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ID 13701
Eprint ID
13701
フルテキストURL
Thumnail 110_1.pdf 1.65 MB
タイトル(別表記)
A case of living related liver transplantation for an adult recipient with primary biliary cirrhosis
著者
八木 孝仁 岡山大学外科学第一講座
漆原 直人 岡山大学外科学第一講座
大石 正博 岡山大学外科学第一講座
松川 啓義 岡山大学外科学第一講座
藤原 俊哉 岡山大学外科学第一講座
松野 剛 岡山大学外科学第一講座
森 雅信 岡山大学外科学第一講座
津下 宏 岡山大学外科学第一講座
高倉 範尚 岡山大学外科学第一講座
田中 紀章 岡山大学外科学第一講座
東 俊宏 岡山大学内科学第一講座
辻 孝夫 岡山大学内科学第一講座
稲垣 優 高知県立中央病院外科
貞森 裕 福山市民病院
上川 康明 三原赤十字病院
抄録
A 49-year-old female received a living related liver transplantation from her son. She had a 13-years history of primary biliary cirrhosis (PBC). The preoperative 1-year survival rate and mortality after 6 months were calculated to be 6.5% and 99.3%, respectively. The graft included left bisegments weighing 435g, and was equal to 43% of the calculated standard liver volume. Massive ascites were sustained due to accompanied portal hypertension. On Postoperative day 7, she manifested massive tarry stool by portal-hypertensive colonopathy. The CT scan revealed a right subphrenic abscess on the postoparative day 14. After drainage of the abscess, the serum total billirubin level decreased to the norman range. She was descharged with extracorptreal tube dainage. On the postoperative day 169, she was readmitted due to acute elevation of the serum bilirubin level. Echography revealed selective dilatation of the hepatic bile duct in the segment 2, and suggested the presence of insufficiency of hepatico-jejunostomy in the early postoperative phase. Despite emergent PTCD, jaundice was sustained and responded poorly to steroid pulse therapy. According to tapering of oral prednisolone, the serum bilirubin level gradually decreased and reached a the plateau between 2 and 4mg/dl. The patient is currently completely free from oral steroid therapy and in receiving interventional hepaticoplasty using the YAG laser system. We concluded that living related liver transplantation is an effective transplantational option for adult end-stage liver disease.
キーワード
living related
liver transplantation
primary biliary cirrhosis
adult
備考
原著
発行日
1998-06-25
出版物タイトル
岡山医学会雑誌
出版物タイトル(別表記)
Journal of Okayama Medical Association
110巻
1-6号
出版者
岡山医学会
出版者(別表記)
Okayama Medical Association
開始ページ
1
終了ページ
8
ISSN
0030-1558
NCID
AN00032489
資料タイプ
学術雑誌論文
オフィシャル URL
https://www.jstage.jst.go.jp/article/joma1947/110/1-6/110_1-6_1/_article/-char/ja/
関連URL
http://www.okayama-u.ac.jp/user/oma/index.html
参考文献
1) Raia S, Nery JR and Mies S : Liver transplantation from live donors, Lancet ii (1988) 497.
2) Tokunaga y, Tanaka K, Uemoto S, Tanaka A, Morimoto T and Yamaoka Y : Risk factors and complications in living related liver transplantation. Transplant Proc (1994) 30, 140-144.
3) Broelsch CE, Whitington PF, Emond JC, Heffron TG, Thislethwaite JR Stevens L, Pipre J, Whitington SH and Lichtor JL : Liver transplantation in children from living related donors. Ann Surg (1991) 214, 437-439.
4) Hashikura Y, Makuuchi M, Kawasaki S, Matsunami H, Igegami T, Nakazawa Y, Kiyosawa K and Ichida T : Successful living-related partial liver transplantation to an adult patient. Lancet (1994) 343, 1233-1234.
5) 辻 孝夫,東 俊宏,山田剛太郎,浮田 實,友田 純,伊藤俊雄,小出典男,草地省蔵,山本和秀,水野元夫,下村宏之,坂口孝作:肝移植の適応基準;岡山医学会雑誌(1991)103,155-165.
6) Urata K, Kawasaki S, Matsunami H, Hashikura Y, Ikegami T, Ishizone S, MOmose Y, Komiyama A and Makuuchi M : Calculation of child and adult standard liver volume for liver transplantation. Hepatology (1995) 21, 1317-1321.
7) Lo CM, Fan ST, Chan JK, Wei W, Lo RJ and Lai CL : Minimum graft volume for successful adult-to-adult living donoer liver transplantation for fulminant hepatic failure. Transplantation (1996) 62, 696-698.
8) 川崎誠治:成人肝疾患に対する生体部分肝移植;肝移植と肝病態,谷川久一,市田隆文編,日本メディカルセンター,東京(1997)pp 185-191.
9) 佐々木睦男:第12回生体部分肝移植懇話会プログラム抄録集;生体部分肝移植事務局 1997年事務局報告(1977)pp 29.
10) Egawa H, Tanaka K, Inomata Y, Uemoto S, Okajima H, Satomura K, Kikuchi T, Yabe S, Nishizawa H and Yamaoka Y : Auxiliary partial orthotopic liver transplantation from a living-related donor : a report of 2 cases. Transplant Proc (1996) 28, 1071-1072.
11) Lygidakis NJ : Segmantal auxiliary liver transplantation : a new approach to an old problem. J Surg Res (1985) 38, 246-251.
12) Demetris AJ, Markus BH, Esquival C, Van Thiel DH, Saidman S, Gorden R, Makowka L, Sysyn GD and Starzl TE : Pathologic analysis of liver transplantation for primary biliary cirrhosis. Hepatology (1988) 8, 939-947.
13) Neuberger J, Portman B, Macdougal BR, Calne RY and Willams R : Recurrence of primary biliary cirrhosis afrer liver transplantation.
N Engl J Med (1982) 306, 1-4.
14) Polson RJ, Portman B, Neuberger J, Calne RY and Williams R : Evidence of disease recurrence after liver transplantation for primary biliary cirrhosis. Gastroenterology (1989) 97, 715-725.
15) Balan V, Batts KP, Porayko MK, Krom RA, Ludwig J and Wiesner RH : Histological evidence for recurrenceo of primary biliary cirrhosis after liver transplantation after liver transplantation. Hepatology (1993) 21, 1765-1767.
16) Ichida T, Matsunami H, Kawasaki S, Makuuchi M, Harada T, Itoh S and Asakura H : Living related-donor liver transplantation from adult for primary biliary cirrhosis. Ann Intern Med (1995) 122, 275-276.
17) Gores G, Moore B, Fisher LD, Powell FC and Dickson ER : Primary biliary cirrhosis ; Association with class Ⅱ major histocompatibility complex antigens. Hepatology (1987) 7, 889-892.
18) Greogry WL, Mahal W, Dunn AN, Cavanagh G, Chapman R, Fleming KA, Daly AK, Idle JR, James OFW and Bassendine MF : Primary billary cirrhosis : contribution of HLA class Ⅱ allele DR8. Q J Med (1993) 86, 393-399.
19) 向井 亨,木村彰方,下田慎治,林田一洋,工藤二郎,石橋大海,酒井浩徳,丸山俊博,佐田通夫,仁保喜之:原発性胆汁性肝硬変におけるHLA class Ⅱ;肝臓(1993)34,(suppl.2), 117.
20) Knoop M, Bechistein WO, Schrem H, Lobeck H, Hopf U and Neuhaus P : Clinical significance of recurrent primary biliary cirrhosis after liver transplantation. Transpl Int (1996) 9, (Suppl. 1), 115-119.
言語
Japanese
著作権者
岡山医学会
論文のバージョン
publisher
査読
有り
Eprints Journal Name
joma