impairs survival and regeneration after extensive liver resection, which can be counteracted at least in part by perioperative treatment with VEGF.