Development of safety methods for adult to adult living donor liver transplantation focused on cyclic AMP signal pathway.

开发成人对成人活体肝移植的安全方法，重点关注环AMP信号通路。

基本信息

批准号：
13557102
负责人：
FURUKAWA Hiroyuki
金额：
$ 8.77万
依托单位：
HOKKAIDO UNIVERSITY
依托单位国家：
日本
项目类别：
Grant-in-Aid for Scientific Research (B)
财政年份：
2001
资助国家：
日本
起止时间：
2001 至 2003
项目状态：
已结题

项目摘要

First of all, small-for size graft syndrome is probably due to relative liver ischemia. Although, to dissolve this problem, port-caval shunt, splenic ligation, and splenectomy are used as surgical interventions, there have been few cases treated by pharmacological pre-conditioning. We try to improve liver damage caused by congestion using 2hr-canine warm ischemic model.Secondly, while right lobe grafting is the most effective alternative for the strategy against small-for-size liver syndrome, the suboptimal hepatic venous outflow may lead to serious graft function. The 3 dimensional (3D) images constructed by multiditector CT were used for pre-operative virtual donor hepatectomy and grafting with reconstruction of MHV tributaries. The emphasizing point in our 3D images is that this method can calculate each volume of the are, of which each hepatic vein drains.Thirdly, the reason why we made up clinical pathways for adult to adult living donor liver transplantation is not only for developing theoretical and technical surgical performance, but also for verifying the validity of our patient care strategy in the other liver transplantation programs.Fourthly, the patients after liver transplantation suffered from small-for-size syndrome, basically, need much amount of albumin product, because the ability of the small liver allografts seem to require long time to get mature productivity. In such situation, young surgeons are likely to use much more albumin product than appropriate dose. To lead them to proper direction, we showed our manual haw to use albumin product.Finally, we summarized present status of adult to adult liver transplantation in both Japanese and western countries. In addition, we compared the treatments of graft dysfunction between our program and the others.

首先，小尺寸的移植综合征可能是由于相对肝缺血引起的。尽管为了解决这个问题，但港口分流，脾连接和脾切除术被用作手术干预措施，但很少有药理学预先修复治疗的病例。我们试图通过使用2HR - 甲氨酸温暖的缺血模型来改善拥塞造成的肝脏损害。第二，右叶移植是针对小型肝综合征策略的最有效的替代方法功能。由多主体CT构建的3个维图（3D）图像用于术前虚拟供体肝切除术和通过重建MHV支流的嫁接。我们3D图像中强调的点是，该方法可以计算每种肝静脉排水的每一卷。三分之一，这是我们为成年活着的供体肝脏移植构成成人临床途径的原因，不仅用于发展理论的理论和技术手术表现，但也用于验证其他肝移植程序中患者护理策略的有效性。小肝移植物的能力似乎需要长时间才能提高生产力。在这种情况下，年轻外科医生可能会使用比适当剂量更多的白蛋白产品。为了使他们朝着正确的方向发展，我们展示了使用白蛋白产品的手动鹰。最后，我们总结了日本和西方国家的成人肝脏移植的现状。此外，我们比较了程序与其他程序之间的移植功能障碍的治疗方法。