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Liver Transplantation From Non-Heart Beating Cadaver Donor

Research Project

Project/Area Number 09470259
Research Category

Grant-in-Aid for Scientific Research (B)

Allocation TypeSingle-year Grants
Section一般
Research Field General surgery
Research InstitutionTokyo Women's Medical University

Principal Investigator

FUCHINOUE Shohei  Tokyo Women's Medical University, Surgery III, Assistant Profesor, 医学部, 助教授 (10147382)

Co-Investigator(Kenkyū-buntansha) SAWADA Tokihiko  Tokyo Women's Medical University, Surgery III, Assistant, 医学部, 助手 (20266761)
NAKAJIMA Ichiro  Tokyo Women's Medical University, Surgery III, Lecture Instructor, 医学部, 講師 (80198077)
TOJIMBARA Tamotsu  Tokyo Women's Medical University, Surgery III, Assistant, 医学部, 助手 (80197847)
SANNOMIYA Akihito  Tokyo Women's Medical University, Surgery III, Assistant, 医学部, 助手 (40297445)
MURAKAMI Tohru  Tokyo Women's Medical University, Surgery III, Assistant, 医学部, 助手 (50287356)
小池 太郎  東京女子医科大学, 医学部, 助手 (80246537)
阿部 正浩  東京女子医科大学, 医学部, 助手 (90246538)
藤田 省吾  東京女子医科大学, 医学部, 助手 (70209055)
Project Period (FY) 1997 – 1999
Project Status Completed (Fiscal Year 1999)
Budget Amount *help
¥9,800,000 (Direct Cost: ¥9,800,000)
Fiscal Year 1999: ¥3,000,000 (Direct Cost: ¥3,000,000)
Fiscal Year 1998: ¥3,800,000 (Direct Cost: ¥3,800,000)
Fiscal Year 1997: ¥3,000,000 (Direct Cost: ¥3,000,000)
KeywordsLIVER TRANSPLANTATION / NON-HEART BEATING DONOR / FLUSH SOLUTION / PRESERVATION SOLUTION / ANHEPATIC PHASE / PORCINE MODEL / 肝保存 / 臓器移植
Research Abstract

A successful method for effective liver procurement and preservation from non-heart beating donors (NHBD) would have enormous benefit to resolve the problem of organ shortage. In this study, we developed a porcine LTx model from NHBD after sustaining a shock state, and evaluated the efffect of passive versus active veno-venous bypass on liver graft function in the NHBD model. In addition, we investigated the effect of a novel preservation solution, sodium lactobionate sucrose (SLS) solution, in the NHBD model as compared with Euro-Collins (EC) and University of Wisconsin (UW) solutions.
Operative procedures were performed with the pigs, weighing 17-20 kg. In donors, livers were subjected to 120 min of in situ warm ischemia induced by 60 min of a shock state following by 60 min of cardiac arrest. At the end of warm ischemia (shock state and cardiac arrest), in situ perfusion of the liver with each solution was initiated. The liver graft was preserved in the same solution for 6 hours at 4℃. LTx was performed using the preserved liver grafts without immunosuppression. Passive (tube) or active (pump) veno-venous bypass was used during the anhepatic phase.
Serum levels of liver enzymes in the passive bypass group were significantly higher than those in the active bypass group, when the same solution was used for perfusion and preservation. In the comparative study using EC, UW and SLS solutions, liver graft function in the SLS group was significantly better than those in the EC and UW groups.
These data suggest that intraoperative condition i.e. hemodynamic instability or splanchnic congestion in recipients, in addition to warm ischemic, cold ischemic and reperfusion injury, may affect the liver graft function from NHBD after sustaining a shock state. Furthermore, SLS solution may improve the liver graft viability procured from NHBD and further studies are strongly encouraged.

Report

(4 results)
  • 1999 Annual Research Report   Final Research Report Summary
  • 1998 Annual Research Report
  • 1997 Annual Research Report
  • Research Products

    (17 results)

All Other

All Publications (17 results)

  • [Publications] 三宮彰仁: "心停止ドナーからのブタ同所性肝移植:4℃および37℃UW液を用いた初期灌流液の比較"Organ Biology. 5. 53-57 (1998)

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      1999 Final Research Report Summary
  • [Publications] 唐仁原全: "移植用肝グラフト保存の問題点と初期灌流傷害(initial flushing injury)"今日の移植. 11. 549-557 (1998)

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      1999 Final Research Report Summary
  • [Publications] 唐仁原全: "心停止ドナーを用いたブタ肝移植の研究:初期灌流液の比較"東京女子医科大学総研紀要. 19. 94-95 (1999)

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      1999 Final Research Report Summary
  • [Publications] Tamotsu Tojimbara,: "Porcine liver transplantation from non-heart beating cadaver donor : Effect of passive /active venous bypass on graft function"Transplant Proc. (印刷中).

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      1999 Final Research Report Summary
  • [Publications] Akihito Sannomiya,: "Porcine liver transplantation from non-heart beating cadaver donor : Effect of initial flushing with cold versus warm UW solution"Transplant Proc. (印刷中).

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      1999 Final Research Report Summary
  • [Publications] Akihito Sannomiya: "Porci ne liver transplantation from non-heart beating cadaver donor : Effect of initial flushing with cold versus warm UW solution"Organ Biology. 5. 53-57 (1998)

    • Description
      「研究成果報告書概要(欧文)」より
    • Related Report
      1999 Final Research Report Summary
  • [Publications] Tamotsu Tojimbara: "Experimental basis of liver preservation and initial flushing injury"Transplanation Now. 11. 549-557 (1998)

    • Description
      「研究成果報告書概要(欧文)」より
    • Related Report
      1999 Final Research Report Summary
  • [Publications] Tamotsu Tojimbara: "Porcine liver transplantaion from non-heart beating cadaver donor"Bulletin of Tokyo Women's Medical University Research Institute. 19 (1999)

    • Description
      「研究成果報告書概要(欧文)」より
    • Related Report
      1999 Final Research Report Summary
  • [Publications] Tamotsu Tojimbara: "Porcine liver transplantation from non-heart beating cadaver donor : Effect of passive/active veno-venous bypass on graft function"Transplant Oroc. (in print).

    • Description
      「研究成果報告書概要(欧文)」より
    • Related Report
      1999 Final Research Report Summary
  • [Publications] Akihito Sannomiya: "Porcine liver transplantation from non-heart beating cadaver donor : Effect of initial flushing with cold versus warm UW solution"Transplant Proc. (in print).

    • Description
      「研究成果報告書概要(欧文)」より
    • Related Report
      1999 Final Research Report Summary
  • [Publications] 三宮彰仁: "心停止ドナーからのブタ同所性肝移植:4℃および37℃ UW液を用いた初期灌流液の比較"Organ Biology. 5. 53-57 (1998)

    • Related Report
      1999 Annual Research Report
  • [Publications] 唐仁原全: "移植用肝グラフト保存の問題点と初期灌流傷害(initial flushing injury)"今日の移植. 11. 549-557 (1998)

    • Related Report
      1999 Annual Research Report
  • [Publications] 唐仁原全: "心停止ドナーを用いたブタ肝移植の研究:初期灌流液の比較"東京女子医科大学総研紀要. 19. 94-95 (1999)

    • Related Report
      1999 Annual Research Report
  • [Publications] Tamotsu Tojimbara,: "Porcine liver transplantation from non-heart beating cadaver donor: Effect of passive/active veno-venous bypass on graft function"Transplant Proc. (印刷中).

    • Related Report
      1999 Annual Research Report
  • [Publications] Akihito Sannomiya: "Porcine liver transplantation from non-heart beating cadaver donor: Effect of initial flushing with cold versus warm UW solution"Transplant Proc. (印刷中).

    • Related Report
      1999 Annual Research Report
  • [Publications] 唐仁原 全: "移植用グラフト保存の問題点と初期灌流傷害" 今日の移植. 11. 549-557 (1998)

    • Related Report
      1998 Annual Research Report
  • [Publications] 三宮彰仁 他: "心停止ドナーからのブタ同所性肝移植" Organ Biology. 5. 53-57 (1998)

    • Related Report
      1998 Annual Research Report

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Published: 1997-04-01   Modified: 2016-04-21  

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