J.Jpn. Surg. Soc.. 96(3): 160-167, 1995

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Original article

EFFICACY OF LOCAL IMMUNOSUPPRESSION WITH INTRAPORTAL ADMINISTRATION OF CYCLOSPORINE IN LIVER TRANSPLANTATION

The purpose of this study was to evaluate the efficacy of local immunosuppression with intraportal administration of cyclosporine (CsA) in liver transplantation. Mongrel dogs weighing 12-18kg were used. Orthotopic liver transplantation was performed, and animals were divided to the following groups. Group I (n=7) : no treatment, group II (n=7) : CsA 5mg/kg/day intermittent iv, group III (n=5) : CsA 3mg/kg/day continuous iv and group IV (n=8) : CsA 3mg/kg/day continuous portal infusion. Immunosuppressive treatments were carried out for two weeks postransplant. Median survival time (MST) of group IV was significantly prolonged (MST=18 days, range 10-85 days ; p< 0.025) compared with group I (7 days, range 6-13), group II (10 days, range 7-16) and group III (7 days, range 6-10). Data of blood chemical analyses showed that hepatic dysfunction was significantly diminished in group IV compared with other groups (p< 0.05). Blood concentration of CsA on the 5th day (mean±SEM) was significantly lower in group IV (238±22ng/ml) than in group III (438±113ng/ml). Histologic findings showed that rejection reaction was effectively suppressed in group IV, although SG2M% (mean±SEM) of peripheral mononuclear cells of group IV (10.6±3.3%) was equal to that of group III (11.3±1.7%). In conclusion, local immunosuppression could achieve prominent effect in preventing hepatic graft rejection with limited systemic immunosuppression

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