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Latest Updates on Liver Surgery, Liver Regeneration, and Liver Transplantation
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Latest Updates on Liver Surgery, Liver Regeneration, and Liver Transplantation

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Gastroenterology & Hepatopancreatobiliary Medicine".

Deadline for manuscript submissions: 10 November 2026 | Viewed by 963

Editors

Dr. Ivan Romic

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Guest Editor
Department of Abdominal Surgery, University Hospital Centre Zagreb, Zagreb, Croatia
Interests: liver surgery; transplant; regeneration; oncology
Dr. Goran Pavlek

E-Mail Website
Guest Editor Assistant
Department of Surgery, University Hospital Centre Zagreb, 10000 Zagreb, Croatia
Interests: liver surgery; transplant; regeneration; oncology

Special Issue Information

Dear Colleagues,

Liver diseases constitute a major global health burden, affecting diverse populations across the spectrum from acute to chronic conditions. Recent advances—encompassing novel techniques, artificial intelligence-driven tools, and an enhanced understanding of cellular and molecular processes within the liver—have opened new frontiers in the treatment of liver malignancies and parenchymal liver diseases. Improvements in diagnostic imaging as well as advances in surgical and pharmacological therapies have transformed the detection and management of liver disorders. Nevertheless, substantial gaps persist in optimizing surgical technique, risk stratification, access to care, and the multidisciplinary coordination of care. This Special Issue aims to synthesize current evidence and provide comprehensive, evidence-based reviews that summarize the state-of-the-art in diagnosis, staging, and management across major liver diseases, with particular emphasis on liver regeneration and transplantation. In addition, manuscripts that evaluate surgical techniques, clinical applicability, and emerging approaches to liver transplantation are welcome. For this Special Issue, we invite original research articles and reviews. Potential research areas include (but are not limited to) the following: liver oncology, surgical technique, diagnosis of liver diseases, treatment of liver malignancies and parenchymal diseases, surgical innovations in liver resections, and liver transplantation.

Dr. Ivan Romic
Guest Editor

Dr. Goran Pavlek
Guest Editor Assistant

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 250 words) can be sent to the Editorial Office for assessment.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-anonymized peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • liver surgery
  • transplant
  • regeneration
  • oncology
  • liver regeneration

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Published Papers (1 paper)

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Review

12 pages, 699 KB  
Review
Functional Liver Recovery After Major Hepatectomy: Integrating Hemodynamic Optimization and Oxidative Stress
by Vanja Silić, Ivan Romić, Daniela Bandić Pavlović, Goran Pavlek, Gzim Redžepi and Emil Kinda
J. Clin. Med. 2026, 15(9), 3494; https://doi.org/10.3390/jcm15093494 - 2 May 2026
Cited by 1 | Viewed by 614
Abstract
Background: Major liver resections that include the removal of four or more Couinaud segments require precise assessment of the future liver remnant (FLR) to prevent post-hepatectomy liver failure (PHLF). Volumetry, although standard in surgical planning, does not always reflect true functional reserve, [...] Read more.
Background: Major liver resections that include the removal of four or more Couinaud segments require precise assessment of the future liver remnant (FLR) to prevent post-hepatectomy liver failure (PHLF). Volumetry, although standard in surgical planning, does not always reflect true functional reserve, especially in steatotic, fibrotic or chemotherapy-damaged liver. Methods: This review proposes an integrative physiological framework of functional liver recovery after a major hepatectomy that connects preoperative functional assessments—indocyanine clearance (ICG-PDR), Liver Maximum Function Capacity test (LiMAx) and 99mTc-mebrofenin SPECT/CT—with perioperative hemodynamic, oxidative and metabolic parameters. A narrative literature review was performed using PubMed and Web of Science, covering publications from January 2000 to January 2025. The search combined keywords and MeSH terms such as major hepatectomy, liver regeneration, hemodynamic optimization, oxidative stress and post-hepatectomy liver failure. We focused on clinically relevant studies, including randomized controlled studies and consensus guidelines, and complemented the search by screening the reference lists of selected articles. When direct clinical evidence was limited, a physiologically grounded interpretation was used to support a pragmatic framework for perioperative management. Results: The framework integrates three complementary physiological domains that together determine functional liver recovery. The first relates to hemodynamic stability, including optimal maintenance of arterial and venous pressures as well as portal-splanchnic gradients, which support adequate perfusion and oxygenation of hepatocytes. The second addresses the balance between oxidative stress and antioxidant defense, where the key indicators are the level of lipid peroxidation and endogenous antioxidant capacity. The third domain evaluates the functional ability of the liver through dynamic tests of synthesis and metabolism, such as factor V, indocyanine clearance (ICG-PDR), and the LiMAx test. With the integration of these three domains, a functional profile of liver recovery can be defined, facilitating monitoring of the physiological response in real time and guiding individualized perioperative support to the individual needs of the patient. Conclusions: Functional recovery follows a dynamic continuum, progressing from early reperfusion stress through hemodynamic stabilization to progressive hepatocellular regeneration. Integration of functional FLR assessment with perioperative physiological monitoring may support more individualized prediction of the regenerative capacity and therapeutic decision-making. This physiology-guided perspective extends assessment beyond remnant volume alone to include functional recovery. Full article
(This article belongs to the Special Issue Latest Updates on Liver Surgery, Liver Regeneration, and Liver Transplantation)
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