Alternatives to orthotopic liver transplantation

367 The proliferative capacity of the liver is vividly captured in the Greek myth of Prometheus. Having stolen fire and tricked Zeus, Prometheus was chained to a rock and sentenced to have his liver eaten each day by an eagle. Because his liver re-grew nightly, he could endure the same punishment endlessly. Although the myth exaggerates the rate at which normal liver mass can be reconstituted, this organ indeed possesses a remarkable ability to regenerate following partial resection until it attains its original size. Increasing the rate of liver regeneration to Promethean levels would offer intriguing therapeutic possibilities, especially as the mechanisms that regulate the normal process are becoming better understood. The study by Karnezis et al. in this issue of the JCI (1) suggests that a hepatocyte with enhanced growth potential may not be too fanciful, particularly with the technological advances in genetic engineering that we have witnessed this past decade.