1989 Fiscal Year Final Research Report Summary
Graft preservation for liver transplantation.
| Project/Area Number |
62440051
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| Research Category |
Grant-in-Aid for General Scientific Research (A)
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| Allocation Type | Single-year Grants |
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| Research Field |
Digestive surgery
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| Research Institution | Kyushu University |
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Principal Investigator |
OKADOME Kenichiro Kyushu University, Faculty of Medicine, Lecturer, 医学部, 講師 (00127995)
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| Co-Investigator(Kenkyū-buntansha) |
ITASAKA Hidetoshi Kyushu University, Faculty of Medicine, Resident, 医学部, 医員
SHIMADA Mitsuo Kyushu University, Faculty of Medicine, Assistant, 医学部, 助手 (10216070)
TAKENAKA Kenji Fukuoka City Hospital, Director of Surgery., 主幹 (30117155)
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| Project Period (FY) |
1987 – 1989
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| Keywords | Liver transplantation / Graft preservation / Flow-waveform / Pulsatile perfusion / Ex-vivo perfusion model / ATP synthetic ability / Serum LCAT activity / Ammonia level |
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| Research Abstract |
1)Study of the flow-waveform controlled pulsatile liver perfusion. With the objective of a long-term preservation of graft in liver transplantation, we investigated the flow-waveform controlled pulsatile liver perfusion in dogs or pigs. (1)The pulsatile liver perfusion apparatus which was developed for this study produced arterial flow-waveforms of type O to IV. (2)After the preservation under the type O, type III flow-waveforms or the simple storage for 8 hours, the viability of grafts was estimated by blood biochemical parameters and a restoration of ATP content in the graft tissue after re-perfusion of grafts in the ex-vivo perfusion model. Type O group had the best results overall and the utility of liver preservation under the flow-waveform type O was confirmed. (3)There was no significant difference in the survival after orthotopic liver transplantation (OLTx) in pigs between the type O group and the simple storage group. (4)However, in the estimation of blood level of factor VII
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I-related antigen and the level of prostacyclin in perfusate, it was considered that the type O flow-waveform participated in protecting endothelial cells of liver grafts.
2)Study of indicators for an assessment of graft viability. (1)Restoration of ATP contents in the transplanted liver closely related to graft viability in dogs. If the restoration of ATP reached over 80% of initial value at 10min after re-perfusion, the good prognosis was expected. (2)Elimination of endogenous ammonia was significantly rapid after OLTx of fresh livers comparing with OLTx of 8 hour-preserved livers in dogs. This was confirmed a rapid indicator of allograft viability in OLTx. (3)Serum lecithin cholesterol acyltransferase(LCAT) activity served as an early prognostic indicator in pig OLTx. In the survival group, it recovered to the preoperative level from 3 post-operative days, however, no recovery was noted in the early death group. (4)Levels of GOT, GPT, LDH and ammonia in the perfusate flushed from preserved liver graft before OLTx were good indicators of graft viability in dogs. Perfusate level of GOT,GPT and LDH was well correlated with blood level of them, respectively, after OLTx. Perfusate level of ammonia was well correlated with the restoration of ATP contents after OLTx. Less
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