1990 Fiscal Year Final Research Report Summary
Experimental Research for Primary Non-Function in Liver Transplantation
| Project/Area Number |
63570603
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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 |
General surgery
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| Research Institution | Nara Medical University, School of Medicine |
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Principal Investigator |
NAKAJIMA Yoshiyuki Nara Med. Univ., 1st. Dept. of Surgery, Instructor, 医学部・第1外科, 講師 (00142381)
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| Co-Investigator(Kenkyū-buntansha) |
NAKANO Hiroshige Nara Med. Univ., 1st. Dept. of Surgery, Professor, 医学部・第1外科, 教授 (20075071)
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| Project Period (FY) |
1988 – 1990
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| Keywords | liver transplantation / arterial ketone body ratio (AKBR) / plasma amino acids / calcium channel blocker / Diltiazem / hepatic ischemia / primary non-function / charcoal hemofiltration |
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| Research Abstract |
In order to estimate the initial hepatic allograft function, we investigated arterial ketone body ratio (AKBR) and plasma amino acid levels in canine orthotopic liver transplantation. In successful cases, AKBR and plasma amino acids, especially alanine and total free plasma amino acids restored to the preoperative levels 3 hours after arterial reperfusion. On the other hand, in cases which died due to hepatic insufficiency, they could not recover even after reperfusion. Accordingly, AKBR and plasma amino acids are the rapid indicators to estimate the viability of hepatic graft and that primary non-fnction can be detected with these parameters by 3 hours after reperfusion.
Next study was to investigate the protective effect of a calcium channel blocker, Diltiazem (DZ), on ischemic liver damage and whether or not DZ might prevent primary non-function in liver transplantation. AKBR and hepatic arterial blood flow recovered 1 hour after hepatic ischemia for 60 minutes, whereas they were not restored in untreated controls. Furthermore, although all untreated dogs transplanted with warm ischemically damaged livers for 20 minutes died due to liver failure, half number of dogs (50%) which were administered DZ could survive over 48 hours after grafting without hepatic isufficiency. These results showed that DZ has protective effects on liver ischemia and warm ischemic injury in preservation of liver transplantation.
As a treatment of primary non-function, charcoal hemofiltration could not normalize the hepatic function when that was started just after the diagnosis of primary non-function.
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