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Development of the gene therapy against the organ dysfunction in the patients under LVAS support.

Research Project

Project/Area Number 09557109
Research Category

Grant-in-Aid for Scientific Research (B)

Allocation TypeSingle-year Grants
Section展開研究
Research Field Thoracic surgery
Research InstitutionOsaka University

Principal Investigator

SAWA Yoshiki  Osaka University Medical School Lecturer, 医学部, 講師 (00243220)

Co-Investigator(Kenkyū-buntansha) NISHIMURA Motonobu  Osaka University Medical School Asistant Professor, 医学部, 助手 (90291442)
MATUDA Hikaru  Osaka University Medical School Professor, 医学部, 教授 (00028614)
張 釖嶂  大阪大学, 医学部・附属病院, 医員
平田 展章  大阪大学, 医学部, 助手 (70283752)
鍵崎 康治  大阪大学, 医学部・附属病院, 医員
Project Period (FY) 1997 – 1998
Project Status Completed (Fiscal Year 1998)
Budget Amount *help
¥13,500,000 (Direct Cost: ¥13,500,000)
Fiscal Year 1998: ¥1,300,000 (Direct Cost: ¥1,300,000)
Fiscal Year 1997: ¥12,200,000 (Direct Cost: ¥12,200,000)
KeywordsLVAS / liver dysfunction / microcirculation / LVAS / 術後肝障害
Research Abstract

1. To forecast the hyper bilirubinemia in the patients after operation, we evaluated the preoperative factors (hepatocyte damage, hepatic sinusoid-endothelial dysfunction, liver function and inflammatory response). Operations performed were mitral valve replacement. We measured the serum levels of aspartate transaminase (AST), alanine transaminase (ALT), hyaluronic acid (HA), total bilirubin (TB), choline estelase (ChE), interleukm-6 (IL-6), interleukin-8 (IL-8) and CRP before operation. We evaluated the correlation between these indexes and the peak level of TB in seven post-operative days. The levels of preoperative TB, ChE, I-IA and IL-6 had a good correlation with the peak level of postoperative TB.These results suggested that liver function, hepatic sinusoid-endothelial dysfunction and inflammatory reaction may play a significant role in forecast of postoperative hepatic failure in patients.
2. To clarify the mechanism of hyper-bilirubinemia in the setting of left ventricular assis … More t device (LVAS), we evaluated the change of hepatocellular function, hepatic sinusoid-endothelial microcirculation and inflammatory response before and after LVAS implantation. We measured serum levels of total bilirubin (TB), transaminases (ALT,AST), interleukin (IL-6, IL-8), and HA ; a indicater for hepatic sinusoidal circulation, before and after LVAS implantation. The level of I-LA and IL-8, had a good correlation with the level of TB.However, the AST, ALT or 11-6 did not relate to the alternation of TB.These results suggested that hepatic sinusoid-endothelial dysfunction and inflammatory reaction may play a significant role in hepatic failure in patients following implantation of LVAS.
3. Under the current situations we have increasing opportunities to manage the patients with posthepatitis and/or congestive liver dysfunction. In order to prevent postoperative hepatic failure we described perioperative management for those patients. We have no effective methods to estimate the functional reserve, but our data suggested that serum cholineesterase level at the preoperative states might demonstrate prognostic significance. Less

Report

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

    (11 results)

All Other

All Publications (11 results)

  • [Publications] Yoshiki Sawa: "Gene Therapy in Cardiovascular Surgery" Surgery Today. 28. 125-128 (1998)

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      1998 Final Research Report Summary
  • [Publications] 澤 芳樹: "循環器疾患の遺伝子治療" 医学のあゆみ. 185-1. 91-94 (1998)

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      1998 Final Research Report Summary
  • [Publications] 平田 展章: "慢性肝炎,肝硬変合併 心,大血管手術" 日本外科学会雑誌. 98-8. 671-675 (1997)

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      1998 Final Research Report Summary
  • [Publications] Takahiro Yamaguchi: "Hepatic Sinusoid Endothelial Dysfunction Plays a Role in Hyperbilirubinemia in Patients Following Implantation of an LVAD" ASAIO Journal. 43(5). M449-M452 (1997)

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      1998 Final Research Report Summary
  • [Publications] Yoshiki Sawa: "Gene Therapy in Cardiovascular Surgery" Surgery Today. 28. 125-128 (1998)

    • Description
      「研究成果報告書概要(欧文)」より
    • Related Report
      1998 Final Research Report Summary
  • [Publications] Nobuaki Hirata, Hikaru Matuda: "Cardiovascular Surgery in The Patients With Liver Dysfunction" Journal of Japan Surgical society. 98(8). 671-675 (1998)

    • Description
      「研究成果報告書概要(欧文)」より
    • Related Report
      1998 Final Research Report Summary
  • [Publications] Takahiro Yamaguchi, Yoshiaki Sawa, Takafumi Masai, Motonobu Nishimura, Jau-Chang Chang, Toshirou Nishida, Shigeaki Ohtake, and Hiakru Matsuda: "Hepatic Sinusoid Endothelial Dysfunction Plays a Role in Hyperbilirubinemia in patients Following Implantation of an LVAD." ASAIO Journal. 43(5). M449-M452 (1997)

    • Description
      「研究成果報告書概要(欧文)」より
    • Related Report
      1998 Final Research Report Summary
  • [Publications] Yoshiki Sawa: "Gene Therapy in Cardiovascular Surgery" Sugery Today. 28. 125-128 (1998)

    • Related Report
      1998 Annual Research Report
  • [Publications] 澤 芳樹: "循環器疾患の遺伝子治療" 医学のあゆみ. 185-1. 91-94 (1998)

    • Related Report
      1998 Annual Research Report
  • [Publications] 平田 展章: "慢性肝炎、肝硬変合併 心、大血管手術" 日本外科学会雑誌. 98-8. 671-675 (1997)

    • Related Report
      1998 Annual Research Report
  • [Publications] Takahiro Yamaguchi: "HEPATIC SINUSOID-ENDOTHELIAL DYSFUNCTION PLAYS A ROLE IN HYPERBILIRUBINEMIA IN PATIENTS FOLLOWIMNG IMPLANTATION OF LVAS" ASAIO JOURNAL. 43・5. 449-452 (1997)

    • Related Report
      1997 Annual Research Report

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

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