Published online Jun 28, 2023. doi: 10.3748/wjg.v29.i24.3748
Peer-review started: April 3, 2023
First decision: May 4, 2023
Revised: May 13, 2023
Accepted: June 2, 2023
Article in press: June 2, 2023
Published online: June 28, 2023
Processing time: 86 Days and 5 Hours
Partial hepatectomy (PH) can lead to severe complications, including liver failure, due to the low regenerative capacity of the remaining liver, especially after extensive hepatectomy. Liver sinusoidal endothelial cells (LSECs), whose proliferation occurs more slowly and later than hepatocytes after PH, compose the lining of the hepatic sinusoids, which are the smallest blood vessels in the liver. Vascular endothelial growth factor (VEGF), secreted by hepatocytes, promotes LSEC proliferation. Supplementation of exogenous VEGF after hepatectomy also increases the number of LSECs in the remaining liver, thus promoting the reestablishment of the hepatic sinusoids and accelerating liver regeneration. At present, some shortcomings exist in the methods of supplementing exogenous VEGF, such as a low drug concentration in the liver and the reaching of other organs. More-over, VEGF should be administered multiple times and in large doses because of its short half-life. This review summarized the most recent findings on liver regeneration and new strategies for the localized delivery VEGF in the liver.
Core Tip: Low regenerative ability of the liver remaining after partial hepatectomy may lead to serious complications including liver failure. The proliferation of liver sinusoidal endothelial cells (LSECs) is slower and occurs later compared to that of hepatocytes, leading to a delayed recovery of the hepatic sinusoids and impaired liver regeneration. Hepatocytes secrete vascular endothelial growth factor (VEGF) that promotes the proliferation of LSECs, and supplementation of exogenous VEGF after hepatectomy also increases the number of LSECs in the remaining liver, thus promoting the reestablishment of the hepatic sinusoids and accelerating liver regeneration. This review summarized the most recent findings on liver regeneration and new strategies for the localized delivery in the liver.