Researchers at Michigan State University have refuted a long-standing scientific consensus on the role of the protein plasminogen in liver regeneration after surgery. Lower plasminogen levels promoted cell regeneration in mouse experiments. The findings influenced a clinical trial in which the administration of tranexamic acid (TXA) reduced the risk of liver failure. The results were published in the journal Blood.
Plasminogen hinders regeneration instead of promoting it
James Luyendyk and his team at Michigan State University originally investigated the role of plasminogen, a protein involved in breaking down blood clots. Previous studies had suggested a positive effect on liver regeneration. However, the experiments showed the opposite: with reduced plasminogen levels, the liver regenerated more strongly.
The findings led to a clinical investigation in the HeLiX trial.
Background
The liver is one of the few organs capable of regenerating after partial removal (hepatectomy). However, postoperative liver failure remains a serious complication. Tranexamic acid (TXA) is commonly used to reduce bleeding and affects the plasminogen pathway.
Significance for surgery
Patients who received TXA had about one-third the risk of postoperative liver failure compared to the placebo group. The results suggest a new therapeutic target. The study connects basic research in animal models with clinical application in humans.
Voices from the project
"We had a hypothesis based on years of published research. Not only was the hypothesis wrong, the outcome was essentially the opposite of what we expected," said James Luyendyk of Michigan State University.
"Their experimental work provided the hypothesis that led us to analyze the patient data in the HeLiX trial," added Patrick Starlinger of the Mayo Clinic.
Next steps
Further studies are needed to confirm the findings before they change clinical practice. The insights could also be relevant for veterinary medicine, for example, in liver surgeries on dogs. The work highlights the potential of the One Health approach.
FAQ
What is the study about?
Refutation of the previous assumption about the role of plasminogen in liver regeneration after surgery and indications of the effect of tranexamic acid.
Why is the finding relevant?
It could reduce the risk of postoperative liver failure, a serious complication in liver surgery.
What substance was tested in the clinical trial?
Tranexamic acid (TXA), a common hemostatic agent.
Who is involved?
James Luyendyk (Michigan State University) and Patrick Starlinger (Mayo Clinic) with their teams.
What are the next steps planned?
Further validation studies and potential adjustment of clinical protocols.
