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

在日本，活体肝移植被认为是唯一允许进行肝移植的方法。这种方法最重要的是不伤害供体，因为供体是健康的人，并获得适合移植的良好肝移植。一般来说，应冷却器官以防止缺血性损伤，并在获取部分肝脏时应用核心冷却方法。通过对供体肝组织中腺嘌呤核苷酸含量的测定，了解供体肝组织的代谢状态。移植后观察受体存活情况及动脉血酮体比值，评价移植物功能。将所有这些值与采用标准洗脱法进行移植物收获的供体的值进行比较。以腺嘌呤核苷酸含量计算的能荷值，无论是核心冷却组还是洗脱组，在切取过程中和切取后均保持良好。部分肝移植术中和术后酮体比值两组间无差异。因此，用核心冷却法收获的移植物功能似乎与用标准方法收获的移植物功能一样好。核心冷却方法的优点是能够减少采集移植物时的失血量。但即使采用标准的洗脱方法，供体操作也没有出现任何缺点。由于其复杂性，芯冷却方法将仅在有限的情况下应用。

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.