Work

Factors influencing future liver remnant hypertrophy after portal vein embolization: a mini review

Year: 2026

Type: review

Abstract: Background: Portal vein embolization (PVE) promotes future liver remnant (FLR) hypertrophy before major hepatectomy, but the response varies substantially among patients. This review summarizes determinants of post-PVE FLR hypertrophy to support preoperative risk stratification and individualized planning. Methods: Targeted searches of PubMed/MEDLINE, Web of Science, Scopus, Embase, and China National Knowledge Infrastructure (CNKI) through 26 August 2026 combined terms for PVE, liver regeneration or FLR hypertrophy, and predictors or associated factors. Reference lists and the authors' existing reference collection were also screened, and evidence was narratively synthesized across five domains. Results: FLR hypertrophy reflects multiple interacting determinants. Advanced age, selected chemotherapy exposures, and liver fibrosis have been associated with weaker regenerative responses. Elevated inflammatory markers and biliary infection may impair hypertrophy, whereas adequate embolization extent and appropriate embolic material selection may improve the response. Conclusion: FLR hypertrophy after PVE is determined by interacting demographic and clinical, laboratory, hepatic and biliary, tumor-related, and procedure-related factors. Recognizing these determinants may improve patient selection, help predict insufficient hypertrophy, and guide individualized PVE strategies to increase the safety of major hepatectomy.

Source: Frontiers in Surgery

DOI: 10.3389/fsurg.2026.1979361