Review
Copyright ©2007 Baishideng Publishing Group Co., Limited. All rights reserved.
World J Gastroenterol. Feb 7, 2007; 13(5): 657-670
Published online Feb 7, 2007. doi: 10.3748/wjg.v13.i5.657
Role of ischaemic preconditioning in liver regeneration following major liver resection and transplantation
D Gomez, S Homer-Vanniasinkam, AM Graham, KR Prasad
D Gomez, KR Prasad, Department of Hepatobiliary Surgery and Transplantation, St. James’s University Hospital, United Kingdom
S Homer-Vanniasinkam, Department of Vascular Surgery, Leeds General Infirmary, Leeds, United Kingdom
AM Graham, Department of Biomedical Sciences, University of Bradford, Bradford, United Kingdom
Author contributions: All authors contributed equally to the work.
Correspondence to: KR Prasad, Consultant Hepatobiliary and Transplantation Surgery, Department of Hepatobiliary Surgery and Transplantation, St. James’s University Hospital, Beckett Street, Leeds LS9 7TF, United Kingdom. raj.prasad@leedsth.nhs.uk
Telephone: +44-113-2065921 Fax: +44-113-2448182
Received: November 11, 2006
Revised: December 3, 2006
Accepted: December 21, 2006
Published online: February 7, 2007
Abstract

Liver ischaemic preconditioning (IPC) is known to protect the liver from the detrimental effects of ischaemic-reperfusion injury (IRI), which contributes significantly to the morbidity and mortality following major liver surgery. Recent studies have focused on the role of IPC in liver regeneration, the precise mechanism of which are not completely understood. This review discusses the current understanding of the mechanism of liver regeneration and the role of IPC in this setting. Relevant articles were reviewed from the published literature using the Medline database. The search was performed using the keywords “liver”, “ischaemic reperfusion”, “ischaemic preconditioning”, “regeneration”, “hepatectomy” and “transplantation”. The underlying mechanism of liver regeneration is a complex process involving the interaction of cytokines, growth factors and the metabolic demand of the liver. IPC, through various mediators, promotes liver regeneration by up-regulating growth-promoting factors and suppresses growth-inhibiting factors as well as damaging stresses. The increased understanding of the cellular mechanisms involved in IPC will enable the development of alternative treatment modalities aimed at promoting liver regeneration following major liver resection and transplantation.

Keywords: Liver regeneration; Ischaemic reperfusion; Ischaemic preconditioning; Hepatectomy; Transplantation