The features of regenerative hypertrophy of the liver fragments received from related donors/recipients

• Metelin A.V.
• u.E. Mikhaylov
• Ol'ga V. Dymova
• Kamalov Yu.R.
• E.Yu. Kryzhanovskaya
• E.F. Kim
• L.I. Vinnitsky
• N.T. Vorobieva
• Filin A.V.

Abstract

The paper discusses the dynamics of regeneration of liver transplant depending on the starting mass deficit, minimizing the possibility of immunosuppressive therapy for recipients of a liver transplant. The study included 121 patients aged from 7 months to 57 years (median – 11 years, 5th and 95th percentiles – 9 months and 46 years, respectively), which fragment transplant liver from a living related donor was performed from May 2004 to October 2013. The results of liver transplantation equity fragments obtained in the course of anatomical resections from living related donors. On the basis of intraoperative measurement of the mass of the graft, pre-and postoperative volumetry study the dynamics of regenerative processes in the transplanted liver fragments in the early (1 month) the timing of post-transplant period. A comparative analysis of the immunosuppressive protocol at different time periods of development programs related liver transplantation in RNCH RAMS. Peculiarities of the metabolism of calcineurin inhibitors (cyclosporine A (CyA) and tacrolimus (Tac)) due to regenerative adaptation donor liver fragment depending on the absence or presence of the mass deficit transplant. Defined median dose of tacrolimus for recipients after transplantation related liver fragment depending on the age and to the extent that the volume deficit transplant. To assess the state of the transplanted liver fragments using laboratory and ultrasonic techniques. It was established that immunosuppression protocol optimization can be achieved by reducing the dose of corticosteroids. In this approach requires selecting a differentiated doses of tacrolimus according to the age and amount of the graft.

Keywords:liver transplantation, related liver transplantation, transplantation of liver fragments, liver regeneration after transplantation, immunosupressive therapy after liver transplantation, liver transplantation, volume of replaced liver, tacrolimus, cyclosporine, metylprednisone

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