Vaccines, vol.11, no.2, 2023 (SCI-Expanded)
Background: Inflammation and the associated immune pathways are among the most
important factors in liver regeneration after living donor hepatectomy. Various biomarkers, especially
liver function tests, are used to show liver regeneration. The aim of this study was to evaluate
the course of liver regeneration following donor hepatectomy (LDH) by routine and regenerationrelated biomarkers. Method: Data from 63 living liver donors (LLDs) who underwent LDH in Inonu
University Liver Transplant Institute were prospectively analyzed. Serum samples were obtained
on the preoperative day and postoperative days (POD) 1, 3, 5, 10, and 21. Regenerative markers
including alfa-fetoprotein (AFP), des carboxy prothrombin (DCP), ornithine decarboxylase (ODC),
retinol-binding protein 4 (RBP4), and angiotensin-converting enzyme isotype II (ACEII) and liver
function tests including alanine aminotransferase (ALT), aspartate aminotransferase (AST), gammaglutamyl transferase (GGT), alkaline phosphatase (ALP) and total bilirubin levels were all analyzed.
Results: The median age of the LLDs was 29.7 years and 28 LLDs were female. Eight LLDs developed
postoperative complications requiring relaparotomy. The routine laboratory parameters including
AST (<0.001), ALT (<0.001), ALP (<0.001), and total bilirubin (<0.001) showed a significant increase
over time until postoperative day (POD) 3. For the regeneration-related parameters, except for
the RBP4, all parameters including ACEII (p = 0.006), AFP (p = 0.002), DCP (p = 0.007), and ODC
(p = 0.002) showed a significant increase in POD3. The regeneration parameters showed a different
pattern of change. In right-lobe liver grafts, ACEII (p = 0.002), AFP (p = 0.035), and ODC (p = 0.001)
showed a significant increase over time. DCP (p = 0.129) and RBP4 (p = 0.335) showed no significant
changes in right-lobe liver grafts. Conclusions: Regenerative markers are increased in a sustained
fashion following LDH. This is more prominent following right-lobe grafts which are indicative of
progenitor-associated liver regeneration.