J.Jpn. Surg. Soc.
ISSN 1880-1129

[Abstract] [Full Text PDF] （in Japanese / 2226KB） [Members Only And Two Factor Auth.]

J.Jpn. Surg. Soc.. 105(10): 658-663, 2004

Feature topic

MECHANISM OF LIVER FAILURE AFTER HEPATECTOMY

Department of Gastroenterological Surgery, Yokohama City University Graduate School of Medicine, Yokohama, Japan

Shinji Togo, Toru Kubota, Kenichi Matsuo, Tetsuya Shimizu, Nobuyoshi Momiyama, Kazuhisa Takeda, Kuniya Tanaka, Itaru Endo, Hitoshi Sekido, Hiroshi Shimada

Liver failure after hepatectomy is caused by many factors such as excessive hepatectomy, ischemicreperfusion injury, postoperative infection, etc. However, apoptosis of hepatocytes is the most important event in the molecular mechanism of liver failure. Liver failure after excessive hepatectomy is characterized by increased apoptosis of hepatocytes and diminished liver regeneration. The former is induced by hypercytokinemia and hyperendotoxemia, and the latter is caused by cell cycle arrest. In ischernic-reperfusion inj ury of the liver, the apoptosis of hepatocytes is caused by activation of the MMPT and calpain system that are induced by the intracellular accumulation of Ca. The possible mechanism of liver failure in cases with persistent infection is the inhibition of liver regeneration and the induction of apoptosis of hepatocytes due to transforlning growth factor-beta 1. The knowledge of these mechanisms will lead to prompt and appropriate treatments for individual patients.

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