Clinical research on the mechanism of hepatitis C recurrence and its management following liver transplantation for hepatitis C liver cirrhosis

2005 Fiscal Year Final Research Report Summary

• Project/Area Number: 14370356
• Research Category: Grant-in-Aid for Scientific Research (B)
• Allocation Type: Single-year Grants
• Section: 一般
• Research Field: General surgery
• Research Institution: Nagoya University (2004-2005); Kyoto University (2002-2003)
• Principal Investigator: FUJIMOTO Yasuhiro Nagoya University, University Hospital, Research Associate, 医学部附属病院, 助手 (80335281)
• Co-Investigator(Kenkyū-buntansha): TANAKA Koichi Foundation for Biomedical Research and Innovation, General Manager, 先端医療センター長 (20115877) ; KIUCHI Tetsuya Nagoya University, Graduate School of Medicine, Professor, 大学院・医学系研究科, 教授 (40303820) ; UEMOTO Shinji Mie University, Graduate School of Medicine, Professor, 大学院・医学系研究科, 教授 (40252449) ; EGAWA Hiroto Kyoto University, Graduate School of Medicine, Associate Professor, 大学院・医学研究科, 助教授 (40293865) ; KAIHARA Satoshi Kyoto Prefectural University, School of Medicine, Associate Professor, 医学部, 助教授 (70324647)
• Project Period (FY): 2002 – 2005
• Keywords: liver cirrhosis (type C) / liver transplantation / Hep C recurrence / interferon / ribavirin / rejection / living-donor

Research Abstract

Virological recurrence after living-donor liver transplantation for Hep C liver cirrhosis is inevitable. Together with the fact that histological recurrence is evident with over 80% cases at 3 years after transplantation, it is obvious that effective treatment and/or effective prophylaxis are necessary.
The analysis of recipients with Hep C recurrence (F1 and over) at Kyoto University Hospital revealed risk factors as follows : female recipient, male donor, preoperative interferon therapy, non-small graft. However, even with the recipients without risk factors, the recurrence rate reaches around 80%, therefore, they cannot be classified as group without necessity of treatment.
Further investigation at Nagoya University Hospital showed : The extent of post-transplant viral growth is not predictable by the pre-transplant viral load or immediate post-transplant viral load. Viral load (pre-transplant, immediate post-transplant, 1 month after transplant) does not forecast histological recurrence.
It is believed that "lower the viral load, greater the effect of anti-virals," however, the usage of interferon immediate after transplantation is fraught with risk of activation of immune system leading to rejection. Our data suggests that some cases encounter histological rejection in the absence of elevated liver function tests, therefore liver biopsy in order to exclude rejection in indispensable when we consider antiviral therapy immediately after transplantation.
This research contributes to the management and treatment of Hep C recurrence after liver transplantation. Hereafter, continuing research is necessary regarding steroid-free immunosuppression or virus clearing therapy for viral overshoot after transplantation expecting the mitigation of magnitude of virological recurrence.

Research Products

• [Journal Article] Fatal graft-versus-host disease after living donor liver transplantation : Differential impact of donor-dominant one-way HLA matching. (2006)
  • Author(s): Kamei, H., F.Oike, Y.Fujimoto, H.Yamamoto, K.Tanaka, T.Kiuchi
  • Journal Title: Liver Transpl 12(1) Pages: 140-145
  • Description: 「研究成果報告書概要(和文)」より
• [Journal Article] 【生体肝移植 最新の話題】 生体肝移植における感染症 (2005)
  • Author(s): 山本栄和, 長井俊志, 須田竜一郎, 亀井秀弥, 藤本康弘, 木内哲也
  • Journal Title: 臨床外科 60(12) Pages: 1385-1389
  • Description: 「研究成果報告書概要(和文)」より
• [Journal Article] 【生体肝移植をめぐる諸問題】 生体肝移植ドナーをめぐる諸問題 生体肝移植ドナーにおける脂肪肝 (2005)
  • Author(s): 藤本康弘, 山本幸司, 山本栄和, 高田泰次, 木内哲也, 田中紘一
  • Journal Title: 臨床消化器内科 20(12) Pages: 1691-1696
  • Description: 「研究成果報告書概要(和文)」より
• [Journal Article] 【肝細胞癌 今日の治療戦略】 肝癌の治療戦略 肝癌に対する肝移植 (2005)
  • Author(s): 藤本康弘, 須田竜一郎, 亀井秀弥, 山本栄和, 木内哲也
  • Journal Title: 外科治療 93(1) Pages: 64-69
  • Description: 「研究成果報告書概要(和文)」より
• [Journal Article] 肝移植の現状と展望 (2005)
  • Author(s): 藤本康弘, 木内哲也
  • Journal Title: 肝胆膵治療研究会誌 3(1) Pages: 82
  • Description: 「研究成果報告書概要(和文)」より
• [Journal Article] Living-donor liver transplantation for situs inversus : 2 case reports. (2005)
  • Author(s): Kamei, H., M.Kasahara, K.Uryuhara, K.Kozaki, K.Ogawa, Y.Ogura, Y.Fujimoto, Y.Takada, K.Tanaka
  • Journal Title: J Pediatr Surg 40(3) Pages: E35-37
  • Description: 「研究成果報告書概要(和文)」より
• [Journal Article] Auxiliary partial orthotopic living donor liver transplantation : Kyoto University experience. (2005)
  • Author(s): Kasahara, M., Y.Takada, H.Egawa, Y.Fujimoto, Y.Ogura, K.Ogawa, K.Kozaki, H.Haga, M.Ueda, K.Tanaka
  • Journal Title: Am J Transplant 5(3) Pages: 558-565
  • Description: 「研究成果報告書概要(和文)」より
• [Journal Article] Impact of right lobe with middle hepatic vein graft in living-donor liver transplantation. (2005)
  • Author(s): Kasahara, M., Y.Takada, Y.Fujimoto, Y.Ogura, K.Ogawa, K.Uryuhara, Y.Yonekawa, M.Ueda, H.Egawa, K.Tanaka
  • Journal Title: Am J Transplant 5(6) Pages: 1339-1346
  • Description: 「研究成果報告書概要(和文)」より
• [Journal Article] Living donor liver transplantation for biliary atresia complicated by situs inversus : technical highlights. (2005)
  • Author(s): Matsubara, K., Y.Fujimoto, H.Kamei, K.Ogawa, M.Kasahara, M.Ueda, H.Egawa, Y.Takada, M.Kitajama, K.Tanaka
  • Journal Title: Liver Transpl 11(11) Pages: 1444-1447
  • Description: 「研究成果報告書概要(和文)」より
• [Journal Article] Successful laser ablation of diffuse laryngeal swelling in posttransplant lymphoproliferative disorder : the Japanese first case. (2005)
  • Author(s): Nishimura, K., K.Omori, H.Haga, Y.Fujimoto, J.Ito
  • Journal Title: Int J Pediatr Otorhinolaryngol 69(6)2 Pages: 869-873
  • Description: 「研究成果報告書概要(和文)」より
• [Journal Article] Portal vein complications in the long-term course after pediatric living donor liver transplantation. (2005)
  • Author(s): Ueda, M., H.Egawa, K.Ogawa, K.Uryuhara, Y.Fujimoto, M.Kasahara, Y.Ogura, K.Kozaki, Y.Takada, K.Tanaka
  • Journal Title: Transplant Proc 37(2) Pages: 1138-1140
  • Description: 「研究成果報告書概要(和文)」より
• [Journal Article] Proinflammatory and antiinflammatory cytokine production during ischemia-reperfusion injury in a case of identical twin living donor liver transplantation using no immunosuppression. (2005)
  • Author(s): Zhao, X., T.Koshiba, Y.Fujimoto, J.Pirenne, A.Yoshizawa, T.Ito, H.Kamei, K.Jobara, K.Ogawa, K.Uryuhara, Y.Takada, K.Tanaka
  • Journal Title: Transplant Proc 37(1) Pages: 392-394
  • Description: 「研究成果報告書概要(和文)」より
• [Journal Article] Living-donor liver transplantation : Current topics. Infectious disease after living donor liver transplantation (2005)
  • Author(s): Yamamoto, H., S.Nagai, R.Suda, H.Kamei, Y.Fujimoto, T.Kiuchi
  • Journal Title: Rinshogeka 60(12) Pages: 1385-1389
  • Description: 「研究成果報告書概要(欧文)」より
• [Journal Article] Problems in living-donor liver transplantation steatosis in living donors for liver transplantation (2005)
  • Author(s): Fujimoto, Y., K.Yamamoto, H.Yamamoto, Y.Takada, T.Kiuchi, K.Tanaka
  • Journal Title: Rinsho shokakinaika 20(12) Pages: 1691-1696
  • Description: 「研究成果報告書概要(欧文)」より
• [Journal Article] Liver transplantation for hepatocellular carcinoma. (2005)
  • Author(s): Fujimoto, Y., R.Suda, H.Kamei, H.Yamamoto, T.Kiuchi
  • Journal Title: Gekachiryo 93(1) Pages: 64-69
  • Description: 「研究成果報告書概要(欧文)」より
• [Journal Article] Current status and prospectives of liver transplantation (2005)
  • Author(s): Fujimoto, Y., T.Kiuchi
  • Journal Title: Kan-Tan-Sui Chiryo Kenkyukaishi 3(1) Pages: 82
  • Description: 「研究成果報告書概要(欧文)」より
• [Journal Article] Living-donor liver transplantation for situs inversus : 2 case reports. (2005)
  • Author(s): Kamei, H., M.Kasahara, K.Uryuhara, K.Kozaki, K Ogawa, Y.Ogura, Y.Fujimoto, Y.Takada, K.Tanaka.
  • Journal Title: J Pediatr Surg 40(3) Pages: E35-E37
  • Description: 「研究成果報告書概要(欧文)」より
• [Journal Article] Auxiliary partial orthotopic living donor liver transplantation : Kyoto University experience. (2005)
  • Author(s): Kasahara, M., Y.Takada, H.Egawa, Y.Fujimoto, Y.Ogura, K.Ogawa, K.Kozaki, H.Haga, M.Ueda, K.Tanaka.
  • Journal Title: Am J Transplant 5(3) Pages: 558-565
  • Description: 「研究成果報告書概要(欧文)」より
• [Journal Article] Successful laser ablation of diffuse laryngeal swelling in posttransplant lymphoproliferative disorder : the Japanese first case. (2005)
  • Author(s): Nishimura, K., K.Omori, H.Haga, Y.Fujimoto, J.Ito
  • Journal Title: Int J Pediatr Otorhinolaryngol 69(6) Pages: 869-873
  • Description: 「研究成果報告書概要(欧文)」より
• [Journal Article] End-to-side portocaval shunting for a small-for-size graft in living donor liver transplantation. (2004)
  • Author(s): Takada, Y., M.Ueda, Y.Ishikawa, Y.Fujimoto, H.Miyauchi, Y.Ogura, T.Ochiai, K.Tanaka
  • Journal Title: Liver Transpl 10(6) Pages: 807-810
  • Description: 「研究成果報告書概要(和文)」より
• [Journal Article] Successful surgical ligation under intraoperative portal vein pressure monitoring of a large portosystemic shunt presenting as an intrapulmonary shunt : report of a case (2004)
  • Author(s): Yagi, H., Y.Takada, Y.Fujimoto, Y.Ogura, K.Kozaki, M.Ueda, K.Tanaka
  • Journal Title: Surg Today 34(12) Pages: 1049-1052
  • Description: 「研究成果報告書概要(和文)」より
• [Journal Article] Functional portal flow competition after auxiliary partial orthotopic living donor liver transplantation in noncirrhotic metabolic liver disease. (2004)
  • Author(s): Kasahara, M., Y.Takada, K.Kozaki, K.Uryuhara, Y.Ogura, K.Ogawa, Y.Fujimoto, K.Tanaka
  • Journal Title: J Pediatr Surg 39(7) Pages: 1138-1141
  • Description: 「研究成果報告書概要(和文)」より
• [Journal Article] Successful surgical ligation under intraoperative portal vein pressure monitoring of a large portosystemic shunt presenting as an intrapulmonary shunt : report of a case. (2004)
  • Author(s): Yagi, H., Y.Takada, Y.Fujimoto, Y.Ogura, K.Kozaki, M.Ueda, K.Tanaka
  • Journal Title: Surg Today 34(12) Pages: 1049-1052
  • Description: 「研究成果報告書概要(欧文)」より