Hiroyuki Furukawa, Tsuyoshi Shimamura, Tomomi Suzuki, Masahiko Taniguchi, Kenichiro Yamashita, Minoru Ohta, Toshiya Kamiyama, Michiaki Mastushita, Satotu Todo.
器官移植再生医学部，北海道大学医学院，札幌，北海道，日本；器官移植部，北海道大学附属医院，札幌，北海道，日本；普外科，北海道大学医学院，札幌，北海道，日本

简介：肝脏特有的切除后快速再生能力使活体肝移植成为可能。对人类肝脏的这种再生过程和功能恢复至今仍未有过大量的调查。

资料和方法：从2000 年3月至2006年9月，共有125例活体肝移植的捐肝者在我中心施行了肝切除术，其中89例参与到该项研究中。用CT扫描的三维（3D）软件在肝切除术后第1、2、4、12周分别进行容量分析，应用锝99mDTPA -garactosyl人血清白蛋白肝闪烁图来确定肝切除术后第1、2、4、12周的肝功能情况。HH15和LHL15为参数，以剩余肝脏的体积和捐肝者的年龄来划分组别。

结果：当剩余肝脏的体积小于原体积的40%时，在肝切除术后第1、2、4、12周，剩余肝脏的再生率分别为148%、164%、176%和202%，HH15 值分别为0.548、0.588、0.587和0.526，LHL15值分别为 0.951、0.947、0.943和0.956。当剩余肝脏的体积为原体积的40%或以上时，在肝切除术后第1、2、4、12周，再生率分别为 116%、118%、117%和137%，HH15值为0.438、0.484、0.500和0.508，LHL15 值分别为0.947、0.940、0.940和0.933。再生率的统计学差异在以上四个时间点上都有出现（P<0.0001），HH15值在第1 （P<0.0001）、2（P<0.0001）、4（P=0.0002）周，LHL15在12周（p=0.001）也出现了统计学差异，但在老年捐肝者和年轻捐肝者中并未出现。

结论:不管捐肝者的年龄大小，在施行肝切除术后的早期阶段，剩余肝脏的体积越小，再生率越高，肝功能受损情况越大。因此，在术后的早期阶段对捐肝者的精心护理就变得至关重要。

Evaluation of Liver Regeneration and Function of Donors after Living Donor Liver Transplantation
Hiroyuki Furukawa, Tsuyoshi Shimamura, Tomomi Suzuki, Masahiko Taniguchi, Kenichiro Yamashita, Minoru Ohta, Toshiya Kamiyama, Michiaki Mastushita, Satotu Todo. Department of Organ Transplantationand Regenerative Medicine, Hokkaido University School of Medicine, Sapporo, Hokkaido, Japan; Division of Organ Transplantation, Hokkaido University Hospital, Sapporo, Hokkaido, Japan; Department of General Surgery, Hokkaido University School of Medicine, Sapporo, Hokkaido, Japan

Introduction:The unique ability of the liver to regenerate quickly after resection makes living donor liver transplantation (LDLT) possible. This regeneration process and functional recovery in humans are still widely unexplored.

Materials and methods: From March 2000 to September 2006, 125 living donors underwent hepatectomy for LDLT in our center. Of 125, 89 donors were involved in the study. Volumetry was obtained at 1, 2, 4, 12 weeks after hepatectomy using 3D software from CT scan. Technetium-99m-DTPA-garactosyl-human serum albumin liver scintigraphy was used to determine the liver function at 1, 2, 4, 12 weeks after hepatectomy. HH15 (=count for the heart at 15 minutes/ count for the heart at 3 minutes) and LHL 15 (=count for the liver at 15 min/ sum of the count for heart and liver at 15 minutes) were calculated as parameters. The groups were classified under the remnant liver volume and donor age, and the influence was studied.

Results: When the remnant liver volume was less than 40% of the original liver, the regeneration ratios for the remnant liver volume were 148%,164%, 176%, and 202%, HH15 values were 0.548, 0.588, 0.587, 0.526, and LHL15 values were 0.951, 0.947, 0.943, 0.956, at 1, 2, 4, and 12 weeks after hepatectomy. When the remnant liver volume was equal to or more than 40%, regeneration ratios were 116%,118%, 117%, and 137%, HH15 values were 0.438, 0.484, 0.500, 0.508, and LHL15 values were 0.947, 0.940, 0.940, 0.933, at 1, 2, 4, and 12 weeks after hepatectomy. Statistical differences were found in the regeneration ratios at all 4 points (P<0.0001), in HH15 at 1 (P<0.0001), 2 (P<0.0001), and 4 weeks (p=0.0002), and in LHL15 at 12 weeks (p=0.001). No statistical differences were found in the regeneration ratios, HH15 and LHL 15 between old and young donors.

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