生体肝移植における移植肝容積量と自己肝温存同所性生体部分肝移植の開発に関する研究

活体肝移植移植肝体积研究及自体保肝原位部分肝移植的进展

• 批准号: 06404046
• 负责人: TANAKA Koichi
• 金额: $ 10.24万
• 依托单位: KYOTO UNIVERSITY
• 依托单位国家: 日本
• 项目类别: Grant-in-Aid for General Scientific Research (A)
• 财政年份: 1994
• 资助国家: 日本
• 起止时间: 1994 至 1995
• 项目状态: 已结题
• 来源: https://kaken.nii.ac.jp/grant/KAKENHI-PROJECT-06404046/
• 关键词: living related liver transplanttation; auxiliary partial orthotopic liver transplantation; portal vein; canine model; liver degeneration; liver volume; clinical; 移植肝サイズマッチング; 肝移植; 自己肝温存同所性部分肝移植; 肝組織酸素化; 門脈血流量; 生体肝移植分肝機能; living related liver transplanttation; auxiliary partial orthotopic liver transplantation; portal vein; canine model; liver degeneration; liver volume; clinical; 移植肝サイズマッチング; 肝移植; 自己肝温存同所性部分肝移植; 肝組織酸素化; 門脈血流量; 生体肝移植分肝機能

We studied the relation between outcomes and graft volume in our living related liver transplantation series and found that the lower limit of the ratio of graft volume to the recipient body weight was 0.8%. In the setting of living related liver transplantation for children using partial liver grafts of parents, the volume of the partial grafts is usually enough for children. In the setting of adult recipients, however, the ratio is often lower than 0.8%, even though we use left lobe grafts including the middle hepatic vein. To solve this problem, we developed auxiliary partial orthotopic liver transplantation, in which the lateral segments or the left lobe of the native liver was removed from a recipient, a partial graft was trnasplanted, and the preserved native liver helped the graft liver until the graft gro** enough. In our experiment using a canine model, we focused on competition between the native liver and the graft liver regarding portal flow and studied the effects of diversion of the portal flow of the native liver. Our results demonstrated that the entire portal flow of the native liver can be diverted safely to the graft. Based on this result, we applied this technique to clinical transplantation and solved the problem of graft size mismatch in adult living related liver transplantation.

我们研究了与生活相关的肝移植系列中结果与移植体积之间的关系，发现移植体积与受体体重的比率下限为0.8％。在使用父母部分肝移植的儿童的生活相关肝移植的环境中，部分移植物的体积通常足以容纳儿童。但是，在成年接受者的情况下，即使我们使用包括中部肝静脉在内的左叶移植物，该比率通常低于0.8％。为了解决这个问题，我们开发了辅助部分矫形肝移植，其中将天然肝脏的侧面片段或天然肝的左叶从受体中移除，将部分移植物置于plan依，并保存下来的天然肝脏帮助移植物肝脏，直到移植物Gro **足够。在使用犬模型的实验中，我们专注于天然肝脏与移植肝之间的竞争，并研究了天然肝脏门户流动流动的影响。我们的结果表明，天然肝脏的整个门户流动可以安全地转移到移植物上。基于此结果，我们将此技术应用于临床移植，并解决了成人生活相关的肝移植中移植物尺寸不匹配的问题。