Regenerative hyperplasia of the cirrhotic liver following partial hepatectomy

ESECTION of the entire right lobe of the R liver is being performed with some hequency for such conditions as primary malig-Gp.nant neoplasms (hepatoma, cholangiocara-no.noma, and somatic sarcoma), unilobar No-S&d~led an.treatment Use of rats t time of death metastases, cancer of the gallbladder, and, occasionally, benign tumors.The right lobe corn-io 5 killed of gp. 1 mo.rats after part.hepatect.prises 80% of the weight of the human liver, 5 killed 1 mo.after part.hepatect.yet it is now reasonably safe to perform a 5 killed 3 mo.after part.hepatect.total right hepatic lobectomy by preliminary ligation and severance of the right hepatic 5 killed 1 mo.after part.hepatect.duct, the right hepatic artery, and the right of gp. of rats given 30 doses of CCld in olive oil over 60-day branch of the portal vein before transection of per.* the interlobar septum. 2 15 doses 5 kept as nonop.cirrhotic controls: A residual 20% of the liver is enough for CClr in 1 died soon after completion of olive oil inject.sched.; 4 killed 1 mo.after over 30part.hepatect. of other gp. 2 rats the maintenance of life if the individual is an otherwise normally functioning person.Liver day per.15 had 70% r r t .hepatect.; all function tests given to humans before and killed 1 mo.ter 45 doses 3 died before completion of inject.ached.after right hepatic lobectomies often show im-&, cclr in mediate improvement, thus proving the adeolive oil 5 kept as nonop.cirrhotic controls: quacy of the minute residual left lobe.In a over 90-3 died after com letion of inject.day per.sched.; 2 killed f mo. after part.right lobe largely replaced by tumor, there hepatect. of other gp. 3 rats may be insufficient normal parenchyma to take 12 had 7001, part.hepatect.; 4 died within 1st postop.wk.; 6 kllled 1 care of the influx of portal blood, but with mo. after part.hepatect.; 2 killed the precipitate shunting of all portal blood to 3 mo.after part.hepatect.the left lobe at the time of ligation and sever-*The rats given 3o doses of carbon tetrachloride ance of the right branch of the portal vein, are not included in the text of this report because the there follows an amazing demonstration of the results of their treatment were not prticularly contributory and their omission simplifies the report.functional capacity of this liver remnant.Clinical and laboratory investigations, including "second look" observations and biop hypevlaia that may k summarized folsies after a postoperative interval of 2 years, lows.At the moment the right lobe is excised, of htmans s ~r g i c a l l ~ deprived of the right the impulse for liver regeneration is initiated hepatic lobe, together with a series of experi-in h e left lobe.mentS on rats and dogs, have fmmkhed US lobe is not simply due to vascular engorge-With Certain data about regenerative liver ment and edema but rather is due to a tfue proliferation of new liver tissue.Chemical F , ., , " the ~~~~, .i ~l and J~~~ Ewing h a f i m b and analyses of aliquots of the regenerated liver the Sloan-Kettering Institute for Cancer Research, New show values for lipid, nitrogen, and water con-York.N.Y., and the Division of Laboratonar and Retent identical with those of the normal liver.search, New York State Department of Health, Albany, N.Y.Nuclear counts of homogenized residual liver This inv=tigation WaJ supported in part by a re-tissue in the rat and dog confirm the tenet that search grant (C-2027) from the National Cancer Institute, o f the National Institutes of Health.Public H e a l t h the increased liver substance due to a true service.regenerative hyperplasia.The rapidity of liver P-t add=: Pmt-Pduate Department.-1-regeneration after subtotal hepatectomy a p lcgc of Medicine and Denhstry.Seton Hall Univdty.pears to be inversely to the size Newark.N.J.