Deployment and establishment adult living donor liver transplantation-Development of the immunosuppression treatment based on gene analysis treatment based on a gene analysis

成人活体肝移植的部署和建立-基于基因分析的免疫抑制治疗的开发基于基因分析的治疗

• 批准号: 13307038
• 负责人: TANAKA Koichi
• 金额: $ 23.46万
• 依托单位: KYOTO UNIVERSITY
• 依托单位国家: 日本
• 项目类别: Grant-in-Aid for Scientific Research (A)
• 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
• 来源: https://kaken.nii.ac.jp/grant/KAKENHI-PROJECT-13307038/
• 关键词: Liver transplantation; Living donor; Immunity seppression treatment; Memory T cell; Effecter T cell; Cytochrome P450; P glycoprotein; 成人生体肝移植; C型肝炎; 遺伝子解析; 拒絶反応; 薬剤代謝遺伝子; 免疫寛容

It aged 1998, the adult liver transplant from a living donor was introduced completely, and it came for the deployment and establishment as much as possible.In this research period, exact analysis of the vascular construction in the computer picture analysis based on 3DCT was carried out, and the selection and operation technique of the high liver graft of safety based on this were established.As a result, the adult liver transplant from a living donor progressed quickly in this institution, brought about expansion of an adaptation case, the increase in the number of cases, and the improvement in results, and contributed to society greatly.However, the results do not have few examples of early death by postoperative complications by the high risk group in which various internal-organs obstacles are accepted from before an operation, either.The greatest point for this improvement is a measure against infection accompanying each optimal immunity control treatment and immunity insufficiency to a patient.Then, P glycoprotein analysis was performed with Cyp3a4,5 which participates in the medicine metabolism of small intestine membrane about the metabolism of immunosuppressant tecrolimus, and the difference in each patient's immunity control medicine metabolism was clarified.Before and after operation CD45 isoform expression profiling It carried out, using sequential analysis [of a naive using T-lymph cell / memory T lymph cell, and an effecter T-lymph cell / memory T-lymph cell] in peripheral blood lymphocyte.Consequently, we have classified recipients into five groups and established the tailor-maid immunity control treatment to determine the amount of optimal dosage and the medication method of immunosappressants according to five groups.By this research, the adult liver transplant from a living donor can be developed more safely.

1998年，完全引进成人活体肝脏移植，并尽可能地进行部署和建立。在本研究期间，基于3DCT的计算机图像分析对血管结构进行了精确分析并在此基础上建立了高安全性肝移植的选择和手术技术。因此，该机构的成人活体肝移植进展迅速，带来了适应病例的扩大、移植手术量的增加。案例数量和改进情况然而，从术前就接受各种内脏器官障碍的高危人群中，因术后并发症而过早死亡的例子也不在少数。改善是针对伴随各最佳免疫控制治疗和患者免疫缺陷的感染的措施。然后，用参与小肠膜药物代谢的Cyp3a4,5对免疫抑制剂替克莫司的代谢进行P糖蛋白分析，明确了每个患者的免疫调节药物代谢的差异。 手术前后 CD45 亚型表达谱使用序贯分析[幼稚 T 淋巴细胞/记忆 T 淋巴细胞和效应 T 淋巴细胞]因此，我们将受者分为五组，制定量身定制的免疫控制治疗方案，以确定最佳剂量和用药方法。免疫抑制剂分为五组。通过这项研究，可以更安全地开发活体供体的成人肝移植。

项目成果

Koji Umeshita et al.: "Operative morbidity of living liver donors in Japan"The lancet. (2003)

Koji Umeshita 等人：“日本活体肝脏捐献者的手术发病率”柳叶刀。

S.Fukatsu: "Population phamacokinetics of tacrolimus in adult recipients recieving living-donor liver transplantation"EUR J CLIN PHARMACOL. 57. 479-484 (2001)

S.Fukatsu：“接受活体肝移植的成年受者中他克莫司的群体药代动力学”EUR J CLIN PHARMACOL。

Hironori Haga: "Periportal Edema And Necrosis As Diagnostic Histologic Features Of Early Humoral Rejection In A B O - Incompatible Liver Transplantation"Liver Transplantation. 9・12. 1-12 (2003)

Hironori Haga：“A B O 中早期体液排斥的门静脉周围水肿和坏死的诊断组织学特征 - 不相容性肝移植”9・12（2003 年）。

Hiroshi Hisatsune: "Endoscopic Management Of Billary Strictures Aafter Duct-To-Duct Biliary Reconstruction In Right-Lobe Living-Donor Liver Transplantation"Transplantation. 76・5. 810-815 (2003)

Hiroshi Hisatsune：“右叶活体肝移植中胆道狭窄的内镜治疗”76・5（2003）。

Kasahara M et al.: "Monosegmental living donor liver transplantation for infantile hepatic hemangioendothelioma"J pediatr Surg.. 38,7. 1108-1111 (2003)

Kasahara M 等人：“单节段活体肝移植治疗婴儿肝血管内皮瘤”J pediatr Surg. 38,7。