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Analysis of the Impact of graft size on bacterial translocation―study On the preventioon of posttransplant Infection In living donor liver transplantation

Research Project

Project/Area Number 13671231
Research Category

Grant-in-Aid for Scientific Research (C)

Allocation TypeSingle-year Grants
Section一般
Research Field General surgery
Research InstitutionKYOTO UNIVERSITY

Principal Investigator

OIKE Fumitaka  Kyoto University Transplant Surgery Assistant, 医学研究科, 助手 (20324650)

Co-Investigator(Kenkyū-buntansha) KIUCHI Tetsuya  Nagoya University Transplant Surgery Professor, 医学研究科, 教授 (40303820)
UEMOTO Shinji  Mie University Surgery Professor, 医学部, 教授 (40252449)
TANAKA Koichi  Kyoto University Transplant Surgery Professor, 医学研究科, 教授 (20115877)
KAIHARA Satoshi  Kyoto University Transplant Surgery Assistant Professor, 医学研究科, 講師 (70324647)
EGAWA Hiroto  Kyoto University Transplant Surgery Assistant Professor, 医学研究科, 助教授 (40293865)
Project Period (FY) 2001 – 2002
Project Status Completed (Fiscal Year 2002)
Budget Amount *help
¥3,600,000 (Direct Cost: ¥3,600,000)
Fiscal Year 2002: ¥300,000 (Direct Cost: ¥300,000)
Fiscal Year 2001: ¥3,300,000 (Direct Cost: ¥3,300,000)
Keywordsliving donor liver transplantation / Infection / graft saize / portalvenous pressure / bacterial translocation / cellular factors
Research Abstract

It has been shown that survival in smallforsize grafts is worse in living donor liver transplantation (LDLT). The 1-year survival rate in non-ICU bound patients was 91.8% with graft-to-recipient weight ratio (GRWR) of 【greater than or equal】1.0%, 79.5% with GRWR of 0.8-1.0%, and 59.7% with GRWR of < 0.8%. The difference by graft size was even greater in ICU-bound patients
In many failed cases, the direct cause of death was infection. To examine the relationship between graft size and infection, a portal catheter was placed in 79 LDLT cases
Portal vein pressure (PVP) was significantly high in small-for-size grafts. The patients with elevated PVP (【greater than or equal】20 mmHg) demonstrated significantly worse survival (84.5 %vs.38.5%) . In these cases, the incidence of bacteremia was high (64.0% ;PVP 【greater than or equal】20mmHg, 28.8% ;PVP <20mmHg), indicating the association of infection with poor survival
Enteral feeding was introduced in adult LDLT in order to reduce the posttransplant infection by preventing the mucosal injury and by maintaining the normal bacterial flora, because the high incidence of infectious complication in small-for-size grafts is presumably associated with the same mechanisms that promote bacterial translocation observed in rat model of hepatic resection. Enteral feeding also eliminated the long use of central venous catheterization, resulting in the decrease in the risk for catheter-related sepsis
Based on the preliminary result that high PVP may display a strong prognostic value, splenic artery was ligated in seven cases with either elevated PVP (【greater than or equal】20 mmHg after arterial reperfusion) or small-for-size grafts (GRWR< 1.0%). Despite significantly smaller GRWR in patients with splenic artery ligation (SAL), posttransplant PVP was significantly lower than that in non-SAL patients and also survival was significantly better than that in non-SAL patients with high early PVP

Report

(3 results)
  • 2002 Annual Research Report   Final Research Report Summary
  • 2001 Annual Research Report
  • Research Products

    (23 results)

All Other

All Publications (23 results)

  • [Publications] Takashi Ito: "Changes in portal venous pressure in the early phase after living donor liver transplantation : pathogenesis and clinical implications"Transplantation. Vol75 No 8. 1313-1317 (2003)

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      2002 Final Research Report Summary
  • [Publications] Koichi Tanaka: "Impact Of Small-For-Size Graft On Graft Srugical And Postoperative Complications In Adult Living Donor Liver Transplantation"Current Issues In Liver And Small Bowel Transplantaion. 9. 22 (2002)

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      2002 Final Research Report Summary
  • [Publications] Tetsuya Kiuchi: "Small-for-size graft in living donor liver transplantation : how far should we go?"Liver transplantation. 1-16 (2003)

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      2002 Final Research Report Summary
  • [Publications] M Shimamura: "Roles Of The Jejunum And Ileum In The First-pass Effect As Absorptive Barriers For Orally Administered Tacrolimus"Journal Of Surgical Research. 103(2). 215-222 (2002)

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      2002 Final Research Report Summary
  • [Publications] Tetsuya Kiuchi: "Living Donor Liver Transplantation In Kyoto, 2001"Clinical Transplats. 18. 195-201 (2002)

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      2002 Final Research Report Summary
  • [Publications] Koichi Tanaka: "Living-donor Liver Transplantation In The New Decade : Perspective From The Twentieth To The Twenty-First Century"Journal Of Hepatobiriary Pancreat Surg. 9. 218-222 (2002)

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      2002 Final Research Report Summary
  • [Publications] Yoji Maetani: "Factors Influencing lizer regeneration following living-donor lizer Transplantation of the right hepatic lobe"Transplantation. 75・1. 97-102 (2003)

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      2002 Final Research Report Summary
  • [Publications] 田中紘一: "2)成績とQOL 2)成人肝移植"日本外科学会雑誌. 103・5. 397-400 (2002)

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      2002 Final Research Report Summary
  • [Publications] 尾池文隆: "生体肝移植における臨床的免疫寛容"今日の移植. 358-361. 358-361 (2002)

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      2002 Final Research Report Summary
  • [Publications] 田中紘一: "生体肝移植の確立と普及"日医雑誌. 129・1. 65-70 (2002)

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      2002 Final Research Report Summary
  • [Publications] Takashi Ito, et al: "Changes In portal venous pressure In the early phase after living donor liver transplantation :pathogenesis and clinical Implications"Transplantation. Vol175 No8. 1313-1317 (2003)

    • Description
      「研究成果報告書概要(欧文)」より
    • Related Report
      2002 Final Research Report Summary
  • [Publications] koichi Tanaka, et al: "Impact of Small-For-Size Graft on Graft Srugical and postoperative complications In Adult Living Donor Liver Transplantation Current Issues In liver And Small Bowel"Transplantation. 9. 22 (2002)

    • Description
      「研究成果報告書概要(欧文)」より
    • Related Report
      2002 Final Research Report Summary
  • [Publications] Tetsuya Kiuchi, et al: "Small -for-size graft In living donor liver transplantationrhow far should we go?"Liver transplantation. 1-16 (2003)

    • Description
      「研究成果報告書概要(欧文)」より
    • Related Report
      2002 Final Research Report Summary
  • [Publications] Masahiro shimomura, et al: "Roles of The Jejunum And Ileum In The First-pass Effect As Absorptive Barriers For Orally Administered Tacrolirnus"Journal Of Surgical Research. 103(2). 215-222 (2002)

    • Description
      「研究成果報告書概要(欧文)」より
    • Related Report
      2002 Final Research Report Summary
  • [Publications] Tetsuya Kiuchi, et al: "Living Donor Liver Transplantation In Kyoto"2001 Clinical Transplats. 18. 195-201 (2002)

    • Description
      「研究成果報告書概要(欧文)」より
    • Related Report
      2002 Final Research Report Summary
  • [Publications] Koichi Tanaka, et al: "Living-donor Liver Transplantation In The New Decade:Perspective From The Twentieth To The Twenty-First Century"Jounal Of Hepatobiriary Pancreat Surg. 9. 218-222 (2002)

    • Description
      「研究成果報告書概要(欧文)」より
    • Related Report
      2002 Final Research Report Summary
  • [Publications] Yoji Maetani, et al: "Factors Influencing lizer regenerarion following living-donor lizer Transplantation of the right hepatic lobe"Transplantation. 75・1. 97-102 (2003)

    • Description
      「研究成果報告書概要(欧文)」より
    • Related Report
      2002 Final Research Report Summary
  • [Publications] Takashi Ito: "Changes in portal venous pressure in the early phase after living donor liver transplantation : pathogenesis and clinical implications"Transplantation. Vol.175 No.8(In press). (2003)

    • Related Report
      2002 Annual Research Report
  • [Publications] Koichi Tanaka: "Impact Of Small-For-Size Graft On Graft Srugical And Postoperative Complications In Adult Living Donor Liver Transplantation"Current Issues In Liver And Small Bowel Transplantaion. 9. 22 (2002)

    • Related Report
      2002 Annual Research Report
  • [Publications] Tetsuya Kiuchi: "Small-for-size graft in living donor liver transplantation : how far should we go?"Liver transplantation. (In press). (2003)

    • Related Report
      2002 Annual Research Report
  • [Publications] M Shimamura: "Roles Of The Jejunum And Ileum In The First-pass Effect As Absorptive Barriers For Orally Administered Tacrolimus"Journal Of Surgical Research. 103(2). 215-222 (2002)

    • Related Report
      2002 Annual Research Report
  • [Publications] Tetsuya Kiuchi: "Living Donor Liver Transplantation In Kyoto,2001"Clinical Transplats. 18. 195-201 (2002)

    • Related Report
      2002 Annual Research Report
  • [Publications] Koichi Tanaka: "Living-donor Liver Transplantation In The New Decade : Perspective From The Twentieth To The Twenty-First Century"Jounal Of Hepatobiriary Pancreat Surg. 9. 218-222 (2002)

    • Related Report
      2002 Annual Research Report

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Published: 2001-04-01   Modified: 2016-04-21  

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