小體積肝移植的基礎研究進展_《中國普外基礎與臨床雜志》

作者：

梁靚 , 梁廷波

浙江大學醫學院附屬第一醫院肝膽胰外科，衛生部多器官聯合移植重點研究實驗室（杭州 310003）;

關鍵詞：

小體積肝移植門靜脈高壓肝竇微循環內皮素-1

視頻：

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目的介紹小體積肝移植術后移植物損傷機理及移植物保護措施。
方法復習和總結了相關文獻資料并作綜述。
結果小體積肝移植術后過高的門靜脈壓力導致移植物機械性損傷，并通過改變肝竇微循環狀態及激活各類細胞因子使移植物損傷進一步加重。通過手術或藥物的方法降低門靜脈壓力可對移植物起一定的保護作用。
結論了解小體積肝移植術后移植物損傷機理對于臨床提高活體肝移植的效果具有積極的意義。

引用本文： 梁靚,梁廷波. 小體積肝移植的基礎研究進展. 中國普外基礎與臨床雜志, 2010, 17(5): 428-432. doi: 復制

1.	Bismuth H, Houssin D. Reduced-sized orthotopic liver graft in hepatic transplantation in children [J]. Surgery， 1984; 95(3): 367-370.
2.	Strong RW, Lynch SV, Ong TH, et al. Successful liver transplantation from a living donor to her son [J]. N Engl J Med, 1990; 322(21): 1505-1507.
3.	Heaton N. Small-for-size liver syndrome after auxiliary and split liver transplantation: donor selection [J]. Liver Transpl, 2003; 9(9): S26-S28.
4.	Urata K, Hashikura Y, Ikegami T, et al. Standard liver volume in adults [J]. Transplant Proc, 2000; 32(7): 2093-2094.
5.	Kiuchi T, Kasahara M, Uryuhara K, et al. Impact of graft size mismatching on graft prognosis in liver transplantation from living donors[J]. Transplantation, 1999; 67(2): 321-327.
6.	Emond JC, Renz JF, Ferrell LD, et al. Functional analysis of grafts from living donors. Implications for the treatment of older recipients [J]. Ann Surg, 1996; 224(4): 544-552.
7.	Nishizaki T, Ikegami T, Hiroshige S, et al. Small graft for living donor liver transplantation [J]. Ann Surg, 2001; 233(4): 575-580.
8.	Ohkohchi N, Shibuya H, Tsukamoto S, et al. Kupffer’s cells modulate neutrophile activity by superoxide anion and tumor necrosis factor-delta in reperfusion injury of liver transplantation-mechanisms of radical generation and reperfusion injury after cold ischemia [J]. Transplant Proc, 1999; 31(1-2): 1055-1058.
9.	Ku Y, Fukumoto T, Nishida T, et al. Evidence that portal vein decompression improves survival of canine quarter orthotopic liver transplantation [J]. Transplantation, 1995; 59(10): 1388-1392.
10.	Man K, Lo CM, Ng IO, et al. Liver transplantation in rats using small-for-size grafts: a study of hemodynamic and morphological changes [J]. Arch Surg, 2001; 136(3): 280-285.
11.	García-Valdecasas JC, Fuster J, Charco R, et al. Changes in portal vein flow after adult living-donor liver transplantation: does it influence postoperative liver function? [J]. Liver Transpl, 2003; 9(6): 564-569.
12.	Troisi R, de Hemptinne B. Clinical relevance of adapting portal vein flow in living donor liver transplantation in adult patients [J]. Liver Transpl, 2003; 9(9): S36-S41.
13.	Man K, Fan ST, Lo CM, et al. Graft injury in relation to graft size in right lobe live donor liver transplantation: a study of hepatic sinusoidal injury in correlation with portal hemodynamics and intragraft gene expression [J]. Ann Surg, 2003; 237(2): 256-264.
14.	Smyrniotis V, Kostopanagiotou G, Kondi A, et al. Hemodynamic interaction between portal vein and hepatic artery flow in small-for-size split liver transplantation [J]. Transpl Int, 2002; 15(7): 355-360.
15.	Palmes D, Minin E, Budny T, et al. The endothelin/nitric oxide balance determines small-for-size liver injury after reduced-size rat liver transplantation [J]. Virchows Arch, 2005; 447(4): 731-741.
16.	Li J, Liang L, Ma T, et al. Sinusoidal microcirculatory changes after small-for-size liver transplantation in rats [J]. Transpl Int, 2010 Feb 19. [Epub ahead of print].
17.	徐世國，鄭樹森，梁廷波, 等. 大鼠不同體積肝移植早期肺組織內誘導性一氧化氮合成酶的表達 [J]. 中華肝膽外科雜志, 2005; 11(1): 273-275.
18.	Liang TB, Man K, Kin-Wah Lee T, et al. Distinct intragraft response pattern in relation to graft size in liver transplantation [J]. Transplantation, 2003; 75(5): 673-678.
19.	Liang T, Xu S, Yu J, et al. Activation pattern of mitogen-activated protein kinases in early phase of different size liver isografts in rats [J]. Liver Transpl, 2005; 11(12): 1527-1532.
20.	Mao L, Qiu YD, Fang S, et al. Liver progenitor cells activated after 30% small-for-size liver transplantation in rats: a preliminary study [J]. Transplant Proc, 2008; 40(5): 1635-1640.
21.	Huda KA, Guo L, Haga S, et al. Ex vivo adenoviral gene transfer of constitutively activated STAT3 reduces post-transplant liver injury and promotes regeneration in a 20% rat partial liver transplant model [J]. Transpl Int, 2006; 19(5): 415-423.
22.	Debonera F, Wang G, Xie J, et al. Severe preservation injury induces Il-6/STAT3 activation with lack of cell cycle progression after partial liver graft transplantation [J]. Am J Transplant, 2004; 4(12): 1964-1971.
23.	Zhong Z, Schwabe RF, Kai Y, et al. Liver regeneration is suppressed in small-for-size liver grafts after transplantation: involvement of c-Jun N-terminal kinase, cyclin D1, and defective energy supply [J]. Transplantation, 2006; 82(2): 241-250.
24.	Mabuchi A, Mullaney I, Sheard PW, et al. Role of hepatic stellate cell/hepatocyte interaction and activation of hepatic stellate cells in the early phase of liver regeneration in the rat [J]. J Hepatol, 2004; 40(6): 910-916.
25.	Yoshizumi T, Taketomi A, Soejima Y, et al. The beneficial role of simultaneous splenectomy in living donor liver transplantation in patients with small-for-size graft [J]. Transpl Int, 2008; 21(9): 833-842.
26.	Ito T, Kiuchi T, Yamamoto H, et al. Changes in portal venous pressure in the early phase after living donor liver transplantation: pathogenesis and clinical implications [J]. Transplantation, 2003; 75(8): 1313-1317.
27.	Yagi S, Iida T, Hori T, et al. Optimal portal venous circulation for liver graft function after living-donor liver transplantation [J]. Transplantation, 2006; 81(3): 373-378.
28.	Troisi R, de Hemptinne B. Clinical relevance of adapting portal vein flow in living donor liver transplantation in adult patients [J]. Liver Transpl, 2003; 9(9): S36-S41.
29.	Reynaert H, Vaeyens F, Qin H, et al. Somatostatin suppresses endothelin-1-induced rat hepatic stellate cell contraction via somatostatin receptor subtype 1 [J]. Gastroenterology, 2001; 121(4): 915-930.
30.	Xu X, Man K, Zheng SS, et al. Attenuation of acute phase shear stress by somatostatin improves small-for-size liver graft survival [J]. Liver Transpl, 2006; 12(4): 621-627.
31.	Man K, Lee TK, Liang TB, et al. FK 409 ameliorates small-for-size liver graft injury by attenuation of portal hypertension and down-regulation of Egr-1 pathway [J]. Ann Surg, 2004; 240(1): 159-168.
32.	Tenhunen R, Marver HS, Schmid R. The enzymatic conversion of heme to bilirubin by microsomal heme oxygenase [J]. Proc Natl Acad Sci USA, 1968; 61(2): 748-755.
33.	Yang ZF, Tsui TY, Ho DW, et al. Heme oxygenase-1 potentiates the survival of small-for-size liver graft [J]. Liver Transpl, 2004; 10(6): 784-793.
34.	Tang LM, Wang YP, Wang K, et al. Exogenous biliverdin ameliorates ischemia-reperfusion injury in small-for-size rat liver grafts [J]. Transplant Proc, 2007; 39(5): 1338-1344.
35.	Morioka D, Kubota T, Sekido H, et al. Prostaglandin E1 improved the function of transplanted fatty liver in a rat reduced-size-liver transplantation model under conditions of permissible cold preservation [J]. Liver Transpl, 2003; 9(1): 79-86.
36.	Tang LM, Wang YP, Wang K, et al. Protective effect of adenosine A2A receptor activation in small-for-size liver transplantation [J]. Transpl Int, 2007; 20(1): 93-101.
37.	Zhao Y, Man K, Lo CM, et al. Attenuation of small-for-size liver graft injury by FTY720: significance of cell-survival Akt signaling pathway [J]. Am J Transplant, 2004; 4(9): 1399-1407.
38.	Yu Y, Yao AH, Chen N, et al. Mesenchymal stem cells over-expressing hepatocyte growth factor improve small-for-size liver grafts regeneration [J]. Mol Ther, 2007; 15(7): 1382-1389.
39.	Song J, Zhang YW, Yao AH, et al. Adenoviral cardiotrophin-1 transfer improves survival and early graft function after ischemia and reperfusion in rat small-for-size liver transplantation model [J]. Transpl Int, 2008; 21(4): 372-383.
40.	Ricciardi R, Schaffer BK, Shah SA, et al. Bosentan, an endothelin antagonist, augments hepatic graft function by reducing graft circulatory impairment following ischemia/reperfusion injury [J]. J Gastrointest Surg, 2001; 5(3): 322-329.
41.	Palmes D, Budny TB, Stratmann U, et al. Endothelin-A receptor antagonist reduces microcirculatory disturbances and transplant dysfunction after partial liver transplantation [J]. Liver Transpl, 2003; 9(9): 929-939.
42.	Liang L, Ma T, Chen W, et al. Therapeutic potential and related signal pathway of adipose-derived stem cell transplantation for rat liver injury [J]. Hepatol Res, 2009; 39(8): 822-832.

1. Bismuth H, Houssin D. Reduced-sized orthotopic liver graft in hepatic transplantation in children [J]. Surgery， 1984; 95(3): 367-370.
2. Strong RW, Lynch SV, Ong TH, et al. Successful liver transplantation from a living donor to her son [J]. N Engl J Med, 1990; 322(21): 1505-1507.
3. Heaton N. Small-for-size liver syndrome after auxiliary and split liver transplantation: donor selection [J]. Liver Transpl, 2003; 9(9): S26-S28.
4. Urata K, Hashikura Y, Ikegami T, et al. Standard liver volume in adults [J]. Transplant Proc, 2000; 32(7): 2093-2094.
5. Kiuchi T, Kasahara M, Uryuhara K, et al. Impact of graft size mismatching on graft prognosis in liver transplantation from living donors[J]. Transplantation, 1999; 67(2): 321-327.
6. Emond JC, Renz JF, Ferrell LD, et al. Functional analysis of grafts from living donors. Implications for the treatment of older recipients [J]. Ann Surg, 1996; 224(4): 544-552.
7. Nishizaki T, Ikegami T, Hiroshige S, et al. Small graft for living donor liver transplantation [J]. Ann Surg, 2001; 233(4): 575-580.
8. Ohkohchi N, Shibuya H, Tsukamoto S, et al. Kupffer’s cells modulate neutrophile activity by superoxide anion and tumor necrosis factor-delta in reperfusion injury of liver transplantation-mechanisms of radical generation and reperfusion injury after cold ischemia [J]. Transplant Proc, 1999; 31(1-2): 1055-1058.
9. Ku Y, Fukumoto T, Nishida T, et al. Evidence that portal vein decompression improves survival of canine quarter orthotopic liver transplantation [J]. Transplantation, 1995; 59(10): 1388-1392.
10. Man K, Lo CM, Ng IO, et al. Liver transplantation in rats using small-for-size grafts: a study of hemodynamic and morphological changes [J]. Arch Surg, 2001; 136(3): 280-285.
11. García-Valdecasas JC, Fuster J, Charco R, et al. Changes in portal vein flow after adult living-donor liver transplantation: does it influence postoperative liver function? [J]. Liver Transpl, 2003; 9(6): 564-569.
12. Troisi R, de Hemptinne B. Clinical relevance of adapting portal vein flow in living donor liver transplantation in adult patients [J]. Liver Transpl, 2003; 9(9): S36-S41.
13. Man K, Fan ST, Lo CM, et al. Graft injury in relation to graft size in right lobe live donor liver transplantation: a study of hepatic sinusoidal injury in correlation with portal hemodynamics and intragraft gene expression [J]. Ann Surg, 2003; 237(2): 256-264.
14. Smyrniotis V, Kostopanagiotou G, Kondi A, et al. Hemodynamic interaction between portal vein and hepatic artery flow in small-for-size split liver transplantation [J]. Transpl Int, 2002; 15(7): 355-360.
15. Palmes D, Minin E, Budny T, et al. The endothelin/nitric oxide balance determines small-for-size liver injury after reduced-size rat liver transplantation [J]. Virchows Arch, 2005; 447(4): 731-741.
16. Li J, Liang L, Ma T, et al. Sinusoidal microcirculatory changes after small-for-size liver transplantation in rats [J]. Transpl Int, 2010 Feb 19. [Epub ahead of print].
17. 徐世國，鄭樹森，梁廷波, 等. 大鼠不同體積肝移植早期肺組織內誘導性一氧化氮合成酶的表達 [J]. 中華肝膽外科雜志, 2005; 11(1): 273-275.
18. Liang TB, Man K, Kin-Wah Lee T, et al. Distinct intragraft response pattern in relation to graft size in liver transplantation [J]. Transplantation, 2003; 75(5): 673-678.
19. Liang T, Xu S, Yu J, et al. Activation pattern of mitogen-activated protein kinases in early phase of different size liver isografts in rats [J]. Liver Transpl, 2005; 11(12): 1527-1532.
20. Mao L, Qiu YD, Fang S, et al. Liver progenitor cells activated after 30% small-for-size liver transplantation in rats: a preliminary study [J]. Transplant Proc, 2008; 40(5): 1635-1640.
21. Huda KA, Guo L, Haga S, et al. Ex vivo adenoviral gene transfer of constitutively activated STAT3 reduces post-transplant liver injury and promotes regeneration in a 20% rat partial liver transplant model [J]. Transpl Int, 2006; 19(5): 415-423.
22. Debonera F, Wang G, Xie J, et al. Severe preservation injury induces Il-6/STAT3 activation with lack of cell cycle progression after partial liver graft transplantation [J]. Am J Transplant, 2004; 4(12): 1964-1971.
23. Zhong Z, Schwabe RF, Kai Y, et al. Liver regeneration is suppressed in small-for-size liver grafts after transplantation: involvement of c-Jun N-terminal kinase, cyclin D1, and defective energy supply [J]. Transplantation, 2006; 82(2): 241-250.
24. Mabuchi A, Mullaney I, Sheard PW, et al. Role of hepatic stellate cell/hepatocyte interaction and activation of hepatic stellate cells in the early phase of liver regeneration in the rat [J]. J Hepatol, 2004; 40(6): 910-916.
25. Yoshizumi T, Taketomi A, Soejima Y, et al. The beneficial role of simultaneous splenectomy in living donor liver transplantation in patients with small-for-size graft [J]. Transpl Int, 2008; 21(9): 833-842.
26. Ito T, Kiuchi T, Yamamoto H, et al. Changes in portal venous pressure in the early phase after living donor liver transplantation: pathogenesis and clinical implications [J]. Transplantation, 2003; 75(8): 1313-1317.
27. Yagi S, Iida T, Hori T, et al. Optimal portal venous circulation for liver graft function after living-donor liver transplantation [J]. Transplantation, 2006; 81(3): 373-378.
28. Troisi R, de Hemptinne B. Clinical relevance of adapting portal vein flow in living donor liver transplantation in adult patients [J]. Liver Transpl, 2003; 9(9): S36-S41.
29. Reynaert H, Vaeyens F, Qin H, et al. Somatostatin suppresses endothelin-1-induced rat hepatic stellate cell contraction via somatostatin receptor subtype 1 [J]. Gastroenterology, 2001; 121(4): 915-930.
30. Xu X, Man K, Zheng SS, et al. Attenuation of acute phase shear stress by somatostatin improves small-for-size liver graft survival [J]. Liver Transpl, 2006; 12(4): 621-627.
31. Man K, Lee TK, Liang TB, et al. FK 409 ameliorates small-for-size liver graft injury by attenuation of portal hypertension and down-regulation of Egr-1 pathway [J]. Ann Surg, 2004; 240(1): 159-168.
32. Tenhunen R, Marver HS, Schmid R. The enzymatic conversion of heme to bilirubin by microsomal heme oxygenase [J]. Proc Natl Acad Sci USA, 1968; 61(2): 748-755.
33. Yang ZF, Tsui TY, Ho DW, et al. Heme oxygenase-1 potentiates the survival of small-for-size liver graft [J]. Liver Transpl, 2004; 10(6): 784-793.
34. Tang LM, Wang YP, Wang K, et al. Exogenous biliverdin ameliorates ischemia-reperfusion injury in small-for-size rat liver grafts [J]. Transplant Proc, 2007; 39(5): 1338-1344.
35. Morioka D, Kubota T, Sekido H, et al. Prostaglandin E1 improved the function of transplanted fatty liver in a rat reduced-size-liver transplantation model under conditions of permissible cold preservation [J]. Liver Transpl, 2003; 9(1): 79-86.
36. Tang LM, Wang YP, Wang K, et al. Protective effect of adenosine A2A receptor activation in small-for-size liver transplantation [J]. Transpl Int, 2007; 20(1): 93-101.
37. Zhao Y, Man K, Lo CM, et al. Attenuation of small-for-size liver graft injury by FTY720: significance of cell-survival Akt signaling pathway [J]. Am J Transplant, 2004; 4(9): 1399-1407.
38. Yu Y, Yao AH, Chen N, et al. Mesenchymal stem cells over-expressing hepatocyte growth factor improve small-for-size liver grafts regeneration [J]. Mol Ther, 2007; 15(7): 1382-1389.
39. Song J, Zhang YW, Yao AH, et al. Adenoviral cardiotrophin-1 transfer improves survival and early graft function after ischemia and reperfusion in rat small-for-size liver transplantation model [J]. Transpl Int, 2008; 21(4): 372-383.
40. Ricciardi R, Schaffer BK, Shah SA, et al. Bosentan, an endothelin antagonist, augments hepatic graft function by reducing graft circulatory impairment following ischemia/reperfusion injury [J]. J Gastrointest Surg, 2001; 5(3): 322-329.
41. Palmes D, Budny TB, Stratmann U, et al. Endothelin-A receptor antagonist reduces microcirculatory disturbances and transplant dysfunction after partial liver transplantation [J]. Liver Transpl, 2003; 9(9): 929-939.
42. Liang L, Ma T, Chen W, et al. Therapeutic potential and related signal pathway of adipose-derived stem cell transplantation for rat liver injury [J]. Hepatol Res, 2009; 39(8): 822-832.

《中國普外基礎與臨床雜志》

小體積肝移植的基礎研究進展

摘要 全文 圖表 視頻 參考文獻 施引文獻 補充材料

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Content

《中國普外基礎與臨床雜志》

小體積肝移植的基礎研究進展

摘要 全文 圖表 視頻 參考文獻 施引文獻 補充材料

Format

Content

摘要全文圖表視頻參考文獻施引文獻補充材料