22. Workshop für experimentelle und klinische Lebertransplantation ...
22. Workshop für experimentelle und klinische Lebertransplantation ...
22. Workshop für experimentelle und klinische Lebertransplantation ...
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Transplantationsmedizin<br />
Supplement I – 2011, S. 19<br />
steady state concentration of IGFBP1 and<br />
IGFBP2. In addition, JUN and FOSB,<br />
forming the AP1 transcription factor, as<br />
well as MMP7 were reflecting potential<br />
molecular events of liver growth after portal<br />
vein embolization in the non-embolized<br />
liver lobe. These factors comprise Ki-67,<br />
which was significantly increased in the<br />
non-embolized liver tissue. Immunofluorescence<br />
showed a significant upregulation<br />
of β-catenin and JUN in the non-embolized<br />
liver lobe. Moreover, comparison<br />
of our transcriptome data to transcriptomic<br />
signatures of patients with dysplasia or hepatocellular<br />
carcinoma showed divergent<br />
signatures.<br />
Kombinierte Herz-<br />
<strong>Lebertransplantation</strong><br />
F. Rauchfuß, U. Settmacher<br />
Klinik für Allgemein-, Viszeral- <strong>und</strong> Gefäßchirurgie,<br />
Universitätsklinikum Jena<br />
Kombinierte Herz-<strong>Lebertransplantation</strong><br />
sind selten durchgeführte Transplantationen,<br />
können jedoch für Patienten mit terminalen<br />
Herz- <strong>und</strong> Lebererkrankungen die<br />
Therapie der Wahl sein.<br />
Insbesondere die technischen Aspekte dieser<br />
seltenen Transplantationsform sind<br />
nicht standardisiert. Ziel dieser Arbeit ist<br />
es, mittels strukturierter Literaturrecherche<br />
einen Überblick über Indikation, Technik<br />
<strong>und</strong> perioperatives Management zu erlangen<br />
<strong>und</strong> diesen mit den Erfahrungen unseres<br />
Zentrums zu korrelieren.<br />
In der Literaturrecherche zeigte sich, dass<br />
ein breites Spektrum hinsichtlich der operativen<br />
Strategie existiert. Dieses reicht<br />
von der sequentiellen Transplantation (Implantation<br />
der Leber Monate nach der<br />
Herztransplantation) bis zu simultanen<br />
Techniken, bei denen die Leber implantiert,<br />
während das Herz unter extrakorporaler<br />
Zirkulation reperf<strong>und</strong>iert wird.<br />
In unserem Zentrum wird die simultane<br />
Transplantation bevorzugt, wobei die Leber<br />
in der Reperfusionsphase des Herzens<br />
implantiert wird.<br />
Zusammenfassend lässt sich feststellen,<br />
dass die kombinierte Herz-<strong>Lebertransplantation</strong><br />
eine seltene, aber im Einzelfall lebensrettende<br />
Maßnahme sein kann, mit<br />
der, bei sorgfältiger Indikationsstellung,<br />
akzeptable Langzeitüberlebensraten erzielt<br />
werden können. Die operative Strategie ist<br />
hierbei, je nach Zentrum, teilweise sehr<br />
unterschiedlich.<br />
Induction of Fatty Liver in Lew<br />
Rats Using Different Diets<br />
J. Sun 1 , A. Liu 1 , H. Fang 1 , W. Dong 1 ,<br />
O. Dirsch 2 , U. Dahmen 1<br />
1<br />
Experimental Transplantation Surgery, Department<br />
of General, Visceral and Vascular<br />
Surgery, University Hospital of Jena<br />
2<br />
Institute for Pathology, University Hospital of<br />
Jena<br />
Introduction: Non-alcoholic fatty liver<br />
disease (NAFLD) has become an increasing<br />
common disorder in recent years. Animal<br />
models of NAFLD can provide critical<br />
information to <strong>und</strong>erstand the molecular<br />
mechanisms and to investigate therapeutic<br />
strategies. However, selection of the optimal<br />
model is difficult as limited data are<br />
available characterizing the different animal<br />
models. This study was designed to investigate<br />
3 different nutritional models of<br />
NAFLD in respect to the time course and<br />
intensity of fatty changes. Computerized<br />
image analysis system was used to assess<br />
the extent of hepatic steatosis of these models.<br />
Furthermore, the influences of each<br />
diet on the oxidative stress (lipid peroxidation<br />
products, LPO), antioxidant defense<br />
(glutathione, GSH) and microcirculation<br />
were investigated.<br />
Methods: Male LEW rats were fed with<br />
low methionine-low choline diet (FLD),<br />
low methionine-choline plus high fat diet<br />
(MCD+HF) or methionine-choline deficient<br />
diet (MCDD) for 1, 2, 4, 6 weeks and<br />
3 months. Body weight of rats was determined<br />
daily throughout the feeding period.<br />
Severity of hepatic steatosis was judged<br />
using whole slide scan and a newly developed<br />
automated Image analysis system<br />
(MeVis HisCad) through computerized assessment.<br />
The sinusoidal diameter (SD),<br />
blood flow velocity and functional capillary<br />
density (FCD) were measured to assess<br />
microcirculation before liver resection<br />
using Orthogonal Polarization Spectroscopy<br />
(OPS). Biochemistry, LPO and GSH<br />
was investigated.<br />
Results: Rats subjected to the pure MCD<br />
diet lost about 30% of their body weight<br />
within the 3 months of feeding whereas rat<br />
receiving MCD+HF and FLD were gaining<br />
weight. Histology showed almost no<br />
changes in the FLD group. The number of<br />
hepatocytes with fatty changes increased<br />
with feeding time starting with about 10%<br />
after 1w of feeding and reaching a maximum<br />
of 90% after 4w of feeding in both<br />
MCD and MCD+HF diet. However, in<br />
both groups pronounced heterogeneity in<br />
respect to the distribution of hepatocytes
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