J.Jpn. Surg. Soc.
ISSN 1880-1129

[Abstract] [Full Text PDF] （in Japanese / 2187KB） [Members Only And Two Factor Auth.]

J.Jpn. Surg. Soc.. 105(10): 674-679, 2004

Feature topic

LIVER REGENERATION IN LIVING-DONOR LIVER TRANSPLANTATION

1) Organ Transplantation and Regenerative Medicine, Graduate School of Medicine, Hokkaido University
2) Division of Organ Transplantation, Hokkaido University Hospital
3) Department of General Surgery, Graduate School of Medicine, Hokkaido University
4) College of Medical Technology, Hokkaido University, Sapporo, Japan

Maeng Bong Jin1), Tsuyoshi Shimamura2), Masahiko Taniguchi3), Yoshihide Nagasako3), Tomomi Suzuki1), Toshiya Kamiyama3), Michiaki Matsushita4), Hiroyuki Furukawa1), Satoru Todo3)

Liver regeneration in living-donor liver transplantation is summarized from the authors' data. In donors, liver function tests recovered to within the normal range 2 weeks after surgery regardless of graft type. At 2 weeks, the volumetric recovery of the remnant liver was 65% and 80% of the original volume in right and left lobe donors, respectively. These results suggest that functional recovery occurs earlier than morphologic restoration in donors. In recipients, the factor that affected the regeneration rate in size 4 weeks after transplantation was only implanted graft size; the rate was greater in patients in whom smaller grafts were implanted ln recipients with a rate of two or more, however, high portal vein pressure and flow were observed. Further, persistent low platelet counts and hyperbilirubinemia were seen in those patients. These results indicate that size enlargement may be caused by engorgement, and functional recovery is not achieved concurrently with morphologic restoration, especially in patients with smaller grafts. In patients with fulminant hepatic failure who receive auxiliary partial orthotopic liver transplantation, sequential histopathologic observations of the diseased liver revealed that liver regeneration initiates from cytokeratin 17-positive ductules and at least 1 year is necessary for complete recovery.

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