Ischaemia-reperfusion injury with Pringle's maneuver induces unusually large von Willebrand factor multimers after hepatectomy.

• 資料種別: 博士論文
• タイトル: Ischaemia-reperfusion injury with Pringle's maneuver induces unusually large von Willebrand factor multimers after hepatectomy.
• 著者・編者: Yoshikawa, Takahiro; Nomi, Takeo; Sakai, Kazuya; Hayakawa, Masaki; Hokuto, Daisuke; Matsuo, Yasuko; Sho, Masayuki; Matsumoto, Masanori
• 著者標目: Yoshikawa, Takahiro; Nomi, Takeo; Sakai, Kazuya; Hayakawa, Masaki; Hokuto, Daisuke; Matsuo, Yasuko; Sho, Masayuki; Matsumoto, Masanori
• 出版事項: Elsevier
• 出版年月日等: 2019-11
• 出版年（W3CDTF）: 2019-11
• 並列タイトル等: Pringle法に伴う虚血再灌流障害はUnusually Large Von Willebrand Factor Multimersを誘導する
• タイトル（掲載誌）: Thrombosis research
• 巻号年月日等（掲載誌）: 183
• 掲載巻: 183
• 掲載ページ: 20-27
• ISSN（掲載誌）: ISSN : 0049-3848
• 授与機関名: 奈良県立医科大学
• 授与年月日: 2020-03-16
• 報告番号: 乙第1455号
• 学位: 博士（医学）
• 本文の言語コード: eng
• 件名標目: ADAMTS13; Unusually large VWF multimers; Hepatectomy
• 対象利用者: 一般
• 一般注記: type:Thesis; Introduction: von Willebrand factor (VWF) is synthesised in vascular endothelial cells and released into the plasma as unusually large VWF multimers (UL-VWFMs). Sinusoidal endothelial cells are a major target of ischaemia-reperfusion injury due to liver surgery. This study aimed to clarify the effect of hepatectomy on UL-VWFMs. Materials and methods: Thirty-five patients who underwent hepatectomy were eligible for the study. Plasma ADAMTS13 activity and VWF antigen levels were measured by enzyme-linked immunosorbent assay and multimer analysis of plasma VWF was performed according to Ruggeri and Zimmerman's method. For analyses, patients were categorised according to UL-VWFM positivity after hepatectomy. Results: Plasma ADAMTS13 activity significantly decreased from 61.0% (27.7%-126.2%) before operation to 37.4% (20.2%-71.4%) on postoperative day 7 (p < 0.001). Plasma VWF antigen levels significantly increased from 172.1% (80.5%-412.8%) before operation to 361.0% (154.7%-745.8%) on postoperative day 2, which remained high until postoperative day 7 (p < 0.001). Seven patients remained UL-VWFMs-negative and 22 patients became UL-VWFMs-positive after operation. Pringle's maneuver duration was significantly longer and blood loss volume was significantly higher in the UL-VWFMs-positive group (p = 0.001 and p = 0.003, respectively). By multivariable analysis, Pringle's maneuver duration [odds ratio 1.049, 95% confidence interval (CI) 1.001-1.098; p = 0.043] was significantly associated with increased UL-VWFMs level after hepatectomy. UL-VWFMs index was significantly correlated with Pringle's maneuver duration (r = 0.444, p = 0.017). Conclusions: Plasma UL-VWFMs levels increased after hepatectomy due to ischaemia-reperfusion injury with Pringle's maneuver.; 博士（医学）・乙第1455号・令和2年3月16日; Copyright © 2019 Elsevier Ltd. All rights reserved.; identifier:Thrombosis research Vol.183 p.20-27 (2019 Nov); identifier:00493848; identifier:http://ginmu.naramed-u.ac.jp/dspace/handle/10564/3745; identifier:Thrombosis research, 183: 20-27
• オンライン閲覧公開範囲: インターネット公開
• 関連情報（DOI）: 10.1016/j.thromres.2019.09.005
• 連携機関・データベース: 国立情報学研究所 : 学術機関リポジトリデータベース（IRDB）（機関リポジトリ）; https://irdb.nii.ac.jp
• 提供元機関・データベース: 奈良県立医科大学 : 奈良県立医科大学機関リポジトリ GINMU

目次

http://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/3745/1/01%e4%b9%991455%e6%9c%ac%e6%96%87%e3%81%ae%e8%a6%81%e6%97%a8.pdf fulltext

http://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/3745/2/02%e4%b9%991455%e5%af%a9%e6%9f%bb%e8%a6%81%e6%97%a8.pdf fulltext

http://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/3745/3/03%e4%b9%991455%e6%9c%ac%e6%96%87.pdf fulltext