Regeneration in Cirrhosis of the Liver Following Partial Hepatectomy

Distribution of regenerative hepatocytes was observed by autoradiographic study in at liver after partial hepatectomy in order to investigate the relationship between hepatic blood flow around the pseudolobule and regeneration in cirrhosis of the liver. In cirrhotic liver, pseudolobules were mostly supplied by hepatic arterial flow as most of portal blood flow were bypassed around the pseudolobule resulting in marked decrease of sinusoidal blood flow. Regenerative rate of liver remnant was not increased in cirrhotic hepatectomized group during the experimental period, while it was increased to 105.0±21.2% at 48 hours in normal hepatectomized group after operation (P<0. 01). Unelevated regenerative rate in cirrhotic liver may have been induced by marked decrease of sinusoidal portal blood flow caused by intrahepatic portavenous shunt. As judged by H3-thymidine incorporation, DNA synthesis was increased to a maximum of 8335.1±1668.8 dpm/mg/min. at 36 hours in normal liver, and of 6538.9±2898.5 dpm/mg/min. at 48 hours in cirrhotic liver after partial hepatectomy (P<0.01). Average labeled hepatocyte number was also significantly increased to a peak of 48.0±9.1 at 36 hours in lobules of normal liver (P<0.001) and of 12.9±4.8 at 48 hours in pseudolobules of cirrhotic liver after partial hepatectomy (P< 0.01). Dissociation of unelevated regenerative rate of liver remnant from increase of DNA synthesis in cirrhotic hepatectomized group may indicate that cell volume stimulating factor is entirely different from cell number stimulating factor, and each factor plays a role individually. Direction of spreading of regeneration in normal liver was from peripheral zone to central zone, while spreading of regeneration in cirrhotic liver did not have specific direction in the pseudolobule. Direction of spreading of regeneration in normal hepatectomized group may substantiate the relation between direction of intralobular blood flow and liver regeneration. Nonspecific distribution in cirrhotic liver which has no direction of regeneration, indicates that regeneration does not always need the portal blood flow and can be supported by hepatic arterial flow which is expected to contain the portal blood factor after systemic circulation.