Liver volume and function in rat models of regenerative liver surgery

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Resections of liver metastasis of the colon and rectum are the most common reason for liver resections in the western world. The advances of chemotherapies and surgical techniques have increased the pool of patients with resectable livers. Especially techniques to increase the future liver remnant prior to surgery to prevent post-hepatectomy liver failure increase the limits of resectability.Nevertheless, methods like portal vein embolization, portal vein ligation and two-staged hepatectomies are limited by a moderate hypertrophy of the future liver remnant. To overcome this limitation, “Associating Liver Partition and Portal vein ligation for Staged hepatectomy” (ALPPS) was proposed to expand resectability. The combination of portal vein ligation and parenchymal transection leads to a more extensive hypertrophy in a shorter period of time. However, the analysis of the outcomes after ALPPS demonstrated an unexpected increase in post-hepatectomy liver failure. This observation suggested that liver volume potentially overestimates liver function after induction of a rapid hypertrophy. The aim of this project is to find out, if rapid hypertrophy after ALPPS or an extended liver resection in a rat model, is associated with a lack of an increase of liver function relative to liver volume. Furthermore, it will be investigated, if a slow hypertrophy after portal vein ligation also causes an incongruence of the increase of volume and function or not. Liver volume and function are measured by MRI using Gd-EOB-DTPA (Primovist®).The importance of this project is underlined by the fact, that key facts about functionality of hypertrophied parenchyma is still missing, while regenerative surgery is widely used in clinic. The aim of this project is to provide clinicians with basic knowledge about the functionality of liver regeneration after induction of a rapid hypertrophy by using a rodent model.