Total Blood Exchange Suppresses the Early Stage of Liver Regeneration Following Partial Hepatectomy in Rats

Abstract

Despite its obscure and short effect, plasma exchange (PE) remains a mainstay in the treatment of liver disease. However, the question still remains as to whether or not PE suppresses the regeneration of the liver because PE deprives patients of hepatotrophic factors. The effect of PE, which could be a total blood exchange (TBE) in a syngeneic setting, on liver regeneration following a 68% partial hepatectomy (PH) was investigated in rats. In Group 1, 20 ml of blood from normal rats was infused while native blood was removed at 6 and 12 h after PH. In Group 2, 20 ml of blood obtained from PH rats at the same time points was infused. The regeneration rate, labeling index of proliferating cell nuclear antigen (PCNA), and plasma hepatocyte growth factor (HGF) level were determined, and standard liver function tests performed at 24, 48, and 72 h. Although all liver function tests improved in Group 1 at 24 and 48 h, the regeneration rate was significantly impaired. Similarly, the PCNA labeling index was significantly lower in Group 1 than that in Group 2. The plasma HGF level was significantly reduced in Group 1 (6 h blood out versus blood in: 1.1+/-0.5 vs. 0.1+/-0.1 ng/ml, p < 0.05). TBE with normal blood following PH suppressed the early stage of liver regeneration, in part, because of the reduction of HGF even though the blood was purified.

Efficacy of coupled low-volume plasma exchange with plasma filtration adsorption in treating pigs with acute liver failure: A randomised study

“…Moreover, the PE procedure removed all elements of plasma, including some beneficial substances (such as HGF) for hepatocyte proliferation, which possibly suppresses hepatocyte proliferation [46]. We chose low-volume PE as the first Li-ALS step to efficiently utilise fresh plasma, avoid side effects, and reduce losing beneficial substances.…”

Changes in circulating cytokine levels and lymphocyte subsets in healthy liver donors after partial hepatectomy

“…During liver regeneration, quiescent hepatocytes undergo one or two rounds of replication and then return to a non‐proliferative state. Total blood exchange after partial hepatectomy suppresses the early stage of liver regeneration, 1 indicating the existence of factors important for regeneration in serum and blood cells. Although studies of factors involved in hepatic regeneration have been reported, most studies have been limited to animal models.…”

Pharmacokinetics of Tacrolimus and Mycophenolic Acid Are Altered, but Recover at Different Times During Hepatic Regeneration in Rats

“…clearance of tacrolimus in control rats (9.22 ml/min/kg) and the reported blood flow of 55.2 ml/min/kg (Davies and Morris, 1993), and assuming lack of any change in the unbound fraction of tacrolimus, since red blood cells are primarily responsible for binding tacrolimus in blood (Venkataramanan et al, 1995) and since hematocrit does not change during hepatic regeneration (Eguchi et al, 1998;Kurata et al, 2000;Okano et al, 2001), the total body clearance of tacrolimus at the 24th h should have been, at most, 2.21 ml/min/kg. However, although the total body clearance of tacrolimus was significantly decreased 24 h after PHx, the magnitude was much less than what was predicted based on in vitro data.…”