Study for Clinical Application of Liver Transplantation

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1.Organ procurement and organ preservation : In the study regarding the relevance of donor nutritional state to graft liver function, it has been demonstrates that poor nutrition of donor caused the endotherial damage of liver sinusoids and results in the impediment to ability of mitochondrial ATP synthesis rates (Satomi and Tanaka). In the study regarding the organ harvesting, the effect of donor hypothermic therapy on graft function and the proper flow rate of initial flushing of graft organs were investigated (Taira). As an useful graft liver viability assays, hepatic protein synthesis rate assay using the graft tissues obtained by needle biopsy and graft effuent assay were developed (Isono and Sugimachi). For taking measures against ischemic damage of graft liver from non-heart beating donor, the novel methods such as the core cooling technique were investigated (Uchino, Satomi and Fukao).2.Indication of liver transplantation : The objective criterions of indication and emergency l … More evel for liver transplantation were described for trial (0ta). For the development of proper registration program for liver transplantation recipients, the detailed follow-up-study of the registered recipientswas done (Sugimachi). A predictive equation for non-A,non-B acute hepatitis was developed for the criterion of indication for liver transplantation (Tanigawa).3.Postoperative management for liver transplantation : The effect of graft liver size-matching on the postoperative graft function and the problem concerning FK506 immunosuppressive therapy in clinical living-related liver transplantation were researched (Yamaoka). As a novel development of immunosuppressive therapy, the drug-delivery modification for the conventional immunosuppressants (intraportal and intra-hepatic-arterial administration of FK506), the induction of immuno-hyporeactivity utilizing donor-antigen infusion (MMC-treated donor splenocyts infusion), the immuno-regulation by use of gene-therapy (CTLA-Ig gene transduction using adenovirus vector), the use of a novel immunosuppressant (Bactobolamine) were researched (Dohi, Monden, Takagi and Tomikawa).4.Study of xenotransplantation : In order to develop the immuno-regulation method in concordant xenotransplantation, the effects of donor bone marrow utilization and the modification of donor antigen with MMC-treatment were investigated (Dohi and Monden). For the purpose of preventing hyperacute rejection in discordant xenotransplantation, human complement regulating genes were successfully transduced in pigs by use of retrovirus vector (Takagi). Less