To fill the missing fragments of a complex mosaic of liver regeneration

Keti Tsomaia, Nino Inauri, Leila Patarashvili, Nino Karumidze, Elza Azmaipharashvili, Irakli Bebiashvili, Mtvarisa Kordzaia, Manana Kakabadze, Diana Dzidziguri, Dimitri Kordzaia


Background: Liver resection has increased due to the increased number of liver pathologies and frequency of transplantation of the half of liver from living donor. New Surgical approaches allow removal of massive space-occupying hepatic tumors, which earlier was considered as inoperable. Liver regeneration after its resection is one of the most intensively studied processes. It’s a paradox, that in existence of such large number of studies regarding the mechanisms of liver regeneration, structural side of liver’s remnant growth following partial hepatectomy (PH) is practically less researched, and the questions - “How the structure and architectonics of regenerated liver differs from normal, regular liver? “ still waiting for answers.

Method: We have reviewed the articles of the last two decades from Pubmed and Google Scholar medical databases containing in the advanced search engine “title/abstract” at least 2 keywords from the following: Liver regeneration, partial hepatectomy, living donor liver transplantation, liver histology, immunohistochemistry, stem cells.  The additional articles were addressed in case of underlined contextual necessity.

Conclusion: To fill the gaps of our knowledge in the structural changes of liver regeneration after PH, it should be found out:

  • What happens with liver lobules?  Is enlargement of liver remnant after PH is caused by the development of new lobules or increase in the volume of existed ones?
  • How do the branches of the tubular (vascular) structures “follow” liver’s growth – by “developing of new branches” or “extension/elongation” of old ones?
  • What are the differences between architectonics of normal and regenerated liver?                                                                                                                                                                                            The existence of such questions proves the importance of further investigation of liver regeneration to fill the missing fragments of the complex mosaic of liver regeneration, without which it is impossible to imagine this process in whole.


Liver regeneration; partial hepatectomy;liver histology; stem cell; liver donor;

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