Establish of treatment for avoiding the graft failure in liver transplantation with steatotic small for size graft

• Project/Area Number: 17K10519
• Research Category: Grant-in-Aid for Scientific Research (C)
• Allocation Type: Multi-year Fund
• Section: 一般
• Research Field: General surgery
• Research Institution: Kyoto University (2018-2019); Kyoto Prefectural University of Medicine (2017)
• Principal Investigator: IIDA TAKU 京都大学, 医学研究科, 客員研究員 (90437111)
• Co-Investigator(Kenkyū-buntansha): 八木 真太郎 京都大学, 医学研究科, 講師 (60447969)
• Project Period (FY): 2017-04-01 – 2020-03-31
• Project Status: Completed (Fiscal Year 2019)
• Budget Amount: ¥4,680,000 (Direct Cost: ¥3,600,000、Indirect Cost: ¥1,080,000); Fiscal Year 2019: ¥1,170,000 (Direct Cost: ¥900,000、Indirect Cost: ¥270,000); Fiscal Year 2018: ¥1,170,000 (Direct Cost: ¥900,000、Indirect Cost: ¥270,000); Fiscal Year 2017: ¥2,340,000 (Direct Cost: ¥1,800,000、Indirect Cost: ¥540,000)
• Keywords: 肝移植 / 肝再生 / 脂肪肝 / 過小グラフト / marginal graft / 脂肪肝グラフト

Outline of Final Research Achievements

Steatotic liver grafts cause graft failure in liver transplantation. But so far, only the extent of fatty liver was one of the important information to judge the transplantability. The cause of fatty liver graft in the study, was analyzed for the mechanism and prognosis of each steatotic liver graft after liver transplantation. The cause of fatty liver of the donor, the effect of microcirculation disorders and oxidative stress associated with ischemic reperfusion disorders after transplantation could be shown to be different. The therapeutic effect of statins on fatty liver grafts of FHA has been suggested to be effective depending on the cause of fatty liver.

Academic Significance and Societal Importance of the Research Achievements

脂肪肝の成因によって移植後の虚血再灌流障害の病態が異なることが本研究によって明らかとなった。スタチンの血管保護作用から、微小循環障害が中心であるFHAによる脂肪肝グラフトに有効である可能性がある。本研究の学術的意義は成因毎の脂肪肝に対する移植治療戦略の構築が非常に重要であること、またICUでの絶食＋高カロリー輸液管理による脳死ドナーの脂肪肝は、レシピエントの予後に大きな影響を与えると言う問題点を提示する社会的意義を持つに至った。このことから脳死ドナー候補者は出来る限り絶食などの飢餓状態とならない様に管理を行うことが肝要で、移植肝を受け入れるレシピエントの術後予後改善に寄与する事が判明した。

Research Products

• [Journal Article] Anatomical Pitfall in Right Posterior Sector Graft Procurement in Living Donor Liver Transplantation. (2020)
  • Author(s): Kusakabe J, Yagi S, Okamura Y, Iida T, Ogawa E, Ito T, Hata K, Taura K, Okajima H, Kaido T, Uemoto S.
  • Journal Title: Liver Transpl. Volume: Feb;26(2) Issue: 2 Pages: 299-303
  • DOI: 10.1002/lt.25648
  • Peer Reviewed / Open Access
• [Journal Article] Bolus Administration of Polyamines Boosts Effects on Hepatic Ischemia-Reperfusion Injury and Regeneration in Rats (2019)
  • Author(s): Doi Junshi、Fujimoto Yasuhiro、Teratani Takumi、Kasahara Naoya、Maeda Masashi、Tsuruyama Tatsuaki、Iida Taku、Yagi Shintaro、Uemoto Shinji
  • Journal Title: European Surgical Research Volume: 60 Issue: 1-2 Pages: 63-73
  • DOI: 10.1159/000497434
  • Peer Reviewed / Open Access
• [Journal Article] Laparoscopic approach for choledochojejunostomy. (2019)
  • Author(s): Hori T, Aisu Y, Yamamoto M, Yasukawa D, Iida T, Yagi S, Taniguchi K, Uemoto S.
  • Journal Title: Hepatobiliary Pancreat Dis Int. Volume: 18 Issue: 3 Pages: 285-288
  • DOI: 10.1016/j.hbpd.2019.04.004
  • Peer Reviewed / Open Access
• [Journal Article] Impact of pretreatments on outcomes after living donor liver transplantation for hepatocellular carcinoma (2019)
  • Author(s): Ogawa Kohei、Kaido Toshimi、Okajima Hideaki、Fujimoto Yasuhiro、Yoshizawa Atsushi、Yagi Shintaro、Hori Tomohide、Iida Taku、Takada Yasutsugu、Uemoto Shinji
  • Journal Title: Journal of Hepato-Biliary-Pancreatic Sciences Volume: 26 Issue: 2 Pages: 73-81
  • DOI: 10.1002/jhbp.602
  • Peer Reviewed / Open Access
• [Journal Article] Etiologies, risk factors, and outcomes of bacterial cholangitis after living donor liver transplantation. (2018)
  • Author(s): Yao S, Yagi S, Nagao M, Uozumi R, Iida T, Iwamura S, Miyachi Y, Shirai H, Kobayashi A, Okumura S, Hamaguchi Y, Masano Y, Kaido T, Okajima H, Uemoto S.
  • Journal Title: Eur J Clin Microbiol Infect Dis. Volume: 10 Issue: 10 Pages: 1973-1982
  • DOI: 10.1007/s10096-018-3333-4
  • Peer Reviewed / Open Access
• [Journal Article] A High Portal Venous Pressure Gradient Increases Gut-Related Bacteremia and Consequent Early Mortality After Living Donor Liver Transplantation. (2018)
  • Author(s): Yao S, Yagi S, Uozumi R, Iida T, Nagao M, Okamura Y, Anazawa T, Okajima H, Kaido T, Uemoto S.
  • Journal Title: Transplantation. Volume: 4 Issue: 4 Pages: 623-631
  • DOI: 10.1097/tp.0000000000002047
  • Peer Reviewed / Open Access
• [Journal Article] Short- and Long-Term Outcomes of Live Donor Renal Allografts From Older and Younger Donors. (2018)
  • Author(s): Matsuyama T, Ushigome H, Osaka M, Masuda K, Harada S, Nakamura T, Nobori S, Iida T, Yoshimura N.
  • Journal Title: Transplant Proc. Volume: 10 Issue: 10 Pages: 3228-3231
  • DOI: 10.1016/j.transproceed.2018.08.046
  • Peer Reviewed / Open Access
• [Journal Article] Graft Immunocomplex Capture Fluorescence Analysis to Detect Donor-Specific Antibodies and HLA Antigen Complexes in the Allograft. (2017)
  • Author(s): Nakamura T, Ushigome H, Watabe K, Imanishi Y, Masuda K, Matsuyama T, Harada S, Koshino K, Iida T, Nobori S, Yoshimura N.
  • Journal Title: Immunol Invest. Volume: 3 Pages: 295-304
  • Peer Reviewed
• [Journal Article] Successful laparoscopic distal pancreatectomy for a large solid pseudopapillary neoplasm: A case report. (2017)
  • Author(s): Tada S, Iida T, Anazawa T, Yagi S, Seo S, Masui T, Kaido T, Takaori K, Uemoto S.
  • Journal Title: Asian J Endosc Surg. Volume: 10 Pages: 317-320
  • Peer Reviewed
• [Journal Article] Short-term outcomes of laparoscopy-assisted hybrid living donor hepatectomy: a comparison with the conventional open procedure. (2017)
  • Author(s): Kitajima T, Kaido T, Iida T, Seo S, Taura K, Fujimoto Y, Ogawa K, Hatano E, Okajima H, Uemoto S.
  • Journal Title: Surg Endosc Volume: 31 Issue: 12 Pages: 5101-5110
  • DOI: 10.1007/s00464-017-5575-0
  • Peer Reviewed
• [Journal Article] Liver graft preservation using perfluorocarbon improves the outcomes of simulated donation after cardiac death liver transplantation in rats. (2017)
  • Author(s): Okumura S, Uemura T, Zhao X, Masano Y, Tsuruyama T, Fujimoto Y, Iida T, Yagi S, Bezinover D, Spiess B, Kaido T, Uemoto S.
  • Journal Title: Liver Transpl. Volume: 23 Issue: 9 Pages: 1171-1185
  • DOI: 10.1002/lt.24806
  • Peer Reviewed
• [Journal Article] Significance of Proper Graft Selection in Adult Living-Donor Liver Transplant Recipients with Preoperative Deteriorated Condition. (2017)
  • Author(s): Iida T, Masuda K, Matsuyama T, Harada S, Nakamura T, Koshino K, Suzuki T, Nobori S, Ushogome H, Ito T, Sakamoto S, Uryuhara K, Okajima H, Kaihara S, Uemoto S, Yoshimura N.
  • Journal Title: Ann Transplant. Volume: 22 Pages: 541-549
  • Peer Reviewed
• [Journal Article] Risk Factors and Management for Biliary Complications Following Adult Living-Donor Liver Transplantation. (2017)
  • Author(s): Nakamura T, Iida T, Ushigome H, Osaka M, Masuda K, Matsuyama T, Harada S, Nobori S, Yoshimura N.
  • Journal Title: Ann Transplant. Volume: 22 Pages: 671-676
  • Peer Reviewed
• [Journal Article] Comprehensive guide to laparoscope-assisted graft harvesting in live donors for living-donor liver transplantation: perspective of laparoscopic vision. (2017)
  • Author(s): Hori T, Kaido T, Iida T, Yagi S, Uemoto S.
  • Journal Title: Ann Gastroenterol. Volume: 30 Pages: 118-126
  • DOI: 10.20524/aog.2016.0088
  • Peer Reviewed
• [Journal Article] Impact of Skeletal Muscle Mass, Muscle Quality, and Visceral Adiposity on Outcomes Following Resection of Intrahepatic Cholangiocarcinoma. (2017)
  • Author(s): Okumura S, Kaido T, Hamaguchi Y, Kobayashi A, Shirai H, Fujimoto Y, Iida T, Yagi S, Taura K, Hatano E, Okajima H, Uemoto S.
  • Journal Title: Ann Surg Oncol. Volume: 24 Issue: 4 Pages: 1037-1045
  • DOI: 10.1245/s10434-016-5668-3
  • Peer Reviewed
• [Journal Article] New-onset diabetes mellitus after living-donor liver transplantation: association with graft synthetic function. (2017)
  • Author(s): Yagi S, Kaido T, Iida T, Yoshizawa A, Okajima H, Uemoto S.
  • Journal Title: Surg Today. Volume: 47 Issue: 6 Pages: 733-742
  • DOI: 10.1007/s00595-016-1444-z
  • Peer Reviewed
• [Presentation] 大腸癌異時性肝転移に対する肝切除術の治療成績 (2019)
  • Author(s): 飯田拓、岩﨑純治、原田樹幸、森彩、長田圭司、髙橋有和、松浦正徒、塩田哲也、伊丹淳、京極高久
  • Organizer: 第74回 日本消化器外科学会総会
• [Presentation] Evaluation of clinical outcome in the pure laparoscopic liver resection, comparing with the open liver resection. (2019)
  • Author(s): 飯田拓、岩﨑純治、原田樹幸、森彩、長田圭司、髙橋有和、松浦正徒、塩田哲也、伊丹淳、京極高久
  • Organizer: 日本肝胆膵外科学会
• [Presentation] 当院での脳死肝移植術の治療成績とその課題 (2018)
  • Author(s): 飯田拓、大坂雅史、増田康史、松山剛久、原田俊平、中村緑佐、昇修治、牛込秀隆、吉村了勇
  • Organizer: 第73回 日本消化器外科学会総会
• [Presentation] 右葉グラフトの胆管分岐異常に対して、レシピエント胆嚢管を用いて胆道再建した生体肝移植の2例 (2018)
  • Author(s): 松山剛久、飯田拓、大坂雅史、増田康史、原田俊平、中村緑佐、昇修治、牛込秀隆、吉村了勇
  • Organizer: 第73回 日本消化器外科学会総会
• [Presentation] 生体肝移植を施行した肝肺症候群2例の検討 (2018)
  • Author(s): 増田康史、飯田拓、大坂雅史、松山剛久、原田俊平、中村緑佐、昇修治、牛込秀隆、吉村了勇
  • Organizer: 第73回 日本消化器外科学会総会
• [Presentation] 血液透析及び腹膜透析導入患者に対してTEP法が有用であった鼠径ヘルニアの2症例 (2018)
  • Author(s): 原田俊平、飯田拓、大坂雅史、増田康史、松山剛久、中村緑佐、昇修治、牛込秀隆、吉村了勇
  • Organizer: 第73回 日本消化器外科学会総会
• [Presentation] 腹腔鏡下肝切除術を施行した原発不明神経内分泌腫瘍肝転移の1例 (2018)
  • Author(s): 飯田 拓 、岩﨑純治、原田樹幸、森 彩、長田圭司 高橋有和、松浦正徒、塩田哲也、伊丹 淳、京極高久
  • Organizer: 第31回 日本内視鏡外科学会総会
• [Presentation] Significance of proper graft selection on adult living donor liver transplant recipients with preoperative deteriorated condition (2017)
  • Author(s): Taku Iida, Masafumi Osaka, Koji Masuda, Takehisa Matsuyama, Shunpei Harada, Tsukasa Nakamura Shuji Nobori , Hidetaka Ushigome, Norio Yoshimura
  • Organizer: ESOT
  • Int'l Joint Research
• [Presentation] C型肝硬変に対する肝移植成績と術後抗ウイルス療法の現況 (2017)
  • Author(s): 飯田 拓、大坂雅史、増田康史、松山剛久、 原田俊平、中村緑佐、昇 修治、牛込秀隆、吉村了勇
  • Organizer: 第15回 日本消化器外科学会大会
• [Presentation] 血液型不適合肝移植の治療変遷と成績 (2017)
  • Author(s): 飯田 拓 、大坂雅史、増田康史、松山剛久 原田俊平、中村緑佐、昇 修治、牛込秀隆、吉村了勇
  • Organizer: 第53回 日本移植学会総会
• [Presentation] 生体肝移植におけるレシピエント術前状態を考慮したグラフト選択の意義 (2017)
  • Author(s): 飯田 拓 、大坂雅史、増田康史、松山剛久 原田俊平、中村緑佐、昇 修治、牛込秀隆、吉村了勇
  • Organizer: 第117回 日本外科学会
• [Presentation] 成人生体肝移植における右葉グラフト選択の意義の意義 (2017)
  • Author(s): 飯田 拓 、大坂雅史、増田康史、松山剛久 原田俊平、中村緑佐、昇 修治、牛込秀隆、吉村了勇
  • Organizer: 第72回日本消化器外科学会総会