トキタ ダイスケ   TOKITA Daisuke
  時田 大輔
   所属   医学部 医学科(東京女子医科大学病院)
   職種   教授
論文種別 原著
言語種別 英語
査読の有無 査読あり
表題 Intraoperative near-infrared spectroscopy for evaluating hepatic venous outflow in living-donor right lobe liver.
掲載誌名 正式名:Transplantation
略  称:Transplantation
ISSNコード:00411337/00411337
掲載区分国外
巻・号・頁 76(5),pp.791-7
著者・共著者 Ohdan Hideki, Mizunuma Kazuyuki, Tashiro Hirotaka, Tokita Daisuke, Hara Hidetaka, Onoe Takashi, Ishiyama Kohei, Shibata Satoshi, Mitsuta Hiroshi, Ochi Makoto, Nakahara Hideki, Itamoto Toshiyuki, Asahara Toshimasa
発行年月 2003/09
概要 BACKGROUND:This study was performed to determine the usefulness of intraoperative near-infrared spectroscopy (NIRS) for evaluating the extent of congestion in the anterior segment of the graft after living-donor liver transplantation using right lobe grafts that do not have the middle hepatic vein.METHODS:Fifteen patients undergoing living-donor liver transplantation using a right lobe graft without the middle hepatic vein were enrolled in this study. During the course of harvesting and implantation, in vivo NIRS was performed on the liver grafts to determine hemoglobin (Hb) and cytochrome oxidase content in the hepatic tissues.RESULTS:The 15 cases were divided into three groups according to the caliber of the middle hepatic vein tributaries in the right lobe grafts: the small group (<4 mm), the intermediate group (4-7 mm), and the large group (>7 mm). After implantation, congestion (increase in tissue Hb) in the anterior segment was more severe than that in the posterior segment in the intermediate and large groups. However, well-preserved mitochondrial cytochrome oxidase redox state was observed in both segments except for two cases in the large group with severe congestion in the anterior segment. The extent of postoperative congestion in the anterior segment was significantly correlated with the tissue content of remaining Hb in that segment after ex vivo flushing.CONCLUSIONS:Intraoperative NIRS enables quantification of the extent of congestion in the anterior segment after implantation of a right lobe liver graft and even enables prediction of such congestion at the phase of ex vivo perfusion.
DOI 10.1097/01.TP.0000074603.36553.BD
PMID 14501855