Portal vein stenosis preconditioning of living donor liver in swine: early mechanisms of liver regeneration and gain of hepatic functional mass

In order to reduce the morbidity and mortality risk for the donor in living donor liver transplantation (LDLT), we previously identified 20% left portal vein (LPV) stenosis as the effective preconditioning to induce cell proliferation in the contralateral lobe without the downstream ipsilateral atrophy. We report, here, the pathways involved in the first hours after the preconditioning and investigate the changes in liver volume and function. Fourteen pigs entered this study. Five of them were used to study the genetic, cellular and molecular mechanisms set up in the early hours after the establishment of our preconditioning. Nine pigs were equally divided into 3 groups: sham operated animals, 20% LPV stenosis and 100% LPV stenosis. Volumetric scanner and 99mTc-Mebrofenin hepatobiliary scintigraphy were performed before and 14 days after preconditioning in order to study morphological and functional changes in the liver. We demonstrated that liver regeneration triggered by 20% LPV stenosis in the contrala...