ABSTRACT
BACKGROUND/AIMS: In living donor liver transplantation (LDLT), donor safety has top priority, and donor morbidity should be minimized to zero. However, several corporal problems still remain. The effect of hyperbaric oxygenation treatment (HBO) was evaluated for donor morbidity in LDLT. METHODOLOGY: A total of 14 consecutive donors were studied. The donors into were divided into 2 groups as follows: HBO group (n=7), which started HBO 3 days after operation, and a control group (n=7). Patient's factors, graft volume, liver regeneration rate, liver function tests and postoperative complications ware compared between the 2 groups. RESULTS: There was no significant difference between the groups in whole liver, graft and remnant liver volume. The incidence of wound numbness on POD 28 was 86% (6/7) in the control group and 29% (2/7) in the HBO group (p<0.05). Postoperative hospital stay was 14.4 and 14.6 days in the control and HBO group, respectively (p=NS). On POD 14, AST value in the HBO group was significantly lower than in the control group (p<0.05). PT% value in the HBO group was significantly higher than in the control group on POD 14 (p<0.05). Total bilirubin level in the HBO group was significantly lower than in the control group on POD 14 and 28 (p<0.05), and total bile acid value in the HBO group was significantly lower than the control group (p<0.05) on POD 14. Albumin level in the HBO group was significantly higher than the control group on POD 7, 10 and 28 (p<0.05). Four weeks after the operation, the regeneration rate was significantly higher in the HBO group than in the control group (p<0.05). CONCLUSIONS: Liver regeneration was promoted by HBO preserving a function in LDLT using left lobe graft. Hyperbaric oxygen therapy seems to be very useful to LDLT.
Subject(s)
Hepatectomy , Hyperbaric Oxygenation , Liver Transplantation , Living Donors , Postoperative Complications/therapy , Tissue and Organ Harvesting , Adult , Bilirubin/blood , Female , Follow-Up Studies , Humans , Hyperbaric Oxygenation/instrumentation , Liver Function Tests , Liver Regeneration/physiology , Male , Middle Aged , Postoperative Complications/physiopathology , Serum Albumin/metabolism , Wound Healing/physiologyABSTRACT
Fourteen 5-week-old male Sprague-Dawley rats were equally divided into two groups, sham-operated and gastrectomized. Tetracycline and calcein were given to label dentine. Four weeks after surgery, blood was collected for measurement of serum iron, calcium and parathyroid hormone (PTH) and the mandibles and maxillae were then removed. Sagittal sections of the maxilla or cross-sections of the mandible were prepared and examined. Backscattered electron images of the maxilla were taken and the iron content at the neck of incisors was measured by energy-dispersive X-ray. The dentine apposition rate in maxillary incisors was measured by fluorescence microscopy. Serum iron was significantly decreased, while PTH was significantly elevated without any change in the serum calcium in gastrectomized rats. Gastrectomy caused a gross loss of iron content in superficial enamel. The dentine apposition rate was significantly reduced by 30%. Both cortical and cancellous bone in the mandibula were significantly reduced. However, the total bone area in gastrectomized rats was similar to that in sham-operated rats. These results suggest that bone resorption was enhanced and dentine formation was reduced after gastrectomy.
