Perioperative management in clinical liver traus plantation

临床肝移植围手术期处理肝移植后排斥状态的组织学变化与能量代谢变化的对比研究尚未见报道。在本计划中，我们在汉诺威医学中心尝试了淋巴细胞的MTT测定，比较了反映肝移植后肝线粒体能量状态的动脉酮体比（AKBR）的变化。肝移植后，MTT活性不仅在排斥状态下下降，而且在感染状态下也下降。因此，MTT法不能作为排斥反应的良好指标。然而，在AKBR严重下降的患者中，MTT活性也下降。作为合作研究，我们一直在评估用MCPD法测量肝移植再灌注后血红蛋白的饱和比。

Perioperative management in clinical liver transplantationHistological changes comparing with energy metabolic changes in the rejection state after liver transplantation have not ever studied. In this plan, we have tried the MTT assay of lymphocyte comparing with the changes in arterial ketone body ratio (AKBR) which reflects the energy state of the liver mitochondria after liver transplantation in Hannover Medical Center. The activity of MTT decreased not only in the rejection state but also in the infectious state after liver transplantation. Therefore, MTT assay can not be good indicator of the rejection. However, in the patient with critically decreased in AKBR the MTT activity also decreased.As the collaboration study we have been evaluating measuring the saturation ratio of hemoglobin through the liver graft just after reperfusion using the MCPD method.