ID 98211
Title Transcription
カンフゼン ニ タイスル ゲカテキ アプローチ : トクシマ デノ セイタイ カンイショク ノ シンチョク ト セカイ エノ ハッシン ノ タメ ノ アラタナ センリャク
Title Alternative
Surgical approaches for liver failure : progress of living donor liver transplantation in Tokushima University Hospital and a new worldwide strategy from The Tokushima University
Author
Shimada, Mitsuo Department of Digestive and Pediatric Surgery, Institute of Health Biosciences, The University of Tokushima Graduate School|Department of Digestine Surgery and Transplantation, Tokushima University Hospital Tokushima University Educator and Researcher Directory KAKEN Search Researchers
Keywords
liver transplantation from deceased donor
donor action program
splenectomy
artificial liver support system
management center for liver failure
Content Type
Journal Article
Description
I herein introduce a new surgical strategy against liver failure, which includes liver transplantation(especially living donor liver transplantation(LDLT)), splenectomy and artificial liver support system. I wan to emphasize progress of LDLT in Tokushima. Since restart of LDLT in February 2005, five consecutive cases have been done thanks to all staffs in Tokushima University Hospital. Surgical technique of LDLT is excellent, judging from intraoperative blood loss of both donors and recipients. Overall survival rate(80%)is satisfactory. In Japan, only 31 cases underwent liver transplantation from deceased(=brain-dead)donor since February 1999(below 5 cases per year). This number is unbelievable when compared to USA(over 4,500 cases per year). Under such abnormal circumstances, there are many patients with end-stage liver disease who can not under go LDLT due to no donor. Splenectomy is a promising modality for those patients, which brings improvement of hypersplenism(low platelet count and leukocyte count) liver function tests(bilirubin value and ICGR-15),and nutritional state. Furthermore, liver regeneration is suggested to be promoted. Our new type of artificial liver support system using a photocatalystic effect of titanium is also a next-generation therapy for liver failure.
In conclusions, a top-level LDLT became possible in Tokushima, however, increase in number of liver transplantation from deceased donor is a big and urgent problem. Splenectomy may be one of the most important modalities for liver-failured patients without any living donor. I am going to create original and high-quality therapeutic methods for liver failure as many as possible in order to send new information to all over the world as a center of liver-failure management institutions in Shikoku Island.
Again, I appreciate all staffs in TheTokushima University Hospital regarding success in restart of LDLT.
Journal Title
四国医学雑誌
ISSN
00373699
NCID
AN00102041
Publisher
徳島医学会
Volume
62
Issue
3-4
Start Page
123
End Page
129
Sort Key
123
Published Date
2006-08-25
Remark
FullText File
language
jpn
departments
Medical Sciences