Clinical and experimental study of regeneration of nonembolized lobe after portal vein embolization

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This study demonstrated possible mechanism of liver regeneration in the nonembolized lobe after portal vein embolization. Clinical study : After right portal vein embolization, the blood flow of the left portal vein significantly increased, and the diameter of this vein also enlarged. Ultrasonographic measurement revealed that right portal vein embolization induces approximately 150% increase in diameter of the segment 2, segment 3, and segment 4 portal branches. Serum interleukin-6 concentrations significantly increased within 3 hours after portal vein embolization, peaked at 24 hours, then gradually decreased. The concentrations of tumor necrosis factor (TNF)-α and hepatocyte growth factor (HGF) remained unchanged. Experimental study : Human liver sinusoidal microvascular endothelial cells (HLSECs) and human umbilical vein endothelial cells (HUVECs) were cultured on the silicon chamber which were 150% stretched over the entire membrane. After this continuous mechanical stretch, the concentration of interleukin-6 in the supernatant of endothelial cells significantly increased, while the concentrations of TNF-α and HGF were unchanged. Interleukin-6 mRNA expression followed activation of NF κ B. Conclusion : These findings indicate that portal vein embolization dilates the portal branches in the nonembolized lobe, exposing hepatic vasculature to stretch stress. This hemodynamic change may act as a trigger for interleukin-6 release from endothelial cells and contribute to the activation of regenerative cascade in the nonembolized lobes.