Preoperative Granulocyte-Colony Stimulating Factor (G-CSF) Treatment Improves Congested Liver Regeneration

BackgroundHepatic venous congestion after liver surgery can cause liver failure. We evaluated the effectiveness of granulocyte-colony stimulating factor (G-CSF) for regeneration of remnant liver with venous congestion.Materials and MethodsRats were divided into three groups. Group A underwent 60% hepatectomy. Group B underwent 60% hepatectomy with partial venous congestion in remnant liver. Group C underwent the same procedures as group B with G-CSF given preoperatively for 5 d. To evaluate liver regeneration in each group at 1, 2, 3, 5, and 7 d postoperatively, the proliferating cell nuclear antigen (PCNA) labeling index (LI), mitotic index (MI) in the congested area of remnant liver, and regeneration rate of remnant liver weight were measured. CD34 antibody-positive hematopoietic stem cell (HSC) colonies were identified using immunopathological staining.ResultsCompared with group B, in group C, LI, and MI in congested remnant liver increased earlier, peak LI value in the congested area appeared 24 h earlier, and full recovery of remnant liver weight occurred 2 d earlier. On postoperative day 3, remnant liver weight was significantly greater in group C than group B. On microscopy, CD34-positive cells were seen in preoperative group C livers.ConclusionPreoperative G-CSF improves regeneration of livers with venous congestion.