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Study of orthotopic and auxiliary partial liver grafting from living donor

活体原位及辅助部分肝移植的研究

基本信息

批准号：
01480314
负责人：
DOHI Kiyohiko
金额：
$ 4.1万
依托单位：
Hiroshima University
依托单位国家：
日本
项目类别：
Grant-in-Aid for General Scientific Research (B)
财政年份：
1989
资助国家：
日本
起止时间：
1989 至 1991
项目状态：
已结题

项目摘要

1) Establishment of auxiliary partial liver grafting procedure after isolating the whole liver of a young pig, left internal and external lobes were separated by bench surgery, and the left lobe was heterotopically grafted in the lower part of the recipient's liver, leaving the latter, as it was. Anastomosis of the graft hepatic vein with the recipient's IVC, porto-portal anastomosis by oblique graft portal vein and through blood flow blockage around the recipient hepatic hilum enable us to make the grafted liver functional No stable results have been obtained yet, but we have some cases of not less than 5-week survival.2) Establishment of orthotopic partial liver grafing procedureLeft lobe (left internal lobe, external lobe) of a young pig was orthotopically grafted in the recipient, of which the whole liver was isolated. Harvest of a partial liver from the donor and isolation of the recipient's whole liver require considerable amount of skill, but orthotopic partial liver grafting fr … More om the donor in pigs obtained not less than 5-day survival. Moreover, these grafted livers were confirmed to show regenerative hypermat rophy and good function.3) Examination of the graft size for partial liver grafting and immunological reactionWith the view of examining the size of graft liver necessary for the recipient, the size and the regeneration of the graft liver were examined, using rat orthotopic partiall liver grafting showed approximately similar survival rate to total liver grafting and had grafted liver weight recovered to its original weight 5 days postoperatively. Histologically, hepatocytic karyokinesis was noted frequently 2 days postoperatively, but rarely 5 days postoperatively. On the contrary, isogeneic 20%-partial liver grafting showed not only enhanced postoperative hepatic dysfunction and remarkably lowered survival rate, but also lowered hepatic ATP resynthesis and higher endo-toxihemia compared with the former grafting. The above results indicated that partial liver grafting>30% at least was successful in keeping the recipients life. Examination of iunosuppressants in rat's 30% partial liver grafting model suggested FK506 to be less responsible for hepatic dysfunction than CyA. Less

1)辅助性部分肝移植方法的建立在分离幼猪全肝后，用板凳手术分离左内、外叶，左叶异位移植于受体肝脏下部，保留受体肝脏。移植肝静脉与受体下腔静脉吻合，门静脉斜行门静脉吻合，受体肝门周围血流阻断，使移植肝功能恢复。目前尚无稳定的结果，但已有不少于5周存活的病例。2)原位部分肝移植方法的建立：将幼猪的左叶(左内叶、外叶)原位移植于受体体内，分离全肝。从供者身上获取部分肝脏和分离受者的整个肝脏需要相当多的技巧，但来自…的原位部分肝移植更多的供体猪获得了不少于5天的存活。3)部分肝移植大小及免疫反应的检测从受者所需的移植肝大小的角度，对移植肝的大小和再生情况进行了检测，大鼠原位部分肝移植的存活率与全肝移植相近，术后5天移植肝重量已恢复到原来的重量。组织学上，术后2天肝细胞核分裂较多，术后5天较少见。与同种异体20%部分肝移植相比，同种异体20%部分肝移植不仅加重了术后肝功能障碍，显著降低了存活率，而且降低了肝组织ATP再合成，增加了内毒素血症。以上结果表明，至少30%的部分肝移植能成功地保住受体的生命。在大鼠30%部分肝移植模型中对免疫抑制剂的检查表明，FK506对肝功能障碍的责任比CyA小。较少