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Semin Thromb Hemost 2020; 46(06): 735-742
DOI: 10.1055/s-0040-1715450
Review Article

Hemostasis and Liver Regeneration

Patrick Starlinger
1   Department of Surgery, Vienna General Hospital, Medical University of Vienna, Vienna, Austria
2   Department of Surgery, Mayo Clinic, Rochester, Minnesota
,
James P. Luyendyk
3   Department of Pathobiology and Diagnostic Investigation, Michigan State University, East Lansing, Michigan
,
Dafna J. Groeneveld
3   Department of Pathobiology and Diagnostic Investigation, Michigan State University, East Lansing, Michigan
› Author Affiliations Funding This research was supported by grants from the National Institutes of Health (NIH) to J. P. L. (R01 ES017537, DK122813 and DK120289), support from the U.S. Department of Agriculture's National Institute of Food and Agriculture, and an EHA Research Grant from the European Hematology Association to D. G. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institute of Diabetes and Digestive and Kidney Diseases or the NIH.
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Abstract

The liver is unique in its remarkable regenerative capacity, which enables the use of liver resection as a treatment for specific liver diseases, including removal of neoplastic liver disease. After resection, the remaining liver tissue (i.e, liver remnant) regenerates to maintain normal hepatic function. In experimental settings as well as patients, removal of up to two-thirds of the liver mass stimulates a rapid and highly coordinated process resulting in the regeneration of the remaining liver. Mechanisms controlling the initiation and termination of regeneration continue to be discovered, and many of the fundamental signaling pathways controlling the proliferation of liver parenchymal cells (i.e., hepatocytes) have been uncovered. Interestingly, while hemostatic complications (i.e., bleeding and thrombosis) are primarily thought of as a complication of surgery itself, strong evidence suggests that components of the hemostatic system are, in fact, powerful drivers of liver regeneration. This review focuses on the clinical and translational evidence supporting a link between the hemostatic system and liver regeneration, and the mechanisms whereby the hemostatic system directs liver regeneration discovered using experimental settings.

Keywords

partial hepatectomy - platelets - fibrinogen - von Willebrand factor - serotonin - platelet-derived growth factors - hemostasis - liver regeneration - liver failure


Publication History

Article published online:
09 September 2020

© 2020. Thieme. All rights reserved.

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