Gratt Safety Limits in LRLT : Donor and Recipient

LRLT 中的 Grat 安全限制：捐赠者和接受者

• 批准号: 04557056
• 负责人: MAKUUCHI Masatoshi
• 金额: $ 10.18万
• 依托单位: Shinshu University
• 依托单位国家: 日本
• 项目类别: Grant-in-Aid for Developmental Scientific Research (B)
• 财政年份: 1992
• 资助国家: 日本
• 起止时间: 1992 至 1994
• 项目状态: 已结题
• 来源: https://kaken.nii.ac.jp/grant/KAKENHI-PROJECT-04557056/
• 关键词: liver transplantation; living-related; liver resection; liver transplantation; recipient; donor; living donor; h-HGF

Since the year of 1990 in Shinshu University and Kyoto University, the living-related liver transplantation (LRLT) has been used as a form of treatment for terminal liver disease patients. From this time, our attention has been turned to two problems that repeatedly appeared.One of the problems is how much liver tissue can be taken as a graft without compromising the donor's health status. The other one is about the smaller graft that can support the recipient's metabolic demands.In the last four years period we have performed 32 LRLT with a survival rate of about 90% (28 out of 32 patients) and have worked to solve these two problems. Here we briefly describe some of the conclusions.From the total of 38 donors, 14 were submitted to left lateral segmentectomy ; 13 donors submitted to extended left lateral segmentectomy, and 11 donors submitted to a left lobectomy. All the donors had a postoperative period without major complications, being discharged in an average of one week, and retu … More rning to their social activities within two months. Based on these results it was made clear that the left lobectomy can be carried out for grafting in a normal subject without problems related to parenchyma reduction.With regard to the smaller graft that can fit the demands of the recipient, we successfully transplanted to an adult patient a graft that was as small as 34% of the estimated standard liver volume (based on the body surface area). It represents a donor with good liver function, a graft harvested and transplanted based on safety metabolic limits (established for hepatectomies) , and also confirms the viability due to excellent preservation conditions related to the LRLT.Analyzing the data obtained in these four years, we could conclude that the LRLT can be a safe procedure for healthy donors providing even the whole left lobe and for recipients receiving a graft that represents at least 34% of their standard liver volume, calculated from the body surface area. These limits, broader that the ones formerly in use, permit a new array of safe indications for LRLT. Less

自1990年以来，在信州大学和京都大学，活体肝移植（LRLT）已被用作终末期肝病患者的治疗形式。从那时起，我们的注意力转向了两个反复出现的问题，其中一个问题是，在不损害供体健康状况的情况下，可以取多少肝组织作为移植物。在过去的四年中，我们已经进行了32例LRLT，存活率约为90%（32例患者中有28例），并一直致力于解决这两个问题。在这里，我们简要地描述了一些结论。在总共38个供体中，14个被提交给左外叶切除术，13个供体提交给扩大左外叶切除术，11个供体提交给左叶切除术。所有供体术后均无严重并发症，平均1周出院， ...更多信息 在两个月内参加社交活动。根据这些结果，它是明确的，左叶切除可以进行移植在一个正常的主题，没有相关的问题，实质减少。关于较小的移植物，可以满足受体的需求，我们成功地移植到一个成年患者的移植物，小到34%的估计标准肝脏体积（基于体表面积）。它代表了一个肝功能良好的捐赠者，一个基于安全代谢限度收获和移植的移植物（为肝切除术建立），并证实了由于与LRLT相关的优良保存条件而导致的生存能力。分析这四年中获得的数据，我们可以得出结论，LRLT对于提供整个左叶的健康供体和接受移植的受体来说是一种安全的手术，代表至少34%的标准肝脏体积，从体表面积计算。这些限制比以前使用的限制更广泛，允许一系列新的LRLT安全适应症。少

项目成果

Masatoshi Makuuchi et al.: "Donor hepatectomy for living related partial liver transplantation" Surgery. 113. 395-402 (1993)

Masatoshi Makuuchi 等：“活体相关部分肝移植的供体肝切除术”手术。

Seiji Kawasaki, Masatoshi Makuuchi, Hidetoshi Matsunami, et al.: "Preoperative mesurement of segmental liver volume of donor for living related liver transplantation." Hepatology. 18. 1115-1120 (1993)

Seiji Kawasaki、Masatoshi Makuuchi、Hidetoshi Matsunami 等：“活体相关肝移植供体节段肝脏体积的术前测量”。

N. J. Lygidakis, M. Makuuchi: "Pitfalls and complications in the Diagnosis and Management of Hepatobiliary and Pancreatic Diseases." Thieme Medical Publisher New York., 537 (1994)

N. J. Lygidakis，M. Makuuchi：“肝胆和胰腺疾病诊断和治疗中的陷阱和并发症。”

Hidetoshi Matsunami, Masatoshi Makuuchi, Seiji Kawasaki, et al.: "A case of fimilial amyloid polyneuropathy treated with partial liver transplantation usig a graft from a living related donor." Transplantation. 59 (in press).

Hidetoshi Matsunami、Masatoshi Makuuchi、Seiji Kawasaki 等人：“使用活体相关供体的移植物进行部分肝移植治疗家族性淀粉样多发性神经病的病例。”

Seiji Kawasaki, et al: "Liver regeneration in recipients and donors after transplantaion" Lancet. 339. 580-581 (1992)

Seiji Kawasaki 等人：“移植后受者和供者的肝脏再生”《柳叶刀》。