Computational analysis reveals the requirement for cell-cell interaction in liver repopulation by transplanted hepatocytes

Hepatocyte transplantation is a promising alternative to liver transplantation; however, it currently serves only as a temporary treatment until a donor organ becomes available. In contrast, animal studies have demonstrated "liver repopulation", a phenomenon in which transplanted hepatocytes progressively replace host hepatocytes. Despite extensive documentation, the mechanisms driving this process remain poorly understood. More fundamentally, it remains unclear whether liver repopulation is driven by active cell-cell interactions between host and transplanted hepatocytes that induce host cell death, or whether it can be explained solely by intrinsic differences in proliferation and survival between these populations. To address this, we performed computational simulations using an agent-based model constrained by experimental data from repopulation in uninjured rat livers. Our analysis reveals that host hepatocyte death rate is the dominant determinant of repopulation kinetics, whereas variations in proliferation rate have only a limited impact. Notably, experimentally observed repopulation dynamics were only reproduced when cell- cell interactions were incorporated, or alternatively when host hepatocyte lifespan was set to unrealistically short values (approximately 25 days). These findings support a model in which cell- cell interactions play a critical role in efficient liver repopulation. More broadly, this study establishes a conceptual and computational framework for evaluating the requirement for cell-cell interactions in tissue replacement, even in the absence of a defined molecular mechanism.