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2006 Fiscal Year Final Research Report Summary

The strategies for overcoming the graft dysfunction after liver transplantation using small-for-size graft

Research Project

Project/Area Number 17390370
Research Category

Grant-in-Aid for Scientific Research (B)

Allocation TypeSingle-year Grants
Section一般
Research Field Digestive surgery
Research InstitutionThe University of Tokushima

Principal Investigator

SHIMADA Mitsuo  The University of Tokushima, Institute of Health Biosciences, Professor, 大学院ヘルスバイオサイエンス研究部, 教授 (10216070)

Co-Investigator(Kenkyū-buntansha) ITAKURA Mitsuo  The University of Tokushima, Institute of Health Biosciences, Professor, ゲノム機能研究センター, 教授 (60134227)
SOEJIMA Yuji  The University of Tokushima, Institute of Health Biosciences, Part-time lecturer, 大学院ヘルスバイオサイエンス研究部, 非常勤講師 (30325526)
FUJII Masahiko  The University of Tokushima, Institute of Health Biosciences, Part-time lecturer, 大学院ヘルスバイオサイエンス研究部, 非常勤講師 (20380040)
IMURA Satoru  The University of Tokushima, Institute of Health Biosciences, Assistant professor, 大学院ヘルスバイオサイエンス研究部, 助手 (90380021)
MORINE Yuji  Tokushima University, Hospital, Assistant professor, 医学部・歯学部附属病院, 助手 (60398021)
Project Period (FY) 2005 – 2006
Keywordsliver transplantation / small-for-size graft / graft dysfunction / liver regeneration / massive hepatectomy model / heat-shock protein / hyperbaric oxygen / preconditioning
Research Abstract

(1) Medical modulation on liver regeneration-Beneficial Effects on small-for-size graft in liver transplantation
i) Beneficial effects of herbal medicine Inchin-ko-to, on liver function and regeneration after hepatectomy in rats.
The survival period was significantly prolonged in the ICKT group. The transaminase and TBA, T-Bil levels significantly were improved in the ICKT group in the early postoperative period. The remnant liver/body weight ratio in ICKT group had been a significant increase postoperatively. In the ICKT group, PCNA and HO-1 was strongly expressed early postoperatively, but the expression of alpha-SMA was weak.
ii) Pharmacokinetics of Cyclosporine A after massive hepatectomy : A hint for small-for-size graft in living donor liver transplantation
Regarding the blood concentration of CyA, no difference was recognized between 30% and 10% graft model except for 72hrs after Hx. As for liver regeneration, no significant difference was recognized. Regarding the expression of CYP … More 3A2, no change was noted in 30% graft model, on the other hand, CYP3A2 expression reduced. Significant differences were observed in 48 and 72 hrs after hepatectomy between 30% and 10% graft model. The blood concentration of CyA was not dependent on the volume of the liver graft.
iii) Beneficial Effects of Fluvastatin on Hepatic Ischemia-Reperfusion Injury in Rats
Fluvastatin reduced the I/R-induced hepatocellular injury at 6hrs after reperfusion (p<0.05). In the fluvastatin group, the expression of eNOS mRNA was significantly higher, and NOX4 mRNA was significantly lower (p<0.05) than in the control group. Furthermore, the expression of inflammatory cytokines mRNA were suppressed in the fluvastatin group. In particular, TNF-_was significantly lower in the fluvastatin group (p<0.05). This study demonstrated that preoperative administration of fluvastatin had beneficial effects on hepatic I/R injury in rats.
(2) Beneficial Effects of Hyperbaric Oxygen Pretreatment on Massive Hepatectomy Model in Rats
The expression of HSP70 mRNA was significantly increased in HBO-3D group compared to HBO (-) group (P<0.05). The HSP70 and HO-1 positive hepatocytes were significantly increased in HBO-3D group compared to HBO (-) group (P<0.05). Transaminases in both 70%-and 90%Hx-HBO group were significantly decreased compared to those of Hx alone group (P<0.05). The Lw/Bw ratio of 90%Hx-HBO group was significantly increased than in 90%Hx group, compared to that of 90%Hx group 24, 48 and 72 hours after hepatectomy (P<0.05). The survival rate in 90%Hx-HBO group was significantly improved than that in 90%Hx group (P=0.01). HBO pretreatment had beneficial effects in massive hepatiectomy model in rats via the induction of HSP70 and HO-1.
(3) Effects of splenectomy on liver function and liver regeneration after massive hepatectomy in rats.
Survival rate was improved in Hx+Sp group compared with control group (7-days, 60% vs 18.2%, p<0.05). In Hx+Sp group, ALT and total bilirubin were quickly improved 48 hours after hepatectomy, significantly. The remnant liver/body weight ratio after hepatectomy was not significantly different at any time points. PCNA labeling index 48 and 72 hours after hepatectomy in Hx+Sp group was higher than that in control group. Splenectomy promoted hepatocyte proliferation after massive hepatectomy, and improved liver function and survival rate. Splenectomy is considered to be beneficial for improving the outcome in massive hepatectomy, which is a small-for-size graft model in LDALT. Less

  • Research Products

    (21 results)

All 2006 2005 Other

All Journal Article (21 results)

  • [Journal Article] Safe and quick major hepatectomy using stapling devices.2006

    • Author(s)
      Shimada M
    • Journal Title

      Hepato-Gastroenterology Suppl. Vol. 53

      Pages: A25

    • Description
      「研究成果報告書概要(和文)」より
  • [Journal Article] Usefulness of a vessel sealing system in anatomical hepatectomy2006

    • Author(s)
      Sugimoto K
    • Journal Title

      Hepato-Gastroenterology Suppl. Vol. 53

      Pages: A25

    • Description
      「研究成果報告書概要(和文)」より
  • [Journal Article] 生体肝移植における過小グラフトの病態生理と治療戦略2006

    • Author(s)
      島田光生
    • Journal Title

      四国医学会雑誌 62巻1-2

      Pages: 30-37

    • Description
      「研究成果報告書概要(和文)」より
  • [Journal Article] 肝不全に対する外科的アプローチ 徳島での生体肝移植の進捗と世界への発信のための新たな戦略2006

    • Author(s)
      島田光生
    • Journal Title

      四国医学雑誌 62巻3-4

      Pages: 123-129

    • Description
      「研究成果報告書概要(和文)」より
  • [Journal Article] 肝癌に対する肝移植2006

    • Author(s)
      居村暁
    • Journal Title

      肝・胆・膵-state of arts- 318

      Pages: 405-409

    • Description
      「研究成果報告書概要(和文)」より
  • [Journal Article] 肝移植 2)ミラノ基準内と基準外手術の成績2006

    • Author(s)
      居村暁
    • Journal Title

      肝胆膵 特集/肝がん治療のすべて 53

      Pages: 859-867

    • Description
      「研究成果報告書概要(和文)」より
  • [Journal Article] 門脈再建早期・晩期門脈血栓症とその対策2006

    • Author(s)
      森根裕二
    • Journal Title

      外科 特集/生体肝移植における門脈・肝静脈再建 68(3)

    • Description
      「研究成果報告書概要(和文)」より
  • [Journal Article] Living-donor liver transplantation : present status and future perspective.2006

    • Author(s)
      Shimada M, Fujii M, Morine Y, Imura S, Ikemoto T, Ishibashi H.
    • Journal Title

      Journal of Medical Investigation 52(1,2)

      Pages: 22-32

    • Description
      「研究成果報告書概要(欧文)」より
  • [Journal Article] Safe and quick major hepatectomy using stapling devices2006

    • Author(s)
      Shimada M, Yoshizumi T, Imura S, Morine Y, Ikemoto T, Miyake K.
    • Journal Title

      Hepato-Gastroenterology Suppl 53

      Pages: A25

    • Description
      「研究成果報告書概要(欧文)」より
  • [Journal Article] Usefulness of a vessel sealing system in anatomical hepatectomy2006

    • Author(s)
      Sugimoto K, Imura S, Morine Y, Ikemoto T, Yoshizumi T, Shimada M.
    • Journal Title

      Hepato-Gastroenterology Suppl 53

      Pages: A25

    • Description
      「研究成果報告書概要(欧文)」より
  • [Journal Article] Treatment strategy for small-for-size graft in living donor liver transplantation2006

    • Author(s)
      Shimada M, Soejima Y, Fujii M, Morine Y, Imura S, Ikemoto T.
    • Journal Title

      Shikoku Acta Medica 62(1,2)

      Pages: 30-37

    • Description
      「研究成果報告書概要(欧文)」より
  • [Journal Article] Surgical approaches for liver failure : progress of living donor liver transplantation in Tokushima University Hospital and a new worldwide strategy from The Tokushima University2006

    • Author(s)
      Shimada M.
    • Journal Title

      Shikoku Acta Medica 62(3,4)

      Pages: 123-129

    • Description
      「研究成果報告書概要(欧文)」より
  • [Journal Article] Liver transplantation for hepatocellular carcinoma2006

    • Author(s)
      Imura S, Yoshizumi T, Shimada M.
    • Journal Title

      Gastroenterology-state of the arts

      Pages: 405-409

    • Description
      「研究成果報告書概要(欧文)」より
  • [Journal Article] The impact of Milan criteria in liver transplantation for hepatocellular carcinoma2006

    • Author(s)
      Imura S, Shimada M, Yosizumi T, Morine Y, Ikemoto T, Miyake K.
    • Journal Title

      KAN・TAN・SUI 53(5)

      Pages: 859-867

    • Description
      「研究成果報告書概要(欧文)」より
  • [Journal Article] Management of early and delay portal vein thrombosis after liver transplantation2006

    • Author(s)
      Morine Y, Shimada M, Soejima Y, Fujii M, Imura S, Ikemoto T.
    • Journal Title

      SURGERY 68(3)

      Pages: 276-281

    • Description
      「研究成果報告書概要(欧文)」より
  • [Journal Article] Selective Glossonean transaction using endlinear stapling devices.2005

    • Author(s)
      Miyake K, Fujii M, Imura S, Ikemoto T, Morine Y, Soejima Y, Shimada M.
    • Journal Title

      Hepato-Gastroenterology Suppl 52

      Pages: A76

    • Description
      「研究成果報告書概要(欧文)」より
  • [Journal Article] Treatment strategy for small-for-size graft in living donor liver transplantation2005

    • Author(s)
      Shimada M.
    • Journal Title

      Journal of Japanese College of Surgeons 30(5)

      Pages: 816-817

    • Description
      「研究成果報告書概要(欧文)」より
  • [Journal Article] New Type of Artificial Liver Support System (ALSS) Using the Photo-catalyst Effect of Titanium Oxide.

    • Author(s)
      Shinohara H
    • Journal Title

      Digestive Diseases and Science (in press)

    • Description
      「研究成果報告書概要(和文)」より
  • [Journal Article] Pharmacokinetics of Cyclosporine A after massive hepatectomy : A hint for small-for-size graft in living donor liver transplantation.

    • Author(s)
      Shinohara H
    • Journal Title

      Digestive Diseases and Science (in press)

    • Description
      「研究成果報告書概要(和文)」より
  • [Journal Article] New Type of Artificial Liver Support System (ALSS) Using the Photo-catalystic Effect of Titanium Oxide

    • Author(s)
      Shinohara H, Shimada M, Ikemoto, Morine M, Imura I, Fujii M, Imaizumi T, Murayama.
    • Journal Title

      Digestive Diseases and Science (in press)

    • Description
      「研究成果報告書概要(欧文)」より
  • [Journal Article] Pharmacokinetics of Cyclosporine A after massive hepatectomy : A hint for small-for-size graft in living donor liver transplantation.

    • Author(s)
      Shinohara H, Shimada M, Ogasawara T, Morine Y, Ikemoto T, Imura S.
    • Journal Title

      Digestive Diseases and Science (in press)

    • Description
      「研究成果報告書概要(欧文)」より

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Published: 2008-05-27  

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