2012 Fiscal Year Final Research Report
Establishing treatment strategy for living donor liver transplantation based on the analysis of mechanism of small-for-size syndrome
| Project/Area Number |
22790526
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| Research Category |
Grant-in-Aid for Young Scientists (B)
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| Allocation Type | Single-year Grants |
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| Research Field |
Laboratory medicine
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| Research Institution | Okayama University |
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Principal Investigator |
UMEDA Yuzo 岡山大学, 岡山大学病院, 助教 (10573735)
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| Research Collaborator |
NAGASAKA Takeshi 岡山大学, 岡山大学病院, 助教 (30452569)
YAGI Takahito 岡山大学, 岡山大学病院, 教授 (00304353)
SADAMORI Hiroshi 岡山大学, 大学院・医歯薬学総合研究科, 准教授 (30362974)
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| Project Period (FY) |
2010 – 2012
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| Keywords | 生体肝移植 / 肝再生 / 過小グラフト / small-for-size 症候群 |
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| Research Abstract |
Background: Graft size is one of the critical factors affecting the prognosis of living donor liver transplantation (LDLT), and the occurrence of small-for-size syndrome (SFSS) is a main concern for clinicians. Many centers require the absence of pre-transplant risk factors and a minimal graft size for the prevention of SFSS. The aim of this study is to determine the perioperative risk factors for SFSS and post-transplant mortality. Patients and Methods: We retrospectively analyzed 262 consecutive adult LDLT cases. Results: In a multivariate analysis, the perioperative risk factors were a donor age >= 56 years-old and MELD score >=25. A cut-off value of 0.65% for GW/RBW didn’t have a significant impact on post-transplant graft function, because of the efficacious portal decompression. The occurrence of SFSS and hospital death depend upon the specific combination of graft size, donor age, and MELD. The decision tree analysis for hospital mortality revealed that the value of any one risk factor affected the cut-off values for the other risk factors. Serum levels of various growth factors associated with the proliferation of resident hepatocytes and hepatocyte progenitor cells, the differentiation of hematopoietic stem cells into hepatocyte, and angiogenesis fluctuate after hepatectomy. Especially, associations of serum levels of leptin and HGF with liver regeneration are revealed.
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