The effects of splenectomy, PRP and CGF on liver regeneration and functions in rats with post-hepatectomy liver failure following major hepatectomy

The Effects of Splenectomy, PRP, and CGF on Liver Regeneration and Functions in Rats with Post-Hepatectomy Liver Failure Following Major Hepatectomy Post-hepatectomy liver failure (PHLF) is one of the most significant causes of morbidity and mortality following resection. It manifests with impaired liver synthesis, extraction, and detoxification functions, accompanied by increased INR and hyperbilirubinemia on or after the 5th postoperative day. Recent evidence suggests that platelets positively influence liver regeneration. This study aims to compare the effects of splenectomy (SPx), platelet-rich plasma (PRP), and concentrated growth factor (CGF) on liver regeneration and functions in rats with a PHLF model. In the experimental model, rats were randomly divided into seven groups. One group of animals was sacrificed to obtain PRP and CGF. One group served as the control group, and another as the sham group, while the remaining four groups underwent 70% hepatectomy (PHx) to create the PHLF model. These four groups consisted of PHx, PHx+SPx, PRP, and CGF groups. In the PRP and CGF groups, PRP and CGF were administered via the portal vein following 70% PHx. Liver regeneration was evaluated histopathological and immunohistochemically (Ki-67, STAT3, and pSTAT3). Liver functions were assessed by measuring ALT, AST, total, and direct bilirubin levels. Our results indicated that the PHx and PHx+SPx groups had significantly higher biochemical markers compared to the other groups. PRP significantly increased Ki-67 expression, CGF improved cell morphology and biochemical markers, and reduced mortality. PHx significantly increased STAT3, while SPx did not provide significant improvements in histopathological, immunohistochemical, or biochemical parameters in our study. In conclusion, PRP application enhanced regeneration and improved liver functions, CGF application provided histopathological improvement and positively affected liver functions, reducing mortality, suggesting a potential role in the treatment of PHLF. The role of STAT3 in liver fibrosis and hepatocyte aging, beyond liver regeneration, suggests its role in regeneration assessment is debatable. Further studies are needed to clearly evaluate the roles of PRP and CGF in posthepatectomy liver failure.