1993 Fiscal Year Final Research Report Summary
Postoperative management and immunological study in living related liver trausplantation
| Project/Area Number |
03404039
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| Research Category |
Grant-in-Aid for General Scientific Research (A)
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| Allocation Type | Single-year Grants |
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| Research Field |
Digestive surgery
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| Research Institution | Kyoto University |
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Principal Investigator |
TANAKA Koichi Kyoto Univ. Surg, Associate Professor, 医学部, 助教授 (20115877)
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| Co-Investigator(Kenkyū-buntansha) |
HONDA Kazuo Kyoto Univ. Surg, Assistant, 医学部, 助手 (00209321)
INAMOTO Takashi Kyoto Univ. Surg, Lecturer, 医学部, 講師 (10135577)
YAMAOKA Yoshio Kyoto Univ. Surg, Professor, 医学部, 教授 (90089102)
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| Project Period (FY) |
1991 – 1993
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| Keywords | immunosuppressant / Liver transplantation / Histocompatibility / living donor / Tacrolimus / Hla |
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| Research Abstract |
Ninety four children received living related liver transplantation (LRLT) from June 1990 to April 1994. It is well known that the large dose administration of immunosuppressant is accompanied by a high incidence of bacterial and viral infection and that steroids induce growth retardation. To reduce side effects and growth inhibition, we have been studying to minimized doges of immunosuppressants and develope optimal FK 506 dosing in LRLT.Steroids were withdrawn in 90% of recipients. A new protocol of FK 506 dosing was established with monitoring trough concentration using microparticle enzyme immunoassay method. It is sometimes said that the problem of immune reaction is not a crucial one to liver transplantation due to the liver's supposed to tolerance to immunity compared with heart and kidney transprantation. To evaluate the immunological role of the HLA class II matching between donor and recipient in LRLT, the postoperative clinical course was investigated. The matching of DRB1, DQB1 and DPB1 was revealed to have a beneficial effect in LRLT, while the matching of DQA1 was of a negative effect on graft function. The matching of HLAII should be reevaluated using reliable molecular method and deserve appropriate consideration in LRLT
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