1988 Fiscal Year Final Research Report Summary
Organization and Systematization of the Clinical Liver Transplantation at Kitasato University
| Project/Area Number |
62440052
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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 | KITASATO UNIVERSITY, SCHOOL OF MEDICINE |
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Principal Investigator |
ASO Koichi KITASATO UNIVERSITY,SCHOOL OF MEDICINE,PROFESSOR, 医学部, 教授 (00050310)
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| Co-Investigator(Kenkyū-buntansha) |
OHWADA Takashi KITASATO UNIVERSITY,SCHOOL OF MEDICINE,PROFESSOR, 医学部, 教助 (00050469)
SHIBATA Hisao KITASATO UNIVERSITY,SCHOOL OF MEDICINE,PROFESSOR, 医学部, 教授 (60050340)
TAZAKI Yoshiaki KITASATO UNIVERSITY,SCHOOL OF MEDICINE,PROFESSOR, 医学部, 教授 (80050326)
YADA Kenzo KITASATO UNIVERSITY,SCHOOL OF MEDICINE,PROFESSOR, 医学部, 教授 (90050351)
KASHIWAGI Noboru KITASATO UNIVERSITY,SCHOOL OF MEDICINE,PROFESSOR, 医学部, 教授 (60095502)
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| Project Period (FY) |
1987 – 1988
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| Keywords | Hepatocellular Carcinoma / Liver Cirrhosis / Human Liver Transplantation / Brain Death Cadaver Donor / HLA-typing / Transplantation Network / Organ Preservation / 移植ネットワーク |
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| Research Abstract |
The purpose of this project is to begin starting the clinical liver transplantation (L-TX) at Kitasato University Hospital, and organize the special fields related to L-TX. As no good cadaver donors for L-TX could be obtained during these two years, we couldn't perform the clinical L-TX. However during these two years each project teams research has progressed. So we are now prepared to perform the clinical L-TX both technically and systematically.
Regarding the HLA system, it was confirmed that the recipient's HLA-DR phenotypes influenced the survival of living lerated donor renal allografts. The DNA-typing with reference to HLA-DR specificities has also been investigated, and a novel human classII specificity DQ"Wa" residing on DQ molecules was identified. In analysis on the underlying mechanisms in the maintenance of pregnancy, the success in effective prevention of abortion by immunizing the wife with the husbands' lymphocytes has been obtained, and the antiidiotypic antibody in the
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wife's serum which reacted with the wife's lymphocytes against husbands' HLA antigens was discovered. The prolongation of skin and kidney graft survival in dogs by a combined treatment of preoperative fractioned lymphoid irradiation, donor bone marrow cell infusion shortly before grafting, and short-term administration of AZA,CYA or FK506 suggested to induce donor specific unresponsiveness.
In the clinical study of 46 cases of cadavers with brain death, the primary injury group showed that cardiac standstill (so-called "heart death") took place 29.3 hours (mean time) after the determination of brain death, but on the other hand in the secondary injury group the mean time was 10.2 hours. It was suggested that the serial measurement of neuron specific enolase predicted the posibility of brain death within 24 hours after resuscitation. 80% of the 102 cases of critical subarachnoidal hemorrhage died of brain death. All of these cases of brain death were irreversible. The mortality rate of 113 patients with putaminal hemorrhage with the onset within 24 hours was 51.3%. All these patients died under the brain death atate. Their mean age was 58.1 years and they had many complications due to arteriosclerosis, so there were very few potential cadaver donoros for L-TX.
According to clinical evaluations of 271 cases of hepatocellular carcinoma, 288 cases of liver cirrhosis, 17 cases of primary hepatobiliary cirrhosis and 2 cases of Cridler Najar syndrome, it was demonstrated that the lives of many patients with these diseases could be saved by L-TX.
An organic germanium compound showed the protective effect on warm ischemia of rat kidneys and the effectiveness of the prolongation for kidney preservation. Using the bypass procedure during the anhepatic phase with a Bio-pump, the success rate of canine L-TX achieved was almost 80%.
One of our team members is a leading member of the committee at Toranomon Local Area Kidney Transplantation Center and is proceding with the making of a transplantation network.
For the starting of clinical L-TX, the preparation of the surgical techniques have been completely refined. Less
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