Regulation of liver size and regeneration: Importance in liver transplantation

A. Francavilla, P. Ove, L. Polimeno, M. Coetzee, L. Makowka, M. Barone, D. H. Van Thiel, T. E. Starzl

Research output: Contribution to journalArticlepeer-review


A rapid growth of small livers occurs during the first day after transplantation, which is similar to that observed after partial hepatectomy. None of the typical hormonal alterations observed after hepatectomy occurred during this process. Because hormonal changes did not provide any conclusive answers as related to liver regeneration, in 1975 several investigations on growth factors in serum and tissue were initiated. We have been working on the extraction and purification of hepatic stimulator substance (HSS) since 1980. Similar to the findings with hormones, the considerable knowledge obtained on growth factors has not yet resulted in any conclusive theory on liver regeneration. A better understanding of this process is clinically very important, not only for cases of liver damage but also for hepatic transplantation. The increase in the volume of a small liver transplanted in a larger animal is compared with that of a normal-for-size liver transplanted into a dog of suitable size. A great increase in thymidine kinase, ornithine, and decarboxylase levels and in the percentage of mitoses was detected only in the small liver transplanted in a host of a larger size. This indicates an active hepatocyte proliferation. Regeneration could be seen as a complex mechanism in which the initiating key is the plasma concentration of inhibitors. This possibility even further complicates the already complex view of the regeneration process. In fact, we know only a few pieces of the puzzle that are responsible for the complex system of regeneration, and even more discouraging, we do not fully understand how all these pieces fit together.

Original languageEnglish
Pages (from-to)494-497
Number of pages4
JournalTransplantation Proceedings
Issue number1 SUPPL. 1
Publication statusPublished - 1988

ASJC Scopus subject areas

  • Surgery
  • Transplantation


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