Ukomadu, Chinweike, Greenbaum, Linda and Tchorz, Jan (2020) Clinical translation of liver regeneration therapies: A conceptual road map. Biochemical pharmacology, x (x). x-x. ISSN x

Abstract

The increasing incidence of severe liver diseases worldwide has resulted in a high demand for curative liver transplantation. Unfortunately, the need for transplants by far eclipses the availability of suitable grafts leaving many waitlisted patients to face liver failure and often death. Use of smaller left lobe grafts from living or deceased donors could increase the number of life-saving grafts but is often limited by the graft versus recipient weight ratio defining the safety margins that minimize the risk of small for size syndrome (SFSS. In addition, smaller grafts from deceased donors also face a similar fate. SFSS is a severe complication characterized by failure of a small liver graft to regenerate and occurs when a donor graft is insufficient to meet the metabolic demand of the recipient, leading to liver failure as a result of insufficient liver mass. SFSS is not limited to transplantation but can also occur in the setting of hepatic surgical resections, where life-saving large resections of tumors may be limited by concerns of post-surgical liver failure. There are as yet no available pro-regenerative therapies to enable liver regrowth and thus prevent SFSS. However, there is optimism around targeting factors and pathways that have been identified as regulators of liver regeneration to induce regrowth in-vivo and ex-vivo for clinical use. In this commentary, we propose a roadmap for developing such pro-regenerative therapy and for bringing it into the clinic. We summarize the clinical indications, preclinical models, pro-regenerative pathways and safety considerations necessary for developing such a drug.

Item Type:	Article
Date Deposited:	14 Aug 2025 00:45
Last Modified:	14 Aug 2025 00:45
URI:	https://oak.novartis.com/id/eprint/41433