成人活体亲属供肝部分肝移植术后早期肝脏再生过程中的凝血和纤溶系统

Coagulation and fibrinolytic systems during liver regeneration in the early period after adult living related partial liver transplantation.

作者信息

Sato Y, Nakatsuka H, Yamamoto S, Oya H, Kobayashi T, Watanabe T, Kokai H, Kurosaki I, Shirai Y, Hatakeyama K

机构信息

Division of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan.

出版信息

Transplant Proc. 2008 Oct;40(8):2501-2. doi: 10.1016/j.transproceed.2008.08.050.

DOI:10.1016/j.transproceed.2008.08.050

PMID:18929779

Abstract

In this study, we investigated the differences in the perioperative blood coagulation and fibrinolytic systems (BCF) between donor and recipient after adult living related partial liver transplantation (ALRPLT), with particular reference to serum plasminogen-activator inhibitor-1 (PAI-1) and soluble fibinogen level. The BCF were unstable in the recipient compared with the donor. The recipient fibrinolytic system was the same as the donor system except for PAI-1, which was remarkably increased on day 1 after transplantation in the recipient. The recipient is thought to have disseminated intravascular coagulation in the early period after ALRPLT. Soluble fibrinogen may be a useful marker for improvement in the BCF system. The elevation of PAI-1 in recipients on day 1 after transplantation may be a marker of injury from the shear stress from excessive portal hypertension after ALRPLT.

摘要

在本研究中，我们调查了成人活体亲属部分肝移植（ALRPLT）后供体与受体围手术期血液凝固和纤维蛋白溶解系统（BCF）的差异，特别参考了血清纤溶酶原激活物抑制剂-1（PAI-1）和可溶性纤维蛋白原水平。与供体相比，受体的BCF不稳定。除PAI-1外，受体的纤维蛋白溶解系统与供体系统相同，PAI-1在受体移植后第1天显著升高。据认为，受体在ALRPLT后的早期发生了弥散性血管内凝血。可溶性纤维蛋白原可能是BCF系统改善的有用标志物。移植后第1天受体中PAI-1的升高可能是ALRPLT后门静脉高压过高产生的剪切应力所致损伤的标志物。