臨牀消化器内科 Vol.15 No.2(9)


特集名 脂肪肝をめぐる最近の話題
題名 肝移植と脂肪肝
発刊年月 2000年 02月
著者 初貝 和明 東北大学医学部第二外科
【 要旨 】 脂肪肝は移植した肝グラフトがまったく機能しないprimary graft nonfunction(PNF)のリスクファクターとされており,臨床的には中等度以上の脂肪肝は移植後グラフト機能障害を起こしやすいといわれている.一方,動物実験により類洞の狭小化やクッパー細胞の活性化,膜の流動性の低下などさまざまな要因が脂肪肝移植後のグラフト機能障害に関与していると報告されている.しかし,その詳しいメカニズムは未だに明らかではなく,その予防法の確立も実験段階にとどまっている.今後,増加すると思われる脂肪肝ドナーへの対策を確立するためにも,脂肪肝グラフトの移植後機能不全を引き起こすメカニズムの解明が早急に望まれる.
Theme Fatty Liver Update
Title Transplantation of Steatotic Liver
Author Kazuaki Hatsugai Second Departrnent of Surgery, Tohoku University School of Medicine
[ Summary ] It is well known that steatotic grafts often cause primary graft nonfunction(PNF). Because of a shortage of donors, clinical trials to transplant fatty liver tissue were carried out. Clinically, it has been reported that grafts with moderate steatosis tended to cause graft dysfunction after liver transplantation, However, if the steatosis is of the microvesicular type, even severely steatotic grafts do not cause graft dysfunction. In the experimental model for fatty livers, several causes, such as narrowing of sinusoidal lumen, free radicals from activated Kupffer cells and a change in plasma membrane fluidity, have been pointed out as causes of graft dysfunction. However, the details concerning this are still unclear. As a preventive against graft dysfunction after fatty liver transplantation, several methods were also investigated experimentally. It is expected that we may establish a treatment for the prevention of PNF in grafts with steatosis.
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