NEW LIVER SUPPORT SYSTEM USING EXVIVO PERFUSED LIVER

使用 EXVIVO 灌注肝脏的新型肝脏支持系统

基本信息

批准号：
09671344
负责人：
KAMIYAMA Yasuo
金额：
$ 1.22万
依托单位：
KANSAI MEDICAL UNIVERSITY
依托单位国家：
日本
项目类别：
Grant-in-Aid for Scientific Research (C)
财政年份：
1997
资助国家：
日本
起止时间：
1997 至 1999
项目状态：
已结题

来源：
https://kaken.nii.ac.jp/grant/KAKENHI-PROJECT-09671344/
关键词：
liver failure hepatic coma liver support liver perfusion xenoperfusion liver preservation liver failure hepatic coma liver support NO HGF liver perfusion liver fuilure

项目摘要

This study was conducted to simplify our liver support system used in patients with hepatic coma (Artificial Organ 6(4) : 433-446,1982). To prolong preservation time of the isolated liver, we tried to preserve the liver at a temperature just above the freezing point. In addition, the mechanism was studied by which NO affects the energy metabolism of the failed liver.1. The recipient pigs underwent a ligation of the portal vein and hepatic artery following portacaval shunt. An isolated liver was perfused with arterial blood from the recipient pig while monitoring the metabolic capacity of the ex vivo perfused liver. It was possible to perfuse the isolated liver for more than 24 hours using arterial blood from a pig with ischemic liver failure. The viability of the isolated liver during support of the liver failure pig was well maintained. The oxygen consumption and bile production were significantly higher in the isolated liver connected to the liver failure pig than in the organ connected to the pig without liver failure. These findings suggest that this liver support system has sufficient capacity to support a failed liver.2. We have confirmed the specific freezing point of rat liver and preserve it at a temperature just above that point (-0.8 C). Adenine nucleotide metabolism of the liver preserved at this temperature was well maintained as compared with the organ preserved at 4 C. It is suggested that this novel preservation technique prolong the preservation period.3. In septic patients with liver failure, NO levels in sera were increased and arterial blood ketone body ratio reflecting liver mitochondrial redox state, was depressed. There was a reciprocal relationship between NO level and the ratio. However, in the pig with ischemic liver NO was not increased.

进行了这项研究是为了简化用于肝昏迷患者的肝脏支持系统（人工器官6（4）：433-446,1982）。为了延长孤立的肝脏的保存时间，我们试图在冻结点上方的温度下保存肝脏。另外，研究了该机制，没有影响肝脏失败的能量代谢1。接收者猪进行了门腔分流后的门静脉和肝动脉的连接。从受体猪中灌注孤立的肝脏，同时监测过体内灌注肝脏的代谢能力。使用缺血性肝衰竭的猪的动脉血液，可以将分离的肝脏灌注超过24小时。在支撑肝衰竭时，分离的肝脏的生存能力得到很好地维持。与肝衰竭猪相关的分离肝脏中的氧气消耗和胆汁产生明显高于与没有肝衰竭的猪的器官中。这些发现表明，该肝脏支持系统具有足够的能力来支撑失败的肝脏2。我们已经确认了大鼠肝脏的特异性冰点，并将其保存在高于该点（-0.8 C）的温度下。与保留在4 C的器官相比，保留在此温度下的肝脏的腺嘌呤核苷酸代谢得到了很好的维持。建议这种新型保存技术延长了保存期。3。在肝衰竭的化粪池患者中，血清中没有水平升高，动脉血酮体比反映了肝线粒体氧化还原态，抑郁症。无水平和比率之间存在相互关系。但是，在缺血性肝脏的猪中没有增加。