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
