The mechanism of liver regeneration after portal lmbolization and the effect of transforming growth factor alpha to liver regeneration

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Preoperative portal embolization was performed in 13 patients (6 with bile duct cancer, 3 with metastatic liver tumor, 1 with hepatocellular carcinoma, 1 with gall bladder carcinoma, 1 with bile duct cystadenocarcinoma and 1 with cholangio carcinoma. Twelve cases were no fibrosis and one case was chronic hepatitis in non cancerous lesion. In transileocolic portal embolization the catheter was inserted into the portal vein at laparotomy through the ileocolic vein. The embolization material consisted of a mixture of 2g Gelfoam powder, 10000 units of thrombin, and 200 mg of Amikacin. Serum TGF-alpha levels were measured by enzyme-linked immunosorbent diffusion assay (ELISA). Blood was collected before portal embolization and on days 1, 2, 3, 5, 7, 14 and 21 after surgery from patients who underwent portal embolization. Wedge biopsy specimens were obtained intraoperatively from the right (embolized) and left (non embolized) lobes before hepatic resection. After expression of proliferative cell nuclear antigen (PCNA) was detected immunohistochemically using the monoclonal antibody PC 10, 1000 hepatocytes per section were examined and the labeling index (LI) was defined as the number of PCNA-positive cells per 1000 hepatocytes. All cases had a little change of liver function after PE.Serum TGF-alpha values in eleven cases show two peaks. The values reached the first peak levels on postoperative day 1 to day 3 and the second peak levels on postoperative day 14 to 21. The LI for nonembolized lobe in five cases were significantly higher than those for the embolized lobe.