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活体肝移植术后肝脏体积再生的汇聚过程。

Convergence process of volumetric liver regeneration after living-donor hepatectomy.

机构信息

Division of Hepato-Biliary-Pancreatic and Transplantation Surgery, Department of Surgery, Graduate School of Medicine, University of Tokyo, Tokyo, Japan.

出版信息

J Gastrointest Surg. 2011 Sep;15(9):1594-601. doi: 10.1007/s11605-011-1590-y. Epub 2011 Jun 28.

Abstract

BACKGROUND

We investigated the long-term profiles of liver regeneration after living-donor hepatectomy.

METHODS

Thirty-three donors participated in the study. Preoperative and postoperative liver volume was calculated using computed tomography. Volume assessment was repeated at 1 week, 2 weeks, 1 month, 3 months, 6 months, 12 months, and 4 years postoperatively.

RESULTS

Donors were divided into the right (n = 23; residual liver volume, 42%) and left (n = 10; residual liver volume, 63%) groups according to the operative procedures. The restoration ratio to the preoperative liver volume (right vs. left groups) were 51%, 57%, 64%, 74%, 77%, 81%, and 88% vs. 69%, 72%, 76%, 79%, 83%, 84%, and 91% at 1 week, 2 weeks, 1 month, 3 months, 6 months, 12 months, and 4 years, respectively; the interindividual variation in the restoration ratio to the preoperative liver volume became narrower with time.

CONCLUSION

Liver resection in humans resulted in rapid regeneration during the first 3 months, followed by a more moderate rate of regeneration thereafter, in proportion to the amount of liver mass resected. The volume of the regenerating liver appeared to converge towards the individual preoperative volume with time. However, the liver volume was not restored to the preoperative volume at 4 years after the resection.

摘要

背景

我们研究了活体肝切除术后肝脏再生的长期情况。

方法

33 名供者参与了本研究。术前和术后的肝脏体积通过计算机断层扫描进行计算。术后 1 周、2 周、1 个月、3 个月、6 个月、12 个月和 4 年重复进行体积评估。

结果

根据手术方式,供者分为右(n = 23;剩余肝体积 42%)和左(n = 10;剩余肝体积 63%)两组。与术前肝脏体积相比的恢复比率(右组与左组)分别为 51%、57%、64%、74%、77%、81%和 88%对 69%、72%、76%、79%、83%、84%和 91%,分别在术后 1 周、2 周、1 个月、3 个月、6 个月、12 个月和 4 年;与术前肝脏体积相比的恢复比率的个体间变异性随时间而变窄。

结论

人类肝切除术后在最初 3 个月内肝脏迅速再生,此后以与切除肝质量成比例的速度进行更温和的再生。再生肝的体积似乎随时间向个体术前体积收敛。然而,在切除后 4 年,肝脏体积并未恢复到术前水平。

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