Liver Regeneration in Donors and Adult Recipients After Living Donor Liver Transplantation
Liver Regeneration in Donors and Adult Recipients After Living Donor Liver Transplantation
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DOI：
10.1002/lt.21622
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发表时间：
2008-12-01
影响因子：
4.6
通讯作者：
Kitagawa, Yuko
中科院分区：
文献类型：
--
作者：
Haga, Junko;Shimazu, Motohide;Kitagawa, Yuko
在活体供肝移植中，供体手术的安全性是重中之重。出于对供者安全的担忧，右叶移植的引入为时已晚。我们根据切除的节段和受体的类型来调查供体肝再生，以评估是否发生了适当的再生。87例供者分为3组：左叶供者、左叶供者和右叶供者。47例成年受者被分为左叶或右叶移植受者。术后1周、1个月、2个月、3个月、6个月及1年后分别进行容量测定。右叶供肝组残肝体积为45.4%，术后1个月和6个月分别迅速增加到68.9%和89.8%。6个月时，所有供体组的再生率几乎相同。受体肝脏体积迅速增加，直到2个月超过标准肝脏体积，然后逐渐减少到标准肝脏体积的90%。在供体组中，右叶供体组的肝脏再生最快，且受体肝脏的再生速度快于供体肝脏。通过对大量供者的多次肝再生分析，我们了解了正常的肝再生模式。虽然供体肝脏没有达到最初的体积，但供体1年后肝功能正常。捐助者已恢复正常的日常活动。供体肝切除，甚至是右肝切除，只要有准确的术前容量测量和关于移植物类型选择的慎重决策，就可以安全地实施。肝脏转运14：1718-1724,2008。(C)2008年AASLD。
In living donor liver transplantation, the safety of the donor operation is the highest priority. The introduction of the right lobe graft was late because of concerns about donor safety. We investigated donor liver regeneration by the types of resected segments as well as recipients to assess that appropriate regeneration was occurring. Eighty-seven donors were classified into 3 groups: left lateral section donors, left lobe donors, and right lobe donors. Forty-seven adult recipients were classified as either left or right lobe grafted recipients. Volumetry was retrospectively performed at 1 week, 1, 2, 3, and 6 months, and 1 year after the operation. In the right lobe donor group, the remnant liver volume was 45.4%, and it rapidly increased to 68.9% at 1 month and 89.8% at 6 months. At 6 months, the regeneration ratios were almost the same in all donor groups. The recipient liver volume increased rapidly until 2 months, exceeding the standard liver volume, and then gradually decreased to 90% of the standard liver volume. Livers of the right lobe donor group regenerated fastest in the donor groups, and the recipient liver regenerated faster than the donor liver. Analyzing liver regeneration many times with a large number of donors enabled us to understand the normal liver regeneration pattern. Although the donor livers did not reach their initial volume, the donors showed normal liver function at 1 year. The donors have returned to their normal daily activities. Donor hepatectomy, even right hepatectomy, can be safely performed with accurate preoperative volumetry and careful decision-making concerning graft-type selection. Liver Transpl 14:1718-1724, 2008. (C) 2008 AASLD.