• Title/Summary/Keyword: liver transplantation

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Liver Cut Method Using 4 Points for Hepatic Volumerty at MDCT Image (MDCT 영상에서 간 체적 계산을 위한 4 점 이용 간 분할 방법)

  • Seo, Jeong-Joo;Cho, Baik-Hwan;Park, Jong-Won
    • Journal of the Institute of Electronics Engineers of Korea SP
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    • v.47 no.1
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    • pp.17-24
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    • 2010
  • This paper proposed the method to separate a liver into left and right liver lobes for exact volumetry of the river graft at abdominal MDCT(Multi-Detector Computed Tomography) image before living donor liver transplantation. On the image of segmented liver, 4 points(the middle point of Inferior Vena Cava, a point of Middle Hepatic Vein, a point of Portal Vein, a middle point of gallbladder fossa) are selected. A liver is separated into left and right liver lobes on the basis of the 4 points. The volume and ratio of the river graft are estimated. The volume estimated using 4 points and the manual volume that radiologist processed and estimated are compared with the weight measured during surgery to support proof of the exact volumetry. After selection the 4 points, the time involved in separation a liver into left and right river lobe and volumetry of them is measured for confirmation that the algorithm can be used on real time during surgery. This study progressed to ensure donor's and recipient's safe who will undergo the liver transplantation.

Quality and Availability Evaluation of Human Hepatocytes Isolated from Resected Partial Livers for Toxicology and Drug Metabolism Studies in Korea (독성 및 약물대사 연구를 위한 한국인 부분 간 유래 간세포의 품질 및 활용성 평가)

  • Noh, Jeong-Kwon;Jang, In Keun;Kim, Hyo Eun;Lee, Jong Eun;Yang, Mal Sook;Jang, Eun Mi;Lee, Ji-Hyun;Park, Hey-Jung;Kim, Young-A;Lee, Suk-Koo;Jeong, Ho-Sang;Ahn, Joon-Ik;Lee, Doo-Hoon
    • KSBB Journal
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    • v.29 no.1
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    • pp.58-66
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    • 2014
  • Demand for in vitro pharmacological evaluation and toxicity test using human hepatocytes has been increasing. In USA and Europe, human hepatocytes obtained from donated whole liver unsuitable for transplantation were distributed to researchers and deposited in cell bank facility as cryopreserved vial. In Korea, however, incidence of transplantation- inappropriate whole liver has been quite low and the whole livers almost have so severe liver disease such as fatty or fibrotic liver that cannot meet the demand. In this study we aimed to isolate human hepatocytes from liver resection surgery-originated partial liver, and assure the isolated human hepatocytes and its cryopreserved hepatocytes to be qualified for the in vitro pharmacological evaluation and drug toxicity tests. We compared those with commercially available human hepatocyte, BD $GenTest^{TM}$ by cell morphology, hepatic gene expression, urea synthesis, albumin secretion, ammonia removal, and cytochrome P450 induction activities. Changes in hepatotoxic gene expression after cryopreservation are evaluated with a typical hepatotoxic drug, acetaminophen. Consequently, the fresh hepatocytes from the partial liver and its cryopreserved hepatocytes expressed their intrinsic hepatic functions well and showed equal hepatotoxicity gene expression trend regardless to cryopreservation. Therefore, liver resection surgery-originated partial liver can be used as a useful source of human hepatocytes for various pharmacological and hepatotoxicity test.

Anesthetic Management of the Dental Treatment in a Child with Liver Failure Scheduled for Liver Transplantation - A case report - (간이식 예정인 간부전 환아의 치과치료 시 마취관리 -증례 보고-)

  • Park, Chang-Joo;Jang, Ki-Taeg;Yum, Kwang-Won;Kim, Hyun-Jeong
    • Journal of The Korean Dental Society of Anesthesiology
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    • v.2 no.2 s.3
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    • pp.114-117
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    • 2002
  • Special anesthetic considerations were required for children with acute or chronic liver disease. We experienced a case of dental treatment to control infection under general anesthesia in the 2-year-old girl with liver failure. She was also scheduled for liver tansplantation. Her preanesthetic results of liver function test, electrolytes, and coagulation panel were unstable and out of normal ranges. Uneventful anesthetic induction using isoflurane and atracurium and nasotracheal intubation were carried out. General anesthesia was maintained with isoflurane for 2 hours. Oozing from multiple extraction sites was sustained, so the transfusion of platelet concentration 1 units, fresh frozen plasma 1 unit, and packed red blood cell 1 unit was done. She was recovered without complication but was transferred to pediatric intensive care unit for wound care with her endotracheal tube kept. She was transferred to a ward without noticeable complications next day. So we report this successful case of anesthetic management for dental treatment in a child with liver failure.

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A cost-effective and simple culture method for primary hepatocytes

  • Adaya, Sezin;Hasircib, Nesrin;Gurhana, Ismet Deliloglu
    • Animal cells and systems
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    • v.15 no.1
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    • pp.19-27
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    • 2011
  • Hepatocytes, the major epithelial cells of the liver, maintain their morphology in culture dishes coated with extracellular matrix (ECM) components such as collagen and fibronectin or biodegradable polymers (e.g. chitosan, gelatin). In these coated dishes, survival of cells and maintaining of liver-specific functions may increase. The aim of this study was to determine a suitable, cost-effective and simple system for hepatocyte isolation and culture which may be useful for various applications such as in vitro toxicology studies, hepatocyte transplantation and bioartificial liver (BAL) systems. In order to obtain primary cultures, hepatocytes were isolated from liver by an enzymatic method and cultured on plates coated with collagen, chitosan or gelatin. Collagen, gelatin-sandwich and gelatin-cell mixture methods were also evaluated. Morphology and attachment of the cells were observed by inverted microscope and scanning electron microscope (SEM). An MTT assay was used to determine cell viability and mitochondrial activity.

In Vitro Performance Assessment of a Bioartificial Liver Packed with Polyurethane Foam (다공성 폴리우레탄 충진형 생인공간의 체외 성능 평가)

  • 이두훈;이지현;김성구;박정극
    • KSBB Journal
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    • v.16 no.1
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    • pp.24-29
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    • 2001
  • Recently hepatocyte-based bioartificial liver (BAL) and hepatocyte transplantation have been actively investigated to treat acute hepatic failure. The BAL acts as a bridge to provide patients with more time until a donor organ becomes available for transplantation or until their own liver can be regenerated. In this study, we manufactured a polyurethane foam (PUF) using 15% NCO-prepolymer with a pore opening that allows it to be used as a hepatocyte immobilizing material. Cubes of PUF (3 mm dim.) were seeded with rat primary hepatocytes at a density of 5.5$\pm$1.1$\times$ $10^6$ cells/$cm^3$ PUF by centrifuging them together. The cell laden PUF cubes were packed into a prototype reactor and perfused with a hormonally defined medium for a week. Hepatocytes in the pores of the PUF formed spheroids that showed stable ammonia removal and urea synthesis activities. The albumin production level was comparable to other BAL systems. The PUF packed hepatocyte bioreactor has the potential to be used as a BAL.

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Diagnosis of Graft-Versus-Host Disease after Bone Marrow Transplantation by in vivo Proton MR Spectroscopy of the Liver: Correlation with Pathologic Results

  • Cho, Soon-Gu;Lee, Moon-Hee;Suh, Chang-Hae
    • Proceedings of the KSMRM Conference
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    • 2001.11a
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    • pp.135-135
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    • 2001
  • Purpose: To know the differences of the proton MR spectroscopic features of the liver between th patients with graft-versus-host disease (GVHD) and without GVHD (non-GVHD) after to marrow transplantation (BMT), and to evaluate the possibility to discriminate GVHD fro non-GVHD by analysis of the in vivo proton MR spectra. Method: We evaluated the in vivo proton MR spectra from the livers of 37 patients wh underwent BMT. Our series included 14 cases with GVHD and 23 without GVHD in the liver. Nineteen men and 18 women were included in our series. All cases of GVHD and 2 o non-GVHD were confirmed by liver biopsy and remaining of non-GVHD by evaluation clinical follow up. Proton MR spectroscopy (1H-MRS) was performed at 1.5T GE Sign Horizon (GE Medical System, Milwaukee, USA) system using localized proton STEAM sequence and body coil in all cases with subjects were located in supine position. N respiratory interruption was required during the spectroscopic signal acquisition. Paramete using in MRS were: TR = over 3000ms, TE = 30ms, number of scans = 128, voxel size = ($2{\times}2{\times}2$)$cm^3$, and one NEX. We evaluated the spectra with an attention to the differences o patterns of the peaks between GVHD and non-GVHD groups. The ratio of peak area of peaks at 1.6-4.1ppm to lipid (0.9-1.6ppm) [P(1.6-4.1ppm)/P(0.9-1.6ppm)] was calculated in GVHD and non-GVHD group, and compared the results between these groups. We als evaluated the sensitivity and specificity for discriminating GVHD from non-GVHD by anal of 1H-MRS.

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Effects of Self-efficacy and Transplant-related Knowledge on Compliance with a Therapeutic Regimen for Recipients of Liver Transplant (간이식 수혜자의 자기효능감과 이식 관련 지식이 치료지시이행에 미치는 영향)

  • Moon, So Jung;Kim, Hyun-Ju
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.26 no.3
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    • pp.166-175
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    • 2019
  • Purpose: This study was done to investigate the degree of self-efficacy, transplant-related knowledge, and other factors affecting compliance with a therapeutic regimen for liver transplant recipients. Methods: Participants were 140 patients who had received a liver transplant at a tertiary hospital in Y City, Gyeongnam Province and made regular hospital visits as outpatients. A self-report questionnaire was used to collect the data and collection was done from December 4, 2017 to January 26, 2018. Data were analyzed using frequencies, percentages, means, and standard deviations, and t-test, ANOVA, Pearson's correlation coefficients. Multiple linear regression was performed using SPSS/WIN 21.0 program. Results: Participants scored $113.29{\pm}20.95$ (out of 150) on self-efficacy, $16.38{\pm}3.62$ (out of 18) on transplant-related knowledge, and $148.30{\pm}31.06$ (out of 200) on compliance with the therapeutic regimen. Analyzed of correlations among participant's self-efficacy, transplant-related knowledge, and compliance with the therapeutic regimen showed a significant positive correlation between self-efficacy and compliance with the therapeutic regimen (r=.64, p=.001), but no significant correlations were found between self-efficacy and transplant-related knowledge (r=-.01, p=.912) or between transplant-related knowledge and compliance with the therapeutic regimen (r=.06, p=.458). Multiple regression analysis showed that factors affecting compliance with the therapeutic regimen were state of re-transplantation (${\beta}=.17$, p=.016) and self-efficacy (${\beta}=.53$, p=.001). Conclusion: There is a need to apply a differentiated nursing intervention program considering the differences in patients' self-efficacy, transplant-related knowledge, and compliance with the therapeutic regimen.

Preclinical Study on Biodistribution of Mesenchymal Stem Cells after Local Transplantation into the Brain

  • Narayan Bashyal;Min Gyeong Kim;Jin-Hwa Jung;Rakshya Acharya;Young Jun Lee;Woo Sup Hwang;Jung-Mi Choi;Da-Young Chang;Sung-Soo Kim;Haeyoung Suh-Kim
    • International Journal of Stem Cells
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    • v.16 no.4
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    • pp.415-424
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    • 2023
  • Therapeutic efficacy of mesenchymal stem cells (MSCs) is determined by biodistribution and engraftment in vivo. Compared to intravenous infusion, biodistribution of locally transplanted MSCs are partially understood. Here, we performed a pharmacokinetics (PK) study of MSCs after local transplantation. We grafted human MSCs into the brains of immune-compromised nude mice. Then we extracted genomic DNA from brains, lungs, and livers after transplantation over a month. Using quantitative polymerase chain reaction with human Alu-specific primers, we analyzed biodistribution of the transplanted cells. To evaluate the role of residual immune response in the brain, MSCs expressing a cytosine deaminase (MSCs/CD) were used to ablate resident immune cells at the injection site. The majority of the Alu signals mostly remained at the injection site and decreased over a week, finally becoming undetectable after one month. Negligible signals were transiently detected in the lung and liver during the first week. Suppression of Iba1-positive microglia in the vicinity of the injection site using MSCs/CD prolonged the presence of the Alu signals. After local transplantation in xenograft animal models, human MSCs remain predominantly near the injection site for limited time without disseminating to other organs. Transplantation of human MSCs can locally elicit an immune response in immune compromised animals, and suppressing resident immune cells can prolong the presence of transplanted cells. Our study provides valuable insights into the in vivo fate of locally transplanted stem cells and a local delivery is effective to achieve desired dosages for neurological diseases.

Clinical Characteristics of Tuberculosis in Liver or Heart Transplant Recipients (간 또는 심장이식을 시행 받은 환자에서의 결핵의 발생률 및 임상양상)

  • Jung, Hoon;Oh, Yeon-Mok;Lee, Sang-Do;Kim, Woo-Sung;Kim, Dong-Soon;Kim, Won-Dong;Kim, Jae-Joong;Lee, Sung-Gyu;Shim, Tae-Sun
    • Tuberculosis and Respiratory Diseases
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    • v.61 no.5
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    • pp.440-446
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    • 2006
  • Background: Post-transplant tuberculosis (TB) is a serious complication in solid organ transplant recipients worldwide, However there is little or no data on TB in liver or heart transplant recipients in Korea. Methods: The incidence and clinical characteristics of TB of 730 patients who had undergone a liver transplant in a university hospital in Korea between 1992 and 2004, and 110 heart transplant recipients in the same period, were reviewed retrospectively. Results: The incidence of TB was 1.5%(11/730) and 2.7%(3/110) in the liver and heart transplantation, respectively. The median time from the transplant to the development of TB was 8.4 months(1.0-30.8). and the mean time from the symptoms to the diagnosis of TB was $2.1{\pm}3.6$ months(0.3-13.2). Nine patients (65%) had pulmonary TB and five (35%) had extrapulmonary TB. The leukopenia and positive HbeAg at the baseline, post-transplant diabetes mellitus, and chronic rejection were associated with the development of TB in the liver transplant recipients. Ten patients were treated with a 4-drug standard regimen for a mean duration of $7.8{\pm}3.5$ months. One patients died of TB. Conclusion: The incidence of TB in liver or heart transplant recipients was similar to that reported in other countries with a similar TB-burden.

Review of Adult Polycystic Liver Disease on Ultrasonography (초음파 검사에서 성인의 다낭성 간질환에 대한 고찰)

  • Sim, Hyun-Sun;Jung, Hong-Rayng;Lim, Chung-Hwan
    • The Journal of the Korea Contents Association
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    • v.8 no.10
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    • pp.217-223
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    • 2008
  • Adult polycystic liver disease (PLD) is a rare, benign condition association with autosomal dominant polycystic kidney disease (ADPKD). It is an autosomal dominantly inherited disorder characterized by multiple diffuse cystic lesions of the liver parenchyma. Significant symptoms or complications from liver involvement can occur cases. Surgical therapy is the mainstay of therapy including laparoscopic or open fenestration with or without hepatic resection and orthotopic liver transplantation. We report the literature addressing the presence of abdominal discomport, a case of a patient with PLD. This case showed the typical ultrasonogaphic and computer tomogaphic findings of this disease.