Zenitani Masahiro, Hosoda Hiroshi, Kodama Tasuku, Saka Ryuta, Takama Yuichi, Ueno Takehisa, Tazuke Yuko, Kangawa Kenji, Oue Takaharu, Okuyama Hiroomi
Department of Pediatric Surgery, Hyogo College of Medicine, Nishinomiya, Hyogo, Japan.
Department of Regenerative Medicine and Tissue Engineering, National Cerebral and Cardiovascular Center Research Institute, Suita, Osaka, Japan.
Pediatr Surg Int. 2019 Jun;35(6):709-714. doi: 10.1007/s00383-019-04463-8. Epub 2019 Mar 5.
Ghrelin was recently reported to promote recovery from hepatic injury. We hypothesized that it could also be associated with clinical recovery of the transplanted liver from ischemia and reperfusion injury. Our aims were to investigate perioperative ghrelin changes following pediatric living donor liver transplantation (LDLT) and to analyze the association of these changes with postoperative hepatic function.
We measured plasma acyl ghrelin (AG) concentrations before surgery, at the end of surgery and on postoperative days (PODs) 1, 3 and 7 in 12 children who underwent LDLTs, and, as controls, pre- and post-operatively and on POD1 in 7 children who underwent benign abdominal mass resection. The correlations between the participants' ghrelin profiles and hepatic function-related data were evaluated.
AG levels significantly declined to 15.6% of preoperative levels after LDLT and almost returned to baseline on POD3. Post-operative AG levels were significantly reduced to a greater extent following LDLT than benign abdominal mass resection. AG levels on POD1 inversely correlated with aspartate aminotransferase levels and cold/total ischemia time (P < 0.05).
These results suggest that reduced AG levels on POD1 may reflect the degree of damage to the transplanted liver due to ischemia and reperfusion injury.
最近有报道称胃饥饿素可促进肝损伤的恢复。我们推测它也可能与移植肝脏从缺血再灌注损伤中的临床恢复有关。我们的目的是研究小儿活体肝移植（LDLT）围手术期胃饥饿素的变化，并分析这些变化与术后肝功能的关系。
我们测量了12例接受LDLT的儿童在手术前、手术结束时以及术后第1、3和7天的血浆酰基胃饥饿素（AG）浓度，并作为对照，测量了7例接受良性腹部肿块切除术的儿童在术前、术后和术后第1天的血浆酰基胃饥饿素浓度。评估了参与者的胃饥饿素谱与肝功能相关数据之间的相关性。
LDLT后AG水平显著下降至术前水平的15.6%，并在术后第3天几乎恢复到基线水平。LDLT后术后AG水平的降低程度明显大于良性腹部肿块切除术。术后第1天的AG水平与天冬氨酸转氨酶水平以及冷/总缺血时间呈负相关（P < 0.05）。
这些结果表明，术后第1天AG水平的降低可能反映了缺血再灌注损伤对移植肝脏的损伤程度。
