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RISS 인기검색어
- 검색키워드
- 저자 : Yasuhiko Sugawara (검색결과 2 건)
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Hepatitis C and Liver Transplantation
( Yasuhiko Sugawara ) 대한간학회 2007 Clinical and Molecular Hepatology(대한간학회지) Vol.13 No.5(S)
OBJECTIVES: Hepatitis C virus (HCV) is the most common indication for living donor liver transplantation in Japan. A recent paper in the Western world reported that HCV infection was associated with a 23% increase in mortality and a 30% increase in the rate of liver graft failure. The poor results might be due to recurrence of HCV disease in the graft. If HCV recurs earlier and more severely after transplantation, a specific strategy for preventing the detrimental effects of HCV on the grafts must be developed. METHODS: One strategy might be aggressive treatment for HCV. Treatment of recurrent HCV disease with interferon and ribavirin after liver transplantation is used. One standard regimen includes interferon-alpha2b (3 MU x 3 per week) or PEG interferon (1.5 microg/kg) and ribavirin (600-800 mg/day) for 48 weeks. RESULTS: We have adopted the preemptive therapy in the 92 living donor liver transplant recipients until the end of 2006 and obtained a sustained viral response rate 35%. The 5-year survival rate was 82% which was not significantly different from that of the non hepatitis patients. CONCLUSIONS: Living donor liver transplantation is an effective life saving option with excellent outcome for patients suffering from end-stage liver disease including those due to HCV in regions where deceased donor liver transplantation remains an unrealistic option.
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Revolution and Refinement of Surgical Techniques for Living Donor Partial Liver Transplantation
Ender Dulundu,Yasuhiko Sugawara,Masatoshi Makuuchi 연세대학교의과대학 2004 Yonsei medical journal Vol.45 No.6
Living donor liver transplantation (LDLT) was first successfully performed on a child in 1990 and the Shinshu group performed the same procedure on an adult for the first time in 1994. Over the past few years adult LDLT has been increasing worldwide because of the severe shortage of cadaveric organs, especially in locations where the transplantation of organs from brain-dead donors is rarely practiced. The surgical procedures for LDLT are more technically challenging than those for cadaveric whole liver transplantation. LDLT requires a full understanding of hepatobiliary anatomy and continuous technical refinement of the procedure. The development of innovative techniques is a key factor for a successful LDLT. Some of the technical highlights include selective vascular occlusion techniques for donor hepatectomy, hepatic arterial reconstruction under the microscope, the introduction of intraoperative ultrasound, graft volume estimation, hepatic venous reconstruction using cryopreserved vascular grafts, and the use of the right lateral sector of the liver. These techniques have improved the success rate of LDLT over the past few years. This review focuses on the surgical techniques for LDLT on the basis of our experience with adult LDLT at the Tokyo University Hospital.
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