CD4+CD25+ regulatory T cells decreased future liver remnant after associating liver partition and portal vein ligation for staged hepatectomy

Figure 1 Changes in the proportion of CD4⁺CD25⁺ Tregs to CD4⁺ T cells in peripheral blood before and after surgery for stage 1 ALPPS and stage 2 ALPPS. ALPPS: Associating liver partition and portal vein ligation for staged hepatectomy; Pre: Preoperation; Pod: Postoperative; Tregs: Regulatory T cells.

Figure 2 Trends in future liver remnant volume between stage 1 ALPPS and stage 2 ALPPS. ALPPS: Associating liver partition and portal vein ligation for staged hepatectomy.

Figure 3 Relationship between the proportion of CD4⁺CD25⁺ Tregs in peripheral blood and future liver remnant regeneration indexes after stage 1 ALPPS. A: Proliferative volume, r = -0.442 (P = 0.009); B: Proliferation rate, r = -0.469 (P = 0.005); C: Kinetic growth rate, r = -0.511 (P = 0.001). ALPPS: Associating liver partition and portal vein ligation for staged hepatectomy. FLR: Future liver remnant; Tregs: Regulatory T cells.

Figure 4 Relationship between the proportion of CD4⁺CD25⁺ Tregs after stage 1 ALPPS and the index of future liver remnant regeneration after stage 1 ALPPS. A: Proliferative volume (P < 0.05); B: Proliferation rate (P < 0.05); C: Kinetic growth rate (P < 0.05). ALPPS: Associating liver partition and portal vein ligation for staged hepatectomy. FLR: Future liver remnant; Tregs: Regulatory T cells.

Figure 5 Receiver operating characteristic curve of CD4⁺CD25⁺ Tregs after stage 1 ALPPS and the index of future liver remnant regeneration after stage 1 ALPPS. The AUC between CD4⁺CD25⁺ Tregs percentage and proliferative volume was 0.7197 (0.5400-0.8994; P = 0.029), the AUC between CD4⁺CD25⁺ Tregs percentage and proliferative rate was 0.7474 (0.5806-0.9142; P = 0.014), and the AUC between CD4⁺CD25⁺ Tregs percentage and Kinetic growth rate was 0.7785 (0.6172-0.9399; P = 0.006). ALPPS: Associating liver partition and portal vein ligation for staged hepatectomy. FLR: Future liver remnant; Tregs: Regulatory T cells. AUC: Area under the curve.

Figure 6 Schematic diagram of the immune mechanism that regulatory T cells may participate in after ALPPS. ALPPS: Associating liver partition and portal vein ligation for staged hepatectomy; HCC: Hepatocellular carcinoma; IL: Interleukin; TGF: Transforming growth factor; Tregs: Regulatory T cells.