| Project/Area Number |
03454338
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| Research Category |
Grant-in-Aid for General Scientific Research (B)
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| Allocation Type | Single-year Grants |
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| Research Field |
Thoracic surgery
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| Research Institution | Kanazawa Medical University |
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Principal Investigator |
SHIMIZU Takeshi Kanazawa Medical University, School of Medicine, Professor, 医学部, 教授 (60022844)
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| Co-Investigator(Kenkyū-buntansha) |
TSUCHISHIMA Syuuji Kanazawa Medical University, School of Medicine, Assistant, 医学部, 助手 (40207395)
KANETO Yoshiyuki Kanazawa Medical University, School of Medicine, Instructor, 医学部, 講師 (60194932)
SAKAMOTO Shigeru Kanazawa Medical University, School of Medicine, Instructor, 医学部, 講師 (20148159)
TAKIGUCHI Tomoo Kanazawa Medical University, School of Medicine, Professor, 医学部, 講師 (50064514)
TAKEKOSHI Noboru Kanazawa Medical University, School of Medicine, Professor, 医学部, 教授 (40064539)
笹木 秀幹 金沢医科大学胸部外科, 講師 (60153996)
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| Project Period (FY) |
1991 – 1993
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| Project Status |
Completed (Fiscal Year 1993)
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| Budget Amount *help |
¥5,600,000 (Direct Cost: ¥5,600,000)
Fiscal Year 1993: ¥1,800,000 (Direct Cost: ¥1,800,000)
Fiscal Year 1992: ¥1,800,000 (Direct Cost: ¥1,800,000)
Fiscal Year 1991: ¥2,000,000 (Direct Cost: ¥2,000,000)
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| Keywords | Heart transplantation / Ventricular assist Device (VAD) / bridge to Heart transplant / Cellular immunity / Coagulation factors / Fibrinolysis / Control System of VAD / Pressure volume curve / Emax / リニアアクチュエーター / 人工心臓制御装置 / ポンプと生体の整合性 / 人工循環の生体への影響 / 出血と血栓 / Nafamostant Mesilat / 移植免疫 / ポンプと生体の適合性 / 人工心臓の開発 / 式人工心臓 / 重回帰分析 / Ea / Ees / エネルギ-効率 |
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| Research Abstract |
1. Left ventricular assist device composed of electrohydraulic linear actuator and diaphram type blood pump has been investigated in this institute together with Aisin Seiki LTD.In this study series, the control system of this VAD was designed and examined. From the pressure volume curve obtained in the blood pump Ea/Ees was calculated. It was possible to get Ea/Ees as near to 1 as possible by controling stroke volume, rate, upper duty, lower duty and % systole of the VAD using multiple regression analysis in this control system.
2. In order to speculate the effect of coagulation and fibrinolysis during artificial circulation including VAD on the implanted donor heart and recipient, changes of coagulation and fibrinolysis were examined during and after Cardiopulmonary bypass(CPB) : thrombocytes, beta-TG, ATIII, FPA, PLG, D-dimer, alpha_2PI etc. Both coagulation and fibrinolysis were activated during CPB.Nafamostat Mesilate(NM), however, inhibited these activities. It is considered that
… More
NM administration might prevent thromboembolic and hemorrhagic episodes during ventricular assist.
3. In order to study whether cell mediated immunity responses would be suppressed or activated by the effect of CPB or ventricular assist, peripheral blood lymphocyte subsets and antibody dependent cell mediated cytotoxicity were investigated during artificial circulation. The total lymmphocyte (OKT 3 and OKT 11+) number did not change significantly. Suppressor/cytotoxic T cell(OKT8+) and NK cell (Leu 7+ and Leu 11+) numbers remarkably increased. But helper/inducer T cell(OKT 4+) and B cell(Leu 12+) numbers decreased. Mixed lymphocyte reaction and NK cytotoxicity were also activated during this study. It may be concluded that open heart surgery using CPB is associated with the activation of cytotoxic cell mediated immunity.
4. Inthe recipient of heart transplanation who undergoes VAD as a bridge, blood coagulation, fibrinolysis and cytotoxic cell mediated immunity would be activated and therefore the incidence of thromboembolic episode and acute rejection might increase compared with simple heart transplantation. Less
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