Experimental Research for Primary Non-Function in Liver Transplantation

肝移植原发性无功能的实验研究

基本信息

批准号：
63570603
负责人：
NAKAJIMA Yoshiyuki
金额：
$ 0.7万
依托单位：
Nara Medical University, School of Medicine
依托单位国家：
日本
项目类别：
Grant-in-Aid for General Scientific Research (C)
财政年份：
1988
资助国家：
日本
起止时间：
1988 至 1990
项目状态：
已结题

来源：
https://kaken.nii.ac.jp/grant/KAKENHI-PROJECT-63570603/
关键词：
liver transplantation arterial ketone body ratio (AKBR)plasma amino acids calcium channel blocker Diltiazem hepatic ischemia primary non-function charcoal hemofiltration primary non-function カルシウムイオンカルシウム拮抗剤肝代謝機能 pyruvate Lact

项目摘要

In order to estimate the initial hepatic allograft function, we investigated arterial ketone body ratio (AKBR) and plasma amino acid levels in canine orthotopic liver transplantation. In successful cases, AKBR and plasma amino acids, especially alanine and total free plasma amino acids restored to the preoperative levels 3 hours after arterial reperfusion. On the other hand, in cases which died due to hepatic insufficiency, they could not recover even after reperfusion. Accordingly, AKBR and plasma amino acids are the rapid indicators to estimate the viability of hepatic graft and that primary non-fnction can be detected with these parameters by 3 hours after reperfusion.Next study was to investigate the protective effect of a calcium channel blocker, Diltiazem (DZ), on ischemic liver damage and whether or not DZ might prevent primary non-function in liver transplantation. AKBR and hepatic arterial blood flow recovered 1 hour after hepatic ischemia for 60 minutes, whereas they were not restored in untreated controls. Furthermore, although all untreated dogs transplanted with warm ischemically damaged livers for 20 minutes died due to liver failure, half number of dogs (50%) which were administered DZ could survive over 48 hours after grafting without hepatic isufficiency. These results showed that DZ has protective effects on liver ischemia and warm ischemic injury in preservation of liver transplantation.As a treatment of primary non-function, charcoal hemofiltration could not normalize the hepatic function when that was started just after the diagnosis of primary non-function.

为了估计最初的肝移植功能，我们研究了犬类原位肝移植中的动脉酮体比（AKBR）和血浆氨基酸水平。在成功的情况下，AKBR和血浆氨基酸，尤其是丙氨酸和总游离血浆氨基酸，在动脉再灌注后3小时恢复为术前水平。另一方面，在因肝功能不全而死亡的情况下，即使再灌注后它们也无法恢复。因此，AKBR和血浆氨基酸是估计肝移植的生存能力的快速指标，并且可以在再灌注后3小时之前用这些参数检测到主要的非插入。对钙通道阻滞剂的保护作用是在diltiazem（dz）中的保护作用，对等性肝脏的损害和不限制了dive and infir-frimtion in Diment in lortl fron fortim in lontl fron front infrention nortim frant infirtion。肝缺血1小时后，Akbr和肝动脉血流恢复了60分钟，而未经治疗的对照则没有恢复它们。此外，尽管所有未经治疗的狗被温暖的液压受损肝脏移植了20分钟，但由于肝脏衰竭而死亡，但在没有肝液症的情况下，嫁接后的48小时内，有一半的DZ狗（50％）可以存活48小时。这些结果表明，DZ对保存肝移植的肝脏缺血和温暖缺血性损伤具有保护作用。当治疗原发性无功能时，木炭血液过滤在诊断后刚开始后无法正常化肝功能。