血小板和血清素对活体肝移植供体肝切除术后肝脏再生的影响。
Impact of platelets and serotonin on liver regeneration after living donor hepatectomy.
作者信息
Yoshizumi T, Itoh S, Imai D, Ikegami T, Ninomiya M, Iguchi T, Harimoto N, Takeishi K, Kimura Y, Uchiyama H, Soejima Y, Ikeda T, Kawanaka H, Shirabe K, Maehara Y
机构信息
Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
出版信息
Transplant Proc. 2015 Apr;47(3):683-5. doi: 10.1016/j.transproceed.2014.11.050.
BACKGROUND
Several animal models have revealed that platelet-derived serotonin initiates liver regeneration after hepatectomy. However, there are few reports regarding the effects of serotonin in the clinical setting. The aim of this study was to explore the impact of serotonin and platelets in the early phase after healthy living donor hepatectomy.
STUDY DESIGN
Stored samples from 34 living donors who received left lobectomy with caudate lobectomy (LL+C) or right lobectomy (RL) were available in the study. Serum serotonin levels and platelet counts associated with liver regeneration such as whole liver volume and hepatic graft weight (GW) were retrospectively collected from the database and analyzed.
RESULTS
The remnant liver volume rate of RL grafts was smaller than that of LL+C grafts (45.4% vs 64.7%; P < .001). The regeneration rate at 7 days after surgery did not differ between the 2 groups (123% vs 122%). The serotonin levels and platelet counts decreased after surgery until postoperative day 3, then increased thereafter. The platelet counts and serotonin levels of LL+C donors were significantly higher than those of RL donors.
CONCLUSIONS
Our findings suggest that platelets and serotonin play a pivotal role in initiating liver regeneration in the remnant liver.
背景
多种动物模型已表明，血小板衍生的血清素在肝切除术后启动肝脏再生。然而，关于血清素在临床环境中的作用的报道较少。本研究的目的是探讨血清素和血小板在健康活体供肝肝切除术后早期阶段的影响。
研究设计
本研究使用了34例接受左叶切除加尾状叶切除（LL+C）或右叶切除（RL）的活体供者的储存样本。从数据库中回顾性收集与肝脏再生相关的血清血清素水平和血小板计数，如全肝体积和肝移植重量（GW），并进行分析。
结果
RL移植物的残余肝体积率小于LL+C移植物（45.4%对64.7%；P<.001）。两组术后7天的再生率无差异（123%对122%）。术后血清素水平和血小板计数在术后第3天之前下降，之后升高。LL+C供者的血小板计数和血清素水平显著高于RL供者。
结论
我们的研究结果表明，血小板和血清素在残余肝脏启动肝脏再生中起关键作用。
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