1995 Fiscal Year Final Research Report Summary
Development of a new method for procurement and preservation of the liver from non-heart beating donors
| Project/Area Number |
04670798
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| Research Category |
Grant-in-Aid for General Scientific Research (C)
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| Allocation Type | Single-year Grants |
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| Research Field |
Digestive surgery
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| Research Institution | Saitama Medical University |
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Principal Investigator |
KOYAMA Isamu Saitama Medical School Faculty of Medicine, Associate Professor, 医学部, 助教授 (60178390)
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| Co-Investigator(Kenkyū-buntansha) |
KENNMOKU Kyouichi Saitama Medical School Faculty of Medicine, Chief of Medical Engineering, 医学部, 主任
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| Project Period (FY) |
1992 – 1994
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| Keywords | Warm ischemia / Non-heart-beating donor / Core-Cooling / Cardiopulmonary bypass / Liver transplantation / Heterotopic transplantation / Oxygen consumption / Auxiliary transplantation |
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| Research Abstract |
A shoetage of liver available for transplantation has become a serious problem. The use of non-heast beacing donors in liver transplantation will expand the number of the donors for organ sources. In an attempt to minimize preexisting ischemic damage in non-heart-beating donors (NHBD) and expect the recovery from ischemic injury after transplantation, we developed the core-cooing method using cardiopulmonary bypass for procurement and tested heterotopic auxiliary liver transplantation model for clinical application.
Firstly, we developed a new portable cardiopulmonary bypass machine which was designed for organ procurement. We applied with success this apparatus to the procurement of the kidneys from non-heart beating donors in clinical cadaveric lidney transplantation
This core-cooling system was proved to be better than conventional in-situ flushing method when the warm ischemic liver graft was procured from non-heart beating donors in the experiments using dogs or pigs. Measurement of oxygen contents revealed that liver tissue consumes the oxygen even at 15 C,which supports the advantageous supply of oxygen during cooling of the organs. In another experiment using rats, administration of lipo-prostaglandin E1 increased the survival rate after 120min. of warm ischemia of the liver. Furthermore, the measurement of lover tissue flow 30 min. after reperfusion could predict the survial. In 30 min. of warm ischemia in pigs, either livers removed with or without core-cooling functioned well. However, in 30 min. of warm ischemia in dogs or 60 min. of warm ischemia in pigs, the liver removed with core-cooling functioned better than that removed without core-cooling after heterotopic liver transplantation.
These results conclude that warm ischemic injury of the liver was ameliorated by using core-cooling method, and warm ischemic liver from non-heart-beating donors could be utilized for transplantation if procured by cardiopulmonary bypass and transplanted auxiliary.
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