Kusano M, Mito M
Department of Surgery, Asahikawa Medical College.
Nihon Rinsho. 1992 Jul;50(7):1679-88.
Clinical liver transplantation has been done for patients with irreversible hepatic diseases, but the shortage of donor livers from heart beating cadavers has become very serious. Hepatocyte transplantation requires no vascular anastomosis and donor hepatocytes are easy to obtain from living donors and easy to preserve for a long time. In the animal experiments, transplanted hepatocytes survived in the spleen for long periods of time, and cytochemical investigation revealed differentiated liver functions, such as gluconeogenesis, albumin synthesis, bilirubin conjugation. Intrasplenic transplantation of hepatocytes relieved congenital disorders of liver enzymes in rats. Moreover, transplanted hepatocytes re-composed normal cord structures with hepatic sinusoids in the spleen of rats. Hepatocytes could also be isolated from human cirrhotic livers by a multi-perfusion method, and the viability was almost 80%. After the success in transplantation of human hepatocytes into the spleen of athymic mice, 6 patients have undergone clinical trial of intrasplenic hepatocyte transplantation without any complications. In the future, the progress of gene manipulation techniques may make possible rapid growth of transplanted hepatocytes. Intrasplenic transplantation of isolated hepatocytes provides an in-vivo experimental model to study cellular growth and functions in detail.
临床肝移植已应用于患有不可逆性肝脏疾病的患者，但来自心跳停止尸体的供肝短缺问题已变得非常严重。肝细胞移植无需血管吻合，供体肝细胞易于从活体供体获取且易于长期保存。在动物实验中，移植的肝细胞在脾脏中长时间存活，细胞化学研究显示出分化的肝功能，如糖异生、白蛋白合成、胆红素结合。肝细胞脾内移植可缓解大鼠先天性肝酶紊乱。此外，移植的肝细胞在大鼠脾脏中重新构建了带有肝血窦的正常条索结构。肝细胞也可通过多灌注法从人肝硬化肝脏中分离出来，存活率几乎达80%。在将人肝细胞成功移植到无胸腺小鼠脾脏后，6例患者接受了脾内肝细胞移植临床试验，未出现任何并发症。未来，基因操作技术的进展可能使移植肝细胞快速生长成为可能。分离肝细胞的脾内移植提供了一个体内实验模型，可详细研究细胞生长和功能。
