Van Thiel D H, Gavaler J S, Kam I, Francavilla A, Polimeno L, Schade R R, Smith J, Diven W, Penkrot R J, Starzl T E
Department of Medicine, University of Pittsburgh School of Medicine, Pennsylvania 15261.
Gastroenterology. 1987 Dec;93(6):1414-9. doi: 10.1016/0016-5085(87)90274-5.
Two individuals undergoing orthotopic hepatic transplantation received livers from donors who were on average 10 kg smaller than themselves based on recipient ideal body weight. As a result, the donor livers in these 2 cases were 29%-59% smaller than would be expected had the donor liver and recipient been matched ideally. The liver grafts in the recipients steadily increased in size, as determined by serial computed tomography scanning, to achieve new volumes consistent with those that would have been expected in a normal individual of the recipient's size, sex, and age. Fasting plasma levels of amino acids, glucagon, insulin, and standard liver injury tests were monitored to determine which measure best reflected the changes observed in the size of the grafts over time. No relationship between the changes observed in any of these parameters and hepatic growth was apparent. In both cases, the liver increased in volume at a rate of approximately 70 ml/day. These data demonstrate that a small-for-size liver transplanted into a larger recipient increases in size at a rate of approximately 70 ml/day until it achieves a liver volume consistent with that expected given the recipient's size, age, and sex.
两名接受原位肝移植的患者所接受的供肝，根据受者理想体重计算，供者平均比他们轻10千克。因此，这两例患者的供肝比理想匹配供肝与受者时预期的肝脏小29%至59%。通过系列计算机断层扫描确定，受者体内的肝移植体大小稳步增加，达到了与受者相同体型、性别和年龄的正常个体预期的新体积。监测空腹血浆氨基酸、胰高血糖素、胰岛素水平以及标准肝损伤检测指标，以确定哪种指标最能反映移植体大小随时间的变化。这些参数中观察到的任何变化与肝脏生长之间均无明显关联。在这两例中，肝脏体积均以约70毫升/天的速度增加。这些数据表明，移植到较大受者体内的小体积肝脏以约70毫升/天的速度增大，直至达到与受者体型、年龄和性别预期相符的肝脏体积。
