Relationship among hepatic microcirculation, metabolism and bioactive substances : Elucidation of postoperative heptaci failure

我们研究了肝脏微循环和代谢的动物模型和患者，以阐明术后肝功能衰竭的发病机制。肝脏能量代谢：在肝脏中表达肌酸激酶的转基因小鼠可以耐受肝切除术和内毒素休克时，他们喂以肌酸的食物，这表明，在肝组织中的可用ATP的量是一个重要的因素，从这些手术应激恢复。在这方面，我们目前正在研究肌红蛋白引入肝脏对缺血-再灌注损伤模型的影响，使用大鼠，这将作为一个氧气库在应激条件下。肝脏微循环：我们应用近红外组织光谱（NIRS）评价活体肝移植中移植肝脏的氧合状态。结果表明，HTK液在活体肝移植术中对移植物的保护效果优于UW液，且对肝脏的氧合状态和微循环有较好的保护作用，NIRS是监测移植后移植物氧合状态的有效工具。此外，使用NIRS技术，PGE 1在兔肝缺血模型中改善了吲哚菁绿色的肝脏清除率，而不改变肝脏的氧合状态。肝脏能量代谢在很大程度上参与了术后肝功能衰竭的发病机制，并且将某些基因如肌酸激酶和肌红蛋白引入肝脏似乎对预防术后肝功能衰竭有效。发生术后肝功能衰竭。

We investigated hepatic microcirculation and metabolism in animal models and patients to elucidate the mechanism of the pathogenesis of postoperative hepatic failure.Hepatic energy metabolism : Transgenic mice expressing creatine kinase in the liver could tolerate hepatectomy and endotoxin shock when they were fed with creatine chow, suggesting that the amount of available ATP in the liver tissue is an important factor for the recovery from these surgical stresses. In this regard, we are presently investigating the effect of myoglobin introduced into the liver on an ischemia- reperfusion injury model using rats, which will work as an oxygen reservoir under stress condition.Hepatic microcirculation : We applied a near- infrared tissue spectroscopy (NIRS) for the evaluation of the oxygenation state of the graft liver in living- related liver transplantation. From these studies, HTK solution turned out to preserve the graft better than UW solution in living- related liver transplantation in terms of the oxygenation state and microcirculation of the lvier and NIRS was a useful tool for the monitoring of the oxygenation state of the graft following transplantation. Moreover, using this technique of NIRS,PGE1 turned out to improve hepatic clearance of indocyanine green in a rabbit model of hepatic ischemia without altering the oxygenation state of the liver.From these results, hepatic energy metabolism is largely involved in the pathogenesis of postoperative hepatic failure and the introduction of certain genes such as creatine kinase and myoglobin into the liver appears to be effective for the prevention of the occurrence of postoperative hepatic failure.