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Partial Liver Transplantation from Living Donor Harvested by Core-cooling Method

通过核心冷却法获取活体供体的部分肝脏移植

基本信息

批准号：
01570731
负责人：
YAMAMOTO Tetsu
金额：
$ 1.34万
依托单位：
Asahikawa Medical College
依托单位国家：
日本
项目类别：
Grant-in-Aid for General Scientific Research (C)
财政年份：
1989
资助国家：
日本
起止时间：
1989 至 1990
项目状态：
已结题

项目摘要

Partial liver transplantation from living donor is thought to be an only way which we are allowed to do liver transplantation now in Japan. The most important thing in this method is not to harm the donor because the donor is a healthy person, and to get a good liver graft suitable for transpl antation. In general, the organ should be cooled to prevent the ischemic damage and the core-cooling method was applied on harvesting a part of a liver. The contents of adenine nucleotides in the liver tissue of a donor on before and after graft harvesting were measured for assessing the metabolic state of the donor. The graft functions were also assessed by the results of survival of recipients and the values of keton body ratio in arterial blood after its transplantation. All of these values were compared with those of the donor in which standard washout method was applied for graft harvesting. The values of energy charge calculated by the contents of adenine nucleotides in the donor liver maintained well even during and after harvesting both in core-cooling group and washout group. On the values of keton body ratio during and after partial liver transplantation, no difference was seen in the two groups. So the graft function harvested by core-cooling method seemed to be good enough for transplantation as well as that harvested by standard method. The advantage in core-cooling method is to be able to reduce the blood loss while on harvesting the graft. But even by the standard washout meth od, no disadvantages were occurred in the donor operation. Because of its complexity, the core-cooling method will be applied only in limited cases.

活体部分肝移植被认为是目前日本允许进行肝移植的唯一方式。这种方法最重要的是不伤害供体，因为供体是健康人，并且得到适合移植的良好肝移植物。一般来说，应冷却器官以防止缺血性损伤，并且在收获部分肝脏时采用核心冷却方法。测定供体移植前后肝组织中腺嘌呤核苷酸的含量，以评估供体的代谢状态。并通过受者生存结果和移植后动脉血酮体比值来评估移植物功能。所有这些值均与采用标准冲洗方法收获移植物的供体的值进行比较。在核心冷却组和清洗组中，即使在收获期间和收获后，通过供体肝脏中腺嘌呤核苷酸的含量计算的能量电荷值也保持良好。部分肝移植术中及术后酮体比值两组无差异。因此，通过核心冷却方法获得的移植物功能似乎与通过标准方法获得的移植物功能足够好，适合移植。核心冷却方法的优点是能够减少收获移植物时的失血。但即使采用标准的冲洗方法，供体手术也没有出现任何缺点。由于其复杂性，核心冷却方法仅在有限的情况下应用。