Liver transplantation - studies of hemodynamics and preservation -

1.(1)肝移植血流动力学研究：对犬肝移植模型进行无肝期血流动力学研究。无肝期以肝素化导管(Anthron)为V-V搭桥，术前充分输血及多巴酚丁胺是有效的低血容量状态。(2)部分肝移植(PLTx)：在保留受体下腔静脉的情况下，应用Anthron行门静脉转流术，完成占全肝重量70%的部分肝移植。最长存活时间为28天。相反，30%的RT侧pLTx表现为门脉高压15 mm Hg(Pre，7 mm Hg)，并在24小时内死亡。当供受者肝脏重量比超过70%时(供者/受者)。体重比2.0：1)，术后门静脉压力下降，可行走。在狗的RT侧pLTx中，70%的肝脏被认为是维持移植后立即生存所必需的。2.器官保存：从能量代谢角度研究低氧和热缺血对大鼠肝脏的影响。(1)能量代谢动态平衡由ATP向AMP、黄质和次黄质转化，表明ATP是通过从头合成途径合成的。(2)采用70%部分肝缺血模型，研究热缺血时能量代谢的变化及药物对肝脏的影响。能量代谢变化与(1)模型及药物血栓烷A2合成酶抑制剂(CV-4151，武田药品)相同。Co.)、蛋白酶抑制剂(乌司他丁、莫奇达制药)。公司)吲哚美辛可提高小鼠存活率，改善肝脏能量代谢。

1. (1) Hemodynamic study of liver transplantation: Hemodynamic study during anhepatic phase was done in canine liver transplantation. It was thought to be a hypodynamic state with hypovolemia during anhepatic phase using heparinized catheter (Anthron) as V-V bypass, in which sufficient transfusion before hepatectomy and dobutamine were effective. (2) Partial liver transplantation (pLTx) : Lt-side pLTx, which accounts for 70% of the whole liver weight, was done in dog, preserving IVC of the recipient, with use of Anthron for portal vein bypass. The longest survival was 28 days. On the contrary, Rt-side pLTx, which weights 30% , showed portal hypertension by 15 mmHg (pre, 7 mmHg), and died within 24 hours. When the weight ratio of the liver between donor's and recipient's exceeded 70% (Donor/Recip. body weight ratio; 2.0 : 1), portal vein pressure decreasedand the recipients could walk after the operation. Seventy percent of liver was thought to be necessary to sustain the life immediately after transplantation in Rt-side pLTx in dogs. 2. Organ preservation: The influences of hypoxia and warm ischemia on liver were studied from the viewpoint of the energy metabolism in rats. (1) The dynamic balance of energy metabolism changed from ATP to AMP, xanthin and hypoxanthin, which indicated that atp were synthesized via de novo pathway. (2) Energy metabolic changes and the effect of drugs on liver in warm ischemia were studied with 70% partial liver ischemia model. The energy metabolic changes were the same as in (1) model and drugs, thromboxane A_2 synthetase inhibitor (CV-4151, Takeda Pharm. Co.), protease inhibitor (urinastatin, Mochida Pharm. Co. ) and indomethasin increased the survival ratio and improved the energy metabolism in the liver.