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[Pathophysiology and strategy for small-for-size graft syndrome after living-donor liver transplantation].
- Source :
-
Nihon Geka Gakkai zasshi [Nihon Geka Gakkai Zasshi] 2004 Oct; Vol. 105 (10), pp. 680-6. - Publication Year :
- 2004
-
Abstract
- Small-for-size (SFS) graft syndrome is an important problem after living-donor liver transplantation in adults. Hemodynamic change is thought to be the main cause of graft injury. Excessive portal flow is associated with hepatic sinusoidal injury, and reduction of portal flow improves postoperative liver function. Increased venous outflow due to hepatic venoplasty or reconstruction of the middle hepatic vein decrease the risk of graft congestion. However, the intragraft acute-phase response remains unclear. Recent studies have revealed that downregulation of heat shock protein (HSP) may account for SFS graft injury, and induction of HSP may prevent SFS syndrome. On the other hand, derangement in the regulation of liver regeneration is recognized as another important factor. Further investigation of the regulatory mechanisms of liver regeneration in SFS grafts may suggest a strategy for the prevention and treatment of SFS syndrome. Successful transplantation of marginal-size liver grafts would improve outcome for recipients and increase the margin of safety for living donors.
- Subjects :
- Activins physiology
Follistatin physiology
Graft Survival
Heat-Shock Proteins metabolism
Humans
Liver metabolism
Liver Regeneration physiology
Organ Size
Portal Vein physiology
Regional Blood Flow
Syndrome
Liver anatomy & histology
Liver Failure etiology
Liver Failure prevention & control
Liver Transplantation adverse effects
Liver Transplantation methods
Living Donors
Subjects
Details
- Language :
- Japanese
- ISSN :
- 0301-4894
- Volume :
- 105
- Issue :
- 10
- Database :
- MEDLINE
- Journal :
- Nihon Geka Gakkai zasshi
- Publication Type :
- Academic Journal
- Accession number :
- 15521386