|Budget Amount *help
¥13,200,000 (Direct Cost : ¥13,200,000)
Fiscal Year 2000 : ¥4,300,000 (Direct Cost : ¥4,300,000)
Fiscal Year 1999 : ¥2,200,000 (Direct Cost : ¥2,200,000)
Fiscal Year 1998 : ¥6,700,000 (Direct Cost : ¥6,700,000)
It has been expected that living-related donor liver graft transplantation (LRLT) might have some immunological advantages over cadaveric transplantation. The objective of this study was to analyze a single center's experience with 110 LRLT in pediatric and adult patients with special reference to immunological response in the recipients.
The medical records of 110 consecutive patients who underwent LRLT were reviewed. The relationship between pretransplant covariates and patient and graft survival was analyzed. Actuarial patient/graft survival rates were determined at 1, 3 and 5 years. The type and incidence of posttransplant complications including acute and chronic allograft rejection were analyzed. In addition, the perioperative profiles of serum cytokine levels as well as cytokine mRNA expression in the liver were investigated.
The 1-, 3-, and 5-year actuarial patient and graft survival rates were 88%, 85%, and 85%, respectively. Log-rank test demonstrated that ABC-compatibility predicted patient survival rate, whereas patient age, underlying disease, patient's clinical status, donor-recipient relation, donor age and graft volume/standard liver volume ratio did not. Human leukocyte antigen matching was not the factor affecting the incidence of rejection. Interleukin-6, 8, 12, 15 levels in the serum were elevated in accordance with allograft rejection In the patients with Epstein-Barr virus related posttransplant lymphoproliferative disorder where the cessation of immunosuppressant is possible, serum interleukin-10 level was elevated.
The control of Th1/Th2 cytokine balance as well as the blockade of costimulatory signaling are the keys to overcome immunological sequelae after liver transplantation.