1999 Fiscal Year Final Research Report Summary
Liver Transplantation From Non-Heart Beating Cadaver Donor
| Project/Area Number |
09470259
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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 | Tokyo Women's Medical University |
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Principal Investigator |
FUCHINOUE Shohei Tokyo Women's Medical University, Surgery III, Assistant Profesor, 医学部, 助教授 (10147382)
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| Co-Investigator(Kenkyū-buntansha) |
SAWADA Tokihiko Tokyo Women's Medical University, Surgery III, Assistant, 医学部, 助手 (20266761)
NAKAJIMA Ichiro Tokyo Women's Medical University, Surgery III, Lecture Instructor, 医学部, 講師 (80198077)
TOJIMBARA Tamotsu Tokyo Women's Medical University, Surgery III, Assistant, 医学部, 助手 (80197847)
SANNOMIYA Akihito Tokyo Women's Medical University, Surgery III, Assistant, 医学部, 助手 (40297445)
MURAKAMI Tohru Tokyo Women's Medical University, Surgery III, Assistant, 医学部, 助手 (50287356)
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| Project Period (FY) |
1997 – 1999
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| Keywords | LIVER TRANSPLANTATION / NON-HEART BEATING DONOR / FLUSH SOLUTION / PRESERVATION SOLUTION / ANHEPATIC PHASE / PORCINE MODEL |
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| Research Abstract |
A successful method for effective liver procurement and preservation from non-heart beating donors (NHBD) would have enormous benefit to resolve the problem of organ shortage. In this study, we developed a porcine LTx model from NHBD after sustaining a shock state, and evaluated the efffect of passive versus active veno-venous bypass on liver graft function in the NHBD model. In addition, we investigated the effect of a novel preservation solution, sodium lactobionate sucrose (SLS) solution, in the NHBD model as compared with Euro-Collins (EC) and University of Wisconsin (UW) solutions.
Operative procedures were performed with the pigs, weighing 17-20 kg. In donors, livers were subjected to 120 min of in situ warm ischemia induced by 60 min of a shock state following by 60 min of cardiac arrest. At the end of warm ischemia (shock state and cardiac arrest), in situ perfusion of the liver with each solution was initiated. The liver graft was preserved in the same solution for 6 hours at 4℃. LTx was performed using the preserved liver grafts without immunosuppression. Passive (tube) or active (pump) veno-venous bypass was used during the anhepatic phase.
Serum levels of liver enzymes in the passive bypass group were significantly higher than those in the active bypass group, when the same solution was used for perfusion and preservation. In the comparative study using EC, UW and SLS solutions, liver graft function in the SLS group was significantly better than those in the EC and UW groups.
These data suggest that intraoperative condition i.e. hemodynamic instability or splanchnic congestion in recipients, in addition to warm ischemic, cold ischemic and reperfusion injury, may affect the liver graft function from NHBD after sustaining a shock state. Furthermore, SLS solution may improve the liver graft viability procured from NHBD and further studies are strongly encouraged.
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Research Products
(10 results)
