Clinical

Liver regeneration is slower in living donors than in their recipients

Last Updated: 2004-03-17 13:57:23 -0400 (Reuters Health)

NEW YORK (Reuters Health) - Living donor liver transplantation is possible because near-complete regeneration occurs within weeks in the transplanted graft as well as in the donor's residual liver. Now, researchers have discovered that liver regeneration is slower in the donors than in the recipients of partial grafts.

At the University of Minnesota in Minneapolis, Minnesota, Dr. Abhinav Humar and colleagues used computed tomography volumetrics to analyze liver volume at three months after transplant in patients who had received either a right lobe from a living donor, or a right or left lobe from a cadaver donor in a split liver transplant. The researchers also analyzed liver volume at three months in the living donors.

Their findings are published in the March issue of Liver Transplantation.

When the investigators used a standard formula to calculate subjects' ideal liver volume, they discovered that at three months, living donors had attained an average of 78% of their ideal volume, compared to 103.9% for recipients of right lobes from living donors, 113.6% for recipients of right lobes from cadavers, and 121.4% for recipients of cadaveric left lobes.

The researchers admit that the reasons for their findings remain unclear. They point out, however, that while the donors' livers appeared to regenerate "at a less vigorous pace," this may not have great clinical significance. "Synthetic function was usually completely normal in living donors by 1 week" after their surgery, according to the paper.

"Patients who undergo a partial-liver transplant or a partial hepatectomy offer ideal clinical models for the in vivo study of liver regeneration," the investigators comment. "Studies such as this are important to help solve the mystery of liver regeneration and to ultimately make partial-liver transplants safer for donors and more effective for recipients."

Liver Transpl 2004; 10:374-378