Zinc Supports Liver Regeneration After Partial Resection

Overview

Journal Turk J Surg

Specialty General Surgery

Date 2024 May 2

PMID 38694520

Authors

Yuki Takahashi

Hideyuki Oyama

Akihiro Nakamura

Yuzo Minegishi

Kuniya Tanaka

Affiliations

Soon will be listed here.

Abstract

Objectives: Safe removal of extensive liver tumor burdens depends on regeneration of the remnant liver, which requires a large amount of zinc over a short period of time. We studied how zinc influences regeneration.

Material And Methods: We measured perioperative serum zinc concentrations after liver cancer diagnosis in 77 patients undergoing hepatectomy to determine how serum zinc affected short-term outcomes and remnant liver regeneration.

Results: Serum zinc concentration at diagnosis showed no correlation with inflammatory or nutritional parameters except for a weak correlation with the lymphocyte-to-monocyte ratio. When patients were divided into a high pre-hepatectomy zinc group (≥75 µg/dL, n= 39, H group) and a low zinc group (<75 µg/dL, n= 38, L group), short-term results such as mortality (p> 0.999), morbidity (p= 0.490), and hospital stay (p= 0.591) did not differ between groups. However, hypertrophy in the future liver remnant after hepatectomy in the H group (127.7 ± 24.7% of original volume) was greater than in the L group (115.9 ± 16.7%, p= 0.024). In a subgroup of patients with extended hepatectomy, hypertrophy was 130.9 ± 26.8% in the H group vs. 116.4 ± 16.5% in the L group (p= 0.037).

Conclusion: Greater serum zinc at diagnosis was associated with greater hypertrophy in the future liver remnant.

References

Cherian M, Kang Y . Metallothionein and liver cell regeneration. Exp Biol Med (Maywood). 2006; 231(2):138-44. DOI: 10.1177/153537020623100203. View

Sullivan V, Burnett F, Cousins R . Metallothionein expression is increased in monocytes and erythrocytes of young men during zinc supplementation. J Nutr. 1998; 128(4):707-13. DOI: 10.1093/jn/128.4.707. View

Fisher B, Szuch P, Levine M, Fisher E . A portal blood factor as the humoral agent in liver regeneration. Science. 1971; 171(3971):575-7. DOI: 10.1126/science.171.3971.575. View

Pories W, Henzel J, ROB C, STRAIN W . Acceleration of healing with zinc sulfate. Ann Surg. 1967; 165(3):432-6. PMC: 1617499. DOI: 10.1097/00000658-196703000-00015. View

Shimada M, Matsumata T, Maeda T, Itasaka H, Suehiro T, Sugimachi K . Hepatic regeneration following right lobectomy: estimation of regenerative capacity. Surg Today. 1994; 24(1):44-8. DOI: 10.1007/BF01676884. View

Yamanaka N, Okamoto E, Kawamura E, Kato T, Oriyama T, Fujimoto J . Dynamics of normal and injured human liver regeneration after hepatectomy as assessed on the basis of computed tomography and liver function. Hepatology. 1993; 18(1):79-85. View

Oliver J, Mara T, Cherian M . Impaired hepatic regeneration in metallothionein-I/II knockout mice after partial hepatectomy. Exp Biol Med (Maywood). 2004; 230(1):61-7. DOI: 10.1177/153537020523000108. View

Mohammad M, Mohommad M, Zhou Z, Cave M, Barve A, McClain C . Zinc and liver disease. Nutr Clin Pract. 2012; 27(1):8-20. PMC: 6027651. DOI: 10.1177/0884533611433534. View

Blumgart L, Leach K, Karran S . Observations on liver regeneration after right hepatic lobectomy. Gut. 1971; 12(11):922-8. PMC: 1411942. DOI: 10.1136/gut.12.11.922. View

10.

Buhler R, KAGI J . Human hepatic metallothioneins. FEBS Lett. 1974; 39(2):229-34. DOI: 10.1016/0014-5793(74)80057-8. View

11.

Lin T, Lee C, Chen C, Liau K, Lin W . Regeneration of human liver after hepatic lobectomy studied by repeated liver scanning and repeated needle biopsy. Ann Surg. 1979; 190(1):48-53. PMC: 1344456. DOI: 10.1097/00000658-197907000-00011. View

12.

Brooke-Smith M, Figueras J, Ullah S, Rees M, Vauthey J, Hugh T . Prospective evaluation of the International Study Group for Liver Surgery definition of bile leak after a liver resection and the role of routine operative drainage: an international multicentre study. HPB (Oxford). 2014; 17(1):46-51. PMC: 4266440. DOI: 10.1111/hpb.12322. View

13.

Forrest L, McMillan D, McArdle C, Angerson W, Dunlop D . Evaluation of cumulative prognostic scores based on the systemic inflammatory response in patients with inoperable non-small-cell lung cancer. Br J Cancer. 2003; 89(6):1028-30. PMC: 2376960. DOI: 10.1038/sj.bjc.6601242. View

14.

Hoffmann T, Dworacki G, Tsukihiro T, Meidenbauer N, Gooding W, Johnson J . Spontaneous apoptosis of circulating T lymphocytes in patients with head and neck cancer and its clinical importance. Clin Cancer Res. 2002; 8(8):2553-62. View

15.

Starzl T, Porter K, Kashiwagi N . Portal hepatotrophic factors, diabetes mellitus and acute liver atrophy, hypertrophy and regeneration. Surg Gynecol Obstet. 1975; 141(6):843-58. PMC: 2671396. View

16.

Nagasue N, Yukaya H, Ogawa Y, Kohno H, Nakamura T . Human liver regeneration after major hepatic resection. A study of normal liver and livers with chronic hepatitis and cirrhosis. Ann Surg. 1987; 206(1):30-9. PMC: 1492934. DOI: 10.1097/00000658-198707000-00005. View

17.

Davis S, Cousins R . Metallothionein expression in animals: a physiological perspective on function. J Nutr. 2000; 130(5):1085-8. DOI: 10.1093/jn/130.5.1085. View

18.

Watanabe T, Arakawa T, Fukuda T, Higuchi K, Kobayashi K . Zinc deficiency delays gastric ulcer healing in rats. Dig Dis Sci. 1995; 40(6):1340-4. DOI: 10.1007/BF02065548. View

19.

Parker J, Siemsen J . Liver regeneration following hepatectomy, evaluated by scintillation scanning. Radiology. 1967; 88(2):342-4. DOI: 10.1148/88.2.342. View

20.

Yokoyama Y, Nishio H, Ebata T, Igami T, Sugawara G, Nagino M . Value of indocyanine green clearance of the future liver remnant in predicting outcome after resection for biliary cancer. Br J Surg. 2010; 97(8):1260-8. DOI: 10.1002/bjs.7084. View