| Project/Area Number |
14370356
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| Research Category |
Grant-in-Aid for Scientific Research (B)
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| Allocation Type | Single-year Grants |
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| Section | 一般 |
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| Research Field |
General surgery
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| Research Institution | Nagoya University (2004-2005)
Kyoto University (2002-2003) |
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Principal Investigator |
FUJIMOTO Yasuhiro Nagoya University, University Hospital, Research Associate, 医学部附属病院, 助手 (80335281)
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| Co-Investigator(Kenkyū-buntansha) |
TANAKA Koichi Foundation for Biomedical Research and Innovation, General Manager, 先端医療センター長 (20115877)
KIUCHI Tetsuya Nagoya University, Graduate School of Medicine, Professor, 大学院・医学系研究科, 教授 (40303820)
UEMOTO Shinji Mie University, Graduate School of Medicine, Professor, 大学院・医学系研究科, 教授 (40252449)
EGAWA Hiroto Kyoto University, Graduate School of Medicine, Associate Professor, 大学院・医学研究科, 助教授 (40293865)
KAIHARA Satoshi Kyoto Prefectural University, School of Medicine, Associate Professor, 医学部, 助教授 (70324647)
鍋島 紀滋 京都大学, 医学研究科, 助手 (80314178)
羽賀 博典 京都大学, 医学研究科, 助手 (10252462)
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| Project Period (FY) |
2002 – 2005
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| Project Status |
Completed (Fiscal Year 2005)
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| Budget Amount *help |
¥14,000,000 (Direct Cost: ¥14,000,000)
Fiscal Year 2005: ¥1,900,000 (Direct Cost: ¥1,900,000)
Fiscal Year 2004: ¥1,800,000 (Direct Cost: ¥1,800,000)
Fiscal Year 2003: ¥1,600,000 (Direct Cost: ¥1,600,000)
Fiscal Year 2002: ¥8,700,000 (Direct Cost: ¥8,700,000)
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| Keywords | liver cirrhosis (type C) / liver transplantation / Hep C recurrence / interferon / ribavirin / rejection / living-donor / プロトコール肝生検 / 生体部分肝移植 / 免疫抑制剤 / 繊維化 / C型肝炎 / プロトコールバイオプシー / 一卵性双生児 / 脂肪肝 / ステロイドパルス療法 / 生体肝移植 |
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| Research Abstract |
Virological recurrence after living-donor liver transplantation for Hep C liver cirrhosis is inevitable. Together with the fact that histological recurrence is evident with over 80% cases at 3 years after transplantation, it is obvious that effective treatment and/or effective prophylaxis are necessary.
The analysis of recipients with Hep C recurrence (F1 and over) at Kyoto University Hospital revealed risk factors as follows : female recipient, male donor, preoperative interferon therapy, non-small graft. However, even with the recipients without risk factors, the recurrence rate reaches around 80%, therefore, they cannot be classified as group without necessity of treatment.
Further investigation at Nagoya University Hospital showed : The extent of post-transplant viral growth is not predictable by the pre-transplant viral load or immediate post-transplant viral load. Viral load (pre-transplant, immediate post-transplant, 1 month after transplant) does not forecast histological recurrence.
It is believed that "lower the viral load, greater the effect of anti-virals," however, the usage of interferon immediate after transplantation is fraught with risk of activation of immune system leading to rejection. Our data suggests that some cases encounter histological rejection in the absence of elevated liver function tests, therefore liver biopsy in order to exclude rejection in indispensable when we consider antiviral therapy immediately after transplantation.
This research contributes to the management and treatment of Hep C recurrence after liver transplantation. Hereafter, continuing research is necessary regarding steroid-free immunosuppression or virus clearing therapy for viral overshoot after transplantation expecting the mitigation of magnitude of virological recurrence.
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