Study of Orthotopic Liver Transplantation in Warm Ischemically Damaged Graft-Protective Effects by Antioxidants-

1)再灌注损伤不仅发生在短暂性肝缺血后，也发生在肝移植过程中。辅酶Q_<10>(CoQ<@210)预处理可显著提高30分钟热缺血损伤（30-WID）肝移植物的存活率（45%），而未处理的肝移植物存活率为0%。CoQ<@D210@>D2预处理完全抑制了30-WID肝移植后4小时内脂质过氧化水平的显著升高和内源性CoQ同源物（CoQ<@D29@>D2, CoQ<@D210@>D2）的显著降低，从而改善了能量代谢。提示外源性CoQ<@D210@>D2具有抗脂质过氧化的作用。这些结果表明，大鼠肝脏原位移植后再灌注损伤的部分原因是生物膜上的脂质过氧化刺激。2)肝移植的主要问题之一是如何在早期评估移植组织的生存能力。对移植物即时功能的评估将为确定预后提供有用的结果。在本研究中，我们确定肝移植后的胆汁流速与三磷酸腺苷水平和移植大鼠的存活率相关。因此，本实验移植模型表明，移植后胆汁生成监测是评估肝脏缺血性损伤程度和动物预后的有用指标。3)在肝移植手术中，与手缝合技术相比，袖带技术（非缝合血管吻合）可以最大限度地减少肝脏的热缺血损伤和门静脉夹持受者时血流动力学的紊乱，也可以避免因凝血异常而出血。最近，日本开发了一种新型的合成可吸收袖带材料（乳酸-乙醇酸共聚物作为可生物降解材料）。我们尝试将这种可吸收袖带材料应用于大鼠肝移植血管吻合。吻合5个月后袖带层完全吸收，吻合血管腔内无任何狭窄和血栓形成。少

1) The phenomenon of reperfusion injury should occur not only after transient hepatic ischemia, but also during hepatic transplantation. Pretreatment with coenzyme Q_<10>(CoQ<@210)was accompanied by a siqnificant increase in the survival rete (45%) of 30-minute warm ischemically damaged (30-WID) liver grafts compared with 0% in nontreated liver grafts. CoQ<@D210@>D2 pretreatment completely suppressed the marked increase of lipid peroxide and decrease of endogenous CoQ homologues (CoQ<@D29@>D2, Coq<@D210@>D2) 4 hours after grafting of 30-WID liver, resulting in the improvement of enerfy metabolism. This result suggests that exogenous CoQ<@D210@>D2 acts as antioxidant of lipid peroxide. These findings provide that reperfusion damage in rat liver after orthotopic transplantaion is partly due to stimulated lipid peroxidation on biomembranes.2) One of the major problems accompanying liver transplantation is how to evaluate the viability of the grafted tissue at an early stage. The ability t … More o assess immediate graft function would provide results useful in the determination of prognosis. In this study, it was determined that bile flow rates after liver transplantation were correlated with adenosine triphosphate levels and the survival of rats given transplants. Thus it was shown in this experimental transplantation model that the monitoring of bile production after grafting is a useful indicator for assessing the extent of ischemic damage to the liver and for prognosis of the animal.3) In liver transplantation surgery, the cuff technique (non-suture vascular anastomosis) in comparison with hand-suture technique can minimize warm ischemic damage to the liver and hemodynamic diturbance during portal-venous clamping to the recipient, and also avoid hemorrhage due to coagulation abnormalities. Recently, new synthetic absorbable cuff materials (lactic acid-glycolic acid copolymer as a biodegradable material) have been developed in Japan. We attempted the application of this absorbable cuff materials to vascular anastomosis in rat liver grafting. The cuff layer was completely absorbed 5 months after anastomosis and any stenosis and thrombosis did not exit in the anastomosed-vascular lumen. Less