Rapid growth of an intact human liver transplanted into a recipient larger than the donor.
Rapid growth of an intact human liver transplanted into a recipient larger than the donor.
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DOI：
10.1016/0016-5085(87)90274-5
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发表时间：
1987-12
期刊：
影响因子：
29.4
通讯作者：
D. H. V. Thiel;Judith S. Gavaler;Igal Kam;A. Francavilla;L. Polimeno;R. R. Schade-R.;J. Smith;W. Diven;R. Penkrot;T. Starzl
中科院分区：
文献类型：
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作者：
D. H. V. Thiel;Judith S. Gavaler;Igal Kam;A. Francavilla;L. Polimeno;R. R. Schade-R.;J. Smith;W. Diven;R. Penkrot;T. Starzl
两名接受原位肝移植的个体接受了来自供体的肝脏，基于受体理想体重，供体平均比自身小10 kg。结果，这2例患者的供肝比预期的供肝和受体理想匹配时小29%-59%。通过连续计算机断层扫描确定，受体中的肝移植物的大小稳步增加，以达到与受体大小、性别和年龄的正常个体预期一致的新体积。监测空腹血浆氨基酸、胰高血糖素、胰岛素水平和标准肝损伤试验，以确定哪种测量最能反映移植物大小随时间的变化。观察到的任何这些参数变化与肝脏生长之间均无明显关系。在这两种情况下，肝脏体积以约70 ml/天的速率增加。这些数据表明，移植到较大受体中的小尺寸肝脏的尺寸以约70 ml/天的速率增加，直到其达到与受体大小，年龄和性别预期一致的肝脏体积。
Two individuals undergoing orthotopic hepatic transplantation received livers from donors who were on average 10 kg smaller than themselves based on recipient ideal body weight. As a result, the donor livers in these 2 cases were 29%–59% smaller than would be expected had the donor liver and recipient been matched ideally. The liver grafts in the recipients steadily increased in size, as determined by serial computed tomography scanning, to achieve new volumes consistent with those that would have been expected in a normal individual of the recipient's size, sex, and age. Fasting plasma levels of amino acids, glucagon, insulin, and standard liver injury tests were monitored to determine which measure best reflected the changes observed in the size of the grafts over time. No relationship between the changes observed in any of these parameters and hepatic growth was apparent. In both cases, the liver increased in volume at a rate of ~70 ml/day. These data demonstrate that a small-for-size liver transplanted into a larger recipient increases in size at a rate of ~70 ml/day until it achieves a liver volume consistent with that expected given the recipient's size, age, and sex.