Estrogen therapy for hepatectomy patients with poor liver function?

Chiu, Jeng Jiann; Lin, Lih‐Chang; Chi, Weiwei; Liu, Y.; Lui, YH

doi:10.1054/mehy.2001.1496

Cited by 13 publications

(9 citation statements)

References 27 publications

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“…Previous reports have suggested a clear stimulatory effect of estrogen (30,31). Therefore, the finding in the present study that females had significantly lower rates of liver regeneration compared with males is curious.…”

Section: Discussioncontrasting

confidence: 38%

Liver Regeneration and Surgical Outcome in Donors of Right-Lobe Liver Grafts

Pomfret

Pomposelli²,

Gordon³

et al. 2003

Transplantation

169

164

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Section: Discussioncontrasting

confidence: 38%

Liver Regeneration and Surgical Outcome in Donors of Right-Lobe Liver Grafts

Pomfret

Pomposelli²,

Gordon³

et al. 2003

Transplantation

169

164

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“…Donor age and gender may affect liver regeneration. Some series have reported increased regeneration in younger donors and female donors, possibly secondary to estrogen 17, 18. However, some authors have reported that the liver regeneration rate does not differ by donor age19 or gender 20, 21.…”

Section: Discussionmentioning

confidence: 99%

Liver regeneration in donors and adult recipients after living donor liver transplantation

Haga¹,

Shimazu²,

Wakabayashi³

et al. 2008

Liver Transpl

109

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In living donor liver transplantation, the safety of the donor operation is the highest priority. The introduction of the right lobe graft was late because of concerns about donor safety. We investigated donor liver regeneration by the types of resected segments as well as recipients to assess that appropriate regeneration was occurring. Eighty-seven donors were classified into 3 groups: left lateral section donors, left lobe donors, and right lobe donors. Forty-seven adult recipients were classified as either left or right lobe grafted recipients. Volumetry was retrospectively performed at 1 week, 1, 2, 3, and 6 months, and 1 year after the operation. In the right lobe donor group, the remnant liver volume was 45.4%, and it rapidly increased to 68.9% at 1 month and 89.8% at 6 months. At 6 months, the regeneration ratios were almost the same in all donor groups. The recipient liver volume increased rapidly until 2 months, exceeding the standard liver volume, and then gradually decreased to 90% of the standard liver volume. Livers of the right lobe donor group regenerated fastest in the donor groups, and the recipient liver regenerated faster than the donor liver. Analyzing liver regeneration many times with a large number of donors enabled us to understand the normal liver regeneration pattern. Although the donor livers did not reach their initial volume, the donors showed normal liver function at 1 year. The donors have returned to their normal daily activities. Donor hepatectomy, even right hepatectomy, can be safely performed with accurate preoperative volumetry and careful decision-making concerning graft-type selection. Liver Transpl 14: [1718][1719][1720][1721][1722][1723][1724] 2008 Living donor liver transplantation (LDLT) plays an important role because of cultural attitudes and the scarcity of cadaveric donations in Japan.1 LDLT involves an ethical problem: because the donor operation is performed on a healthy person, donor safety is the highest priority and requires special attention. LDLT was a treatment first for infants, then for children, and finally for adults. Although a left lobe graft provides enough volume for pediatric recipients, some adult recipients require a right lobe graft. There is little question about donor safety, on the basis of remnant liver volume requirements alone, if only a left lateral section and left lobe graft are procured. It is in the use of a right lobe that issues of donor safety come into play. Several authors have studied donor safety, especially with respect to surgical complications and clinical courses.2,3 Donor safety from various standpoints should be studied further in order to gain insight into the postoperative recovery pattern of a healthy person and to prevent complications.Although the human liver can tolerate more than 70% hepatectomy, 4 unfortunately some living donors have died of excessive loss of the liver.5-7 Precise evaluations of donor liver volume are important in order to prevent unexpected hepatic insufficiency and to evaluate normal liver rege...

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“…With the assumption that exposure to estrogen for short periods might aid liver regeneration, Chiu et al 19 administered estradiol to patients with liver function deficiency after hepatectomies and found that In this study, the administration of estradiol hexahydrobenzoate determined a higher number of positive PCNA hepatocytes at both times studied, although this number was higher after 36 hours. The number of mitosis figures proved to be higher after seven days in both groups, with no significant difference between one group and the other.…”

Section: Discussionmentioning

confidence: 50%

“…Chiu et al 19 demonstrated that patients with liver function deficiency, following hepatectomies, saw an improvement in their function when treated with estradiol.…”

Section: Introductionmentioning

confidence: 99%