京都大学 · 医学
Yagi教授の研究室は、肝再生および肝移植後の長期的成績を高めるため、特に門脈血流動態や移植後における血管新生・成長因子の役割に注目した研究を推進しています。特に、成人および小児への生体供肝移植における移植肝の機能予後や、門脈圧が再生に与える影響を、臨床的・生理学的アプローチで解明しています。また、ドナー年齢や移植肝体積比(GRWR)が予後要因として果たす役割についても、精密な解析を実施しています。
Figures are computed from collected data and may differ slightly.
The liver is a unique organ with an abundant regenerative capacity. Therefore, partial hepatectomy (PHx) or partial liver transplantation (PLTx) can be safely performed. Liver regeneration involves a complex network of numerous hepatotropic factors, cytokines, pathways, and transcriptional factors. Compared with liver regeneration after a viral- or drug-induced liver injury, that of post-PHx or -PLTx has several distinct features, such as hemodynamic changes in portal venous flow or pressure, ti
Several reports claim that portal hypertension after living-donor liver transplantation (LDLT) adversely affects graft function, but few have assessed the impact of portal venous pressure (PVP) on graft regeneration. We divided 32 adult LDLT recipients based on mean PVP during the 1st 3 days after LDLT into a group with a PVP > or = 20 mm of Hg (H Group; n = 17), and a group with a PVP < 20 mm of Hg (L Group; n = 15). Outcome in the H Group was poorer than in the L Group (58.8 vs. 92.9% at 1 yea
Liver graft function was better when PVF and graft compliance were higher and PVP was maintained under 20 mmHg.
Donor age is an independent, strong prognostic factor in adult-to-adult LDLT.
Few studies have examined the long-term outcomes and prognostic factors associated with pediatric living living-donor liver transplantation (LDLT) using reduced and hyper-reduced left lateral segment grafts. We conducted a retrospective, single-center assessment of the outcomes of this procedure, as well as clinical factors that influenced graft and patient survival. Between September 2000 and December 2009, 49 patients (median age: 7 months, weight: 5.45 kg) underwent LDLT using reduced (partia
Similar outcomes were observed for small and large graft use regardless of lobe selection. 0.6% in GRWR was reasonable as the minimum requirement of graft volume in LDLT. However, small grafts should be indicated carefully for high-risk cases.
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