A study of split-liver transplantation from brain death donor.

劈离式肝移植在日本被认为是一种比较容易接受的肝移植方法。本研究的目的是通过建立劈离式肝移植的动物模型，寻找一种更安全的劈离式肝移植术式。在这项研究中，手术结果进行了评估，移植条件相比，手术和preservation.Subject和methodsForty 6白色猪，年龄从1至一个半月，用于这项研究，包括血液消费者。所有手术均在满意的全身麻醉下完成。根据手术程序将动物分为两组。A组按活体肝移植供肝的手术程序原位劈离肝实质。grafts.in另一组（B组），立即切取肝脏，在后台手术中分割.此外，在两个不同的机构，我们的机构和北海道大学第一外科，同时移植两个病例的移植物。在这些实验之后，在移植物表面的微循环，生化肝功能测试和胆汁分泌量的变化进行了评价，两组之间包括operatingresult.Results和conclusionThe结果我们的研究表明，在收获（原位分裂）之前的肝实质的划分被认为是保持移植物的活力更好。虽然脑死亡的供体并不总是处于足够的状态来进行长时间的手术，但为了保持肝脏的广泛应用，我们在日本不得不尝试这种分离式肝移植。

The successful split liver transplantation is considered to be a more acceptable method of liver transplantation in Japan. The purpose of our study is to find a more safety procedure of split liver transplantation using an experimental model. In this study, the operative outcome was evaluated by graft condition compared with operative and preservation.Subject and methodsForty six white porcines, which were aged from one to one and half months, were used for this study including blood spenders. All of the operations were performed under the satisfactory general anesthesia. The animals were divided into two groups by the operative procedure. In one group(group A), the liver parenchyma was split in-situ according to the operative procedure of the donor on the living related liver transplantation. And, the liver was then harvested and completely divided into two grafts.in another group(group B), the livers was immediately harvested and divided on the back table operation. In addition, simultaneous transplantation of both grafts of two cases were performed at two different institutions, our institution and 1st Department of Surgery in Hokkaido University. Following these experiments, the changes of the microcirculation at the graft surface, biochemical liver function test and the amount of bile exertion were evaluated between two groups including operative results.Results and conclusionThe results of our study demonstrated that the division of the liver parenchyma prior to harvest (in-situ splitting) is considered to keep the viability of the graft better. While the brain death donor is not always in condition enough to undergo a long time operation, we in Japan have to try this splig liver transplantation in order to keep widespread application of livers.