ID 98211
タイトルヨミ
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
タイトル別表記
Surgical approaches for liver failure : progress of living donor liver transplantation in Tokushima University Hospital and a new worldwide strategy from The Tokushima University
著者
島田, 光生 徳島大学大学院器官病態修復医学講座臓器病態外科学分野|徳島大学病院消化器・移植外科 徳島大学 教育研究者総覧 KAKEN研究者をさがす
キーワード
liver transplantation from deceased donor
donor action program
splenectomy
artificial liver support system
management center for liver failure
資料タイプ
学術雑誌論文
抄録
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.
掲載誌名
四国医学雑誌
ISSN
00373699
cat書誌ID
AN00102041
出版者
徳島医学会
62
3-4
開始ページ
123
終了ページ
129
並び順
123
発行日
2006-08-25
備考
フルテキストファイル
言語
jpn
部局
医学系