Apoptosis and the liver: Relevance for the hepato-biliary-pancreatic surgeon

Cell death by apoptosis is thought to be involved in various pathophysiological situations involving the liver. Indeed, an understanding of apoptosis is becoming increasingly helpful for understanding disease and for patients' care. In this article, we review current scientific and clinical concepts of apoptosis, including death factors such as Fas ligand and tumor necrosis factor, apoptotic signal transduction mechanisms, and the role of intracellular proteinases called caspases. We also discuss apoptosis in the liver, as related to ischemia/ reperfusion injury, cholestasis, and cancer, circumstances which physicians often face in the field of the liver surgery.