Does fibrin glue affect liver regeneration? An experimental study in rats

Background: Fibrin glue has been used to prevent bleeding from the raw liver surface after hepatectomy. Fibrin glue has been proposed to induce hepatic regeneration but has not been clarified yet. Aim: In this study, we investigated the effect of fibrin glue on liver regeneration. Settings and Design: An experimental study in rats. Materials and Methods: After the 2/3 hepatectomy, a standard, 1 cm edged triangle was resected from the remaining lobe and a raw surface was obtained in 56 males Wistar rats. The rats were randomized to two groups: liver was repaired with prolene mattress sutures in one group and was sealed with fibrin glue in the other. Four rats were sacrificed immediately after the surgery in both groups for liver weight calculations. It was observed that resected liver constituted 71.6% (± 1.6) of total liver weight. On first, second and seventh day post-operatively, eight rats were sacrificed in each group. Morphological liver regenerations were assessed with liver weight restoration ratio and proliferating cell nuclear antigen (PCNA) labeling index. Results: No rat died during the study. The mean liver weight restoration ratio in suture and fibrin glue groups were similar at each time point studied: The percentage of the restored liver weight in suture and fibrin groups were 45% (± 17.79) and 47.63% (± 11.38) at 24 hour ( P=0.730); 79.50% (± 16.21) and 74.75% (± 10.51) at 48 hour ( P =0.415); 82.5% (± 16.21) and 85.38% (± 9.68) at day seven ( P =0.673). The mean PCNA labeling index in both groups increased at 24 hour (54.62 ± 11.02% in suture group vs. 70.38 ± 15.70% in fibrin group) reached a peak at 48 hour (81.00 ± 10.74% in suture group vs. 84.00 ± 7.19% in fibrin group) and decreased at seventh day after the surgery (37.38 ± 24.49% in suture group vs. 41.63 ± 10.46% in fibrin group). The PCNA labeling index was higher in fibrin glue group 24 hour after the surgery ( P=0.036), but there was no difference between the groups at 48 hour ( P =0.522) and seven day ( P=0.662) after the surgery. Conclusion: The fibrin glue didn't enhance liver regeneration after 2/3 hepatectomy in rats