Prometheus Shows The Liver Grows

Prometheus Bound demonstrates what we have known about liver regeneration since fire was first stolen

Peter Rubens, artist

As punishment for stealing fire, Prometheus was chained to a rock and every day a vulture/eagle came and ate his liver.  The liver grew back and was eaten again and again.  Prometheus was the son of Iapetus who was one of the Titans.  He stole the sacred fire from Zeus and the gods. In punishment, Zeus commanded that Prometheus be chained for eternity in the Caucasus. There, an eagle (or, according to other sources, a vulture) would eat his liver, and each day the liver would be renewed. So the punishment was endless, until Heracles finally killed the bird.   by Jonathan Vadakethu

The left lobe of the human liver grows rapidly.  That is why we can take part of one person’s liver and transplant it into person.  Both grow a liver.  So if that is true, why can’t a liver regenerate on its own after injury from hepatitis or cirrhosis?  Try to picture you skin healing after injury.  Now picture skin growth over the scar.  Scar tissue doesn’t grow because it is, well, scarred.  So injured livers do not regenerate.

If I regenerate my liver, do I regenerate my crazies? Not studied, but these guys from the University of Minnesota say volume of liver regeneration is ideal at 3 months for recipient and donor.  Left lobe may be best. 

I just summarized the below study for you in 2 sentences.  I can’t imagine the difficulty a patient without some medical knowledge has trying to make informed decisions about his/her own life. 

Liver Regeneration After Adult Living Donor and Deceased Donor Split-Liver TransplantsAbhinav Humar,1 Kambiz Kosari,1 Timothy D. Sielaff,1 Brooke Glessing,1Maria Gomes,2 Charles Dietz,2 Galia Rosen,2 John Lake,1 and William D. Payne1

As the number of living donor (LD) and deceased donor (DD) split-liver transplants (SLTs) have increased over the last 5 years, so too has the interest in liver regeneration after such partial-liver transplants. We looked at liver regeneration, as measured by computed tomography (CT) volumetrics, to see if there were significant differences among LDs, right-lobe LD recipients, and SLT recipients. We measured liver volume at 3 months postoperatively by using CT, and we compared the result to the patient’s ideal liver volume (ILV), which was calculated using a standard equation. The study group consisted of 70 adult patients who either had donated their right lobe for LD transplants (n _ 24) or had undergone a partial-liver transplant (right-lobe LD transplants, n _ 24; right-lobe SLTs, n _ 11; left-lobe SLTs, n _ 11). DD (vs. LDs) were younger (P < 0.01), were heavier (P _ 0.06), and had longer ischemic times (P < 0.01). At 3 months postoperatively, LDs had attained 78.6% of their ILV, less than the percentage for right-lobe LD recipients (103.9%; P _0.0002), right-lobe SLT recipients (113.6%; P _ 0.01), and left-lobe SLT recipients (119.7%; P_0.0006). When liver size at the third postoperative month was compared with the liver size immediately postoperatively, LDs had a 1.85-fold increase. This was smaller than the increase seen in right-lobe LD recipients (2.08-fold), right-lobe SLT recipients (2.17-fold), and left-lobe SLT recipients (2.52-fold). In conclusion, liver regeneration, as measured by CT volume, seems to be greatest in SLT recipients. LD recipients seem to have greater liver growth than their donors. The reason for this remains unclear. (LiverTranspl 2004;10:374 –378.And this is just the abstract.

The problem with following the literature and medical education is that you know how not good it is.

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