Ninomiya Mizuki, Shimada Mitsuo, Terashi Takahiro, Ijichi Hideki, Yonemura Yusuke, Harada Noboru, Soejima Yuji, Suehiro Taketoshi, Maehara Yoshihiko
Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
Transplantation. 2004 Feb 15;77(3):373-9. doi: 10.1097/01.TP.0000109777.51902.09.
Although it is generally considered that livers with moderate steatosis can be safely used in the setting of living-donor liver transplantation, the effect of the regenerative process of such a graft on postoperative liver function is incompletely understood. We assessed the morphologic and functional alterations during the regeneration of fatty liver, with special reference to the biliary system.
Wistar rats with normal or fatty livers induced by a choline-deficient diet were subjected to 70% partial hepatectomy (PH). The regenerated liver weight and serum parameters were compared. Furthermore, to assess the spatial alterations of bile canalicular networks, the distribution of AGp110, a fibronectin receptor that localizes on the apical (bile canalicular) membrane of the hepatocytes, was analyzed immunohistochemically.
The serum albumin levels of the fatty-liver rats decreased significantly after 24 hours, and this continued until day 7. The increase in the total bile acid levels of the fatty-liver group was higher and more prolonged compared with that of the normal-liver group. At 24 hours after PH, discontinuity of the AGp110-positive canalicular network was evident in both groups. At 7 days after PH, the typical AGp110-positive canalicular network was almost restored in the normal-liver group. In contrast, the fatty-liver group showed sustained discontinuity of canalicular networks at the same time point.
The livers with moderate steatosis are associated with prolonged cholestasis after 70% PH, and this was caused, in part, by sustained spatial disturbance of bile canalicular networks during the regenerative process.
尽管一般认为中度脂肪变性的肝脏可安全用于活体肝移植,但这种移植物的再生过程对术后肝功能的影响尚未完全明确。我们评估了脂肪肝再生过程中的形态学和功能改变,特别关注了胆道系统。
对通过胆碱缺乏饮食诱导产生正常肝脏或脂肪肝的Wistar大鼠进行70%肝部分切除术(PH)。比较再生肝脏重量和血清参数。此外,为评估胆小管网络的空间改变,采用免疫组织化学方法分析了定位在肝细胞顶端(胆小管)膜上的纤连蛋白受体AGp110的分布。
脂肪肝大鼠血清白蛋白水平在24小时后显著下降,并持续至第7天。与正常肝脏组相比,脂肪肝组总胆汁酸水平的升高更高且持续时间更长。肝部分切除术后24小时,两组AGp110阳性胆小管网络均出现连续性中断。肝部分切除术后7天,正常肝脏组典型的AGp110阳性胆小管网络几乎恢复。相比之下,脂肪肝组在同一时间点胆小管网络持续中断。
中度脂肪变性的肝脏在70%肝部分切除术后伴有胆汁淤积延长,这部分是由于再生过程中胆小管网络持续的空间紊乱所致。