개 자가부분 간이식에서 이식간 초기 기능 지표로서 혈청 젖산 및 아미노산의 단계별 대사 변화

Living-related segmental liver transplantation is currently accepted as one method of treatments of pediatric endstage liver diseases. Immediate recovery of graft function is prerequisite for patients survival, In case of graft failure, early prediction is necessary for retransplantation to avoid decease. Since amino acids and lactic acid are metabolized in liver, levels of those components lin plasma are frequently used as indicators for hepatic graft function. we have investigated the wequential changes of amino acids and lactic acid following autologous segmental liver transplantation in canine to identify the significance of these indicators. Ten mongrel dogs were prepared by harvesting the left lobe frorn experimental dogs, removing the rest of liver using total vascular exclusion and veno-venous bypass, and implanting the left lobe taken at first stage in the orthotopic position. The plasma amino acids and lactic acid concentrations in arterial blood obtained at preoperative period, anhepatic phase, reperfusion-15 min., 1 hour, 3 hours, 6 hours, were measured on Beckman system 6300 amino acid analyzer and Kodak Ektachem 700 XR, Among ten dogs, five of them died within 20 hours (Group 1), and the rest of them died after 20 hours (Group 2). The results indicate: (1) ln both Group, all plasma amino acid levels were increased in anhepatic phase except Valine, Isoleucine, and Arginine. Most highly increased amino acid was Alanine. (2) In group 1, most amino acids were slightly decreased till reperfusion 1 hour, and then increased to the level of anhepatic phase in reperfusion 6 hours. (3) In group 2, most plasma amino acid levels were decreased to preoperative values within 6 hours following reperfusion. (4) The changing patterns of TFPAA (total free plasma amino acid), BCAA/AAA ratio (Branched chain amino acid/aromatic amino acid ratio), and severaI amino acids (Phenylalanine, alanine Proline, Tyrosine) revealed statistically significant difference between two Groupe. (5) While plasma concentration of lactate continued to rise until 6 hours after reperfusion in Group 1, already increased plasma concentration of lactate in anhepatic phase reached plateau during 6 huurs after reperfusion in Group 2. The above changing pattern of plasma concentration of lactate showed statistically significant difference between both Groups (p