CHALLNEGE TO OVERCOME LIVING DONOR LIVER TRANSPLANTATION USING SMALL-FOR-SIZE GRAFT

• Project/Area Number: 21591747
• Research Category: Grant-in-Aid for Scientific Research (C)
• Allocation Type: Single-year Grants
• Section: 一般
• Research Field: Digestive surgery
• Research Institution: Mie University
• Principal Investigator: ISAJI Shuji 三重大学, 大学院・医学系研究科, 教授 (70176121)
• Co-Investigator(Kenkyū-buntansha): TABATA Masami 三重大学, 大学院・医学系研究科, 准教授 (90291418)
• Project Period (FY): 2009 – 2011
• Project Status: Completed (Fiscal Year 2011)
• Budget Amount: ¥3,640,000 (Direct Cost: ¥2,800,000、Indirect Cost: ¥840,000); Fiscal Year 2011: ¥910,000 (Direct Cost: ¥700,000、Indirect Cost: ¥210,000); Fiscal Year 2010: ¥1,300,000 (Direct Cost: ¥1,000,000、Indirect Cost: ¥300,000); Fiscal Year 2009: ¥1,430,000 (Direct Cost: ¥1,100,000、Indirect Cost: ¥330,000)
• Keywords: 生体肝移植 / 過小グラフト / 脾臓 / 脾摘 / 肝再生 / 過少グラフト / 肝類洞内皮 / 門脈圧 / 炎症性サイトカイン / 肝虚血再潅流 / 免疫応答

Research Abstract

Small-for-size liver grafts are a serious obstacle for partial orthotopic liver transplantation. The results using a rat model suggest that a preservation solution containing APC is a potential novel and safe product for small-for-size liver transplantation, alleviating graft injury via anti-inflammatory and antiapoptotic effects and vasorelaxing conditions. Additionally, splenectomy before transplantation inhibited leukocyte infiltrations and pro-inflammatory cytokine synthesis which leads to hepatocellular apoptosis and impaired liver regeneration. Clinically, control of portal venous pressure immediately after living donor liver transplantation using small-for-size liver graft is very important, and preoperative assessment of the recipient's spleen volume and graft volume is very helpful to determine the necessity of splenectomy.

Research Products

• [Journal Article] Intracellular interferon-γstaining analysis of donor-specific T-cell responses in liver transplant recipients (2012)
  • Author(s): Okanami Y, Tsujimura K, Mizuno S, Tabata M, Isaji S, Akatsuka Y, Kuzushima K, Takahashi T, Uemoto S
  • Journal Title: Transplant Proc Volume: 44(2) Pages: 548-54
  • Peer Reviewed
• [Journal Article] Living donor liver transplantation for the patients with portal vein thrombosis : use of an interpositional venous graft passed posteriorly to the pancreatic parenchyma without using jump graft (2012)
  • Author(s): Mizuno S, Murata Y, Kuriyama N, Ohsawa I, Kishiwada M, Hamada T, Usui M, Sakurai H, Tabata M, Isaji S
  • Journal Title: Transplant Proc Volume: 44(2) Pages: 356-9
  • Peer Reviewed
• [Journal Article] Postoperative liver dysfunction in living donors after left-sided graft hepatectomy : portal venous occlusion of the medial segment after lateral segmentectomy and hepatic venous congestion after left lobe hepatectomy (2012)
  • Author(s): Kumamoto K, Mizuno S, Kuriyama N, Ohsawa I, Kishiwada M, Hamada T, Usui M, Sakurai H, Tabata M, Isaji S
  • Journal Title: Transplant Proc Volume: 44(2) Pages: 332-7
  • Peer Reviewed
• [Journal Article] Donor age affects liver regeneration during early period in the graft liver and late period in the remnant liver after living donor liver transplantation (2012)
  • Author(s): Tanemura A, Mizuno S, Wada H, Yamada T, Nobori T, Isaji S
  • Journal Title: World J Surg Volume: 36(5) Pages: 1102-11
  • Peer Reviewed
• [Journal Article] Effect of a prostaglandin I(2) analog on the expression of thrombomodulin in liver and spleen endothelial cells after an extensive hepatectomy (2011)
  • Author(s): Usui M, Kato H, Kuriyama N, Azumi Y, Kishiwada M, Mizuno S, Sakurai H, Tabata M, Hayashi T, Suzuki K, Isaji S
  • Journal Title: Surg Today Volume: 41(2) Pages: 230-6
  • Peer Reviewed
• [Journal Article] Impact of CYP3A5 genotype of recipients as well as donors on the tacrolimus pharmacokinetics and infectious complications after living-donor liver transplantation for Japanese adult recipients (2011)
  • Author(s): Muraki Y, Isaji S, et al
  • Journal Title: Ann Transplant Volume: 16 Pages: 55-62
  • NAID: 120005228794
  • Peer Reviewed
• [Journal Article] Lethal hepatic infarction following plasma exchange in living donor liver transplant patients (2011)
  • Author(s): Mizuno S, Isaji S, et al
  • Journal Title: Transplant Int Volume: 24 Issue: 7 Pages: e57-e58
  • DOI: 10.1111/j.1432-2277.2011.01244.x
  • Peer Reviewed
• [Journal Article] Monitoring peripheral blood CD4+ adenosine triphosphate activity after living donor liver transplantation : impact of combination assaysof immune function and CYP3A5 genotype (2011)
  • Author(s): Mizuno S, Isaji S, et al
  • Journal Title: J Hepatobiliary Pancreat Sci Volume: 18 Issue: 2 Pages: 226-232
  • DOI: 10.1007/s00534-010-0335-8
  • Peer Reviewed
• [Journal Article] The cytoprotective effects of addition of activated protein C into preservation solution on small-for-size grafts in rats. (2010)
  • Author(s): Kuriyama N, Isaji S, et al
  • Journal Title: Liver Transplantation Volume: 16 Pages: 1-11
  • Peer Reviewed
• [Journal Article] Prospective study on the outcome of patients with hepatocellular carcinoma registered for living donor liver transplantation : how long can they wait? (2010)
  • Author(s): Mizuno S, Isaji S, et al
  • Journal Title: Transplantation Volume: 89 Pages: 650-654
  • Peer Reviewed
• [Journal Article] Indocyanine green (ICG) fluorescence imaging-guided cholangiography for donor hepatectomy in living donor liver transplantation. (2010)
  • Author(s): Mizuno S, Isaji S
  • Journal Title: American Journal of Transplantation Volume: 10 Pages: 2725-2726
  • Peer Reviewed
• [Journal Article] The cytoprotective effect of addition of activated protein C into preservation solution on small-for-size grafts in rats (2010)
  • Author(s): Naohisa Kuriyama
  • Journal Title: LIVER TRANSPLANTATION 16 Pages: 1-11
  • Peer Reviewed
• [Presentation] 移植後胆道狭窄に対する治療の長期成績胆管胆管吻合を施行した生体肝移植症例における術後胆道合併症の検討 (2011)
  • Author(s): 水野修吾,村田泰洋,熊本幸司,栗山直久,大澤一郎,岸和田昌之,濱田賢司,臼井正信,櫻井洋至,田端正巳,伊佐地秀司
  • Organizer: 日本移植学会
  • Place of Presentation: 仙台
  • Year and Date: 2011-10-05
• [Presentation] 生体肝移植術後の門脈圧上昇には術前脾容量が関与する (2011)
  • Author(s): 尭天一亨,水野修吾,信岡祐,栗山直久,大澤一郎,岸和田昌之,濱田賢司,臼井正信,櫻井洋至,田端正巳,伊佐地秀司
  • Organizer: 日本移植学会
  • Place of Presentation: 仙台
  • Year and Date: 2011-10-05
• [Presentation] 生体肝移植術後血小板値はなぜ低下するのか? ADAMTS13の変動から見たグラフト肝微小循環障害と予後の観点から (2011)
  • Author(s): 信岡祐,水野修吾,和田秀夫,大澤一郎,岸和田昌之,濱田賢司,臼井正信,櫻井洋至,田端正己,伊佐地秀司
  • Organizer: 日本肝胆膵外科学会
  • Place of Presentation: 東京
  • Year and Date: 2011-06-09
• [Presentation] 生体肝移植術後免疫抑制療法におけるCD4陽性リンパ球ATP活性の有用性特にCYP3A5遺伝子多型との関連性について (2010)
  • Author(s): 水野修吾,服部可奈,濱田賢司,大澤一郎,岸和田昌之,臼井正信,櫻井洋至,田端正己,伊佐地秀司
  • Organizer: 日本移植学会
  • Place of Presentation: 京都
  • Year and Date: 2010-10-21
• [Presentation] 脾臓は肝虚血再灌流障害後の免疫反応を調節する脾臓の新しい機能と肝臓外科における摘脾術の意義の再考 (2010)
  • Author(s): 加藤宏之,濱田賢司,村田泰洋,信岡祐,安積良紀,岸和田昌之,水野修吾,臼井正信,櫻井洋至,田端正己,伊佐地秀司
  • Organizer: 日本肝胆膵外科学会
  • Place of Presentation: 仙台
  • Year and Date: 2010-05-27
• [Presentation] 脾臓は肝虚血再灌流障害後の免疫反応を調節する-脾臓の新しい機能と肝臓外科における摘脾術の意義の再考 (2010)
  • Author(s): 加藤宏之、伊佐地秀司
  • Organizer: 日本肝胆膵外科学会
  • Place of Presentation: 仙台
  • Year and Date: 2010-05-26
• [Presentation] ラット過小グラフト肝移植における脾臓摘出術の細胞保護効果について (2009)
  • Author(s): 栗山直久
  • Organizer: 第109回日本外科学会定期学術集会
  • Place of Presentation: 副胃火国際会議場
  • Year and Date: 2009-04-30
• [Presentation] 肝虚血再還流障害モデルラットに対する組換えヒト可溶性トロンボモジュリンの保護効果 (2009)
  • Author(s): 岸和田昌之
  • Organizer: 第109回日本外科学会定期学術集会
  • Place of Presentation: 福岡国際会議場
  • Year and Date: 2009-04-03
• [Remarks]
  • URL: http://www.medic.mie-u.ac.jp/hbpt/
• [Remarks]
  • URL: http://www.medic.mie-u.ac.jp/hbpt/HBP_and_Transplant_Surgery/gan_yi_zhi.html
• [Remarks]
  • URL: http://web.me.com/shujiisaji1/