Prolonged thrombocytopenia after living donor liver transplantation is a strong prognostic predictor irrespective of splenectomy : the significance of ADAMTS13 and graft function

• Material Type: 博士論文
• Title: Prolonged thrombocytopenia after living donor liver transplantation is a strong prognostic predictor irrespective of splenectomy : the significance of ADAMTS13 and graft function
• Author/Editor: Nobuoka, Yu
• Author Heading: Nobuoka, Yu
• Publication, Distribution, etc.: 三重大学
• Publication Date: 2014-01-01
• Publication Date (W3CDTF): 2014-01-01
• Degree grantor/type: 三重大学
• Date Granted: 2014-07-16
• Date Granted (W3CDTF): 2014-07-16
• Dissertation Number: 甲医学第1685号
• Degree Type: 博士 (医学)
• Conferring No. (Dissertation): 甲医学第1685号
• Text Language Code: eng
• Alias of Author: ノブオカ, ユウ; 信岡, 祐
• Target Audience: 一般
• Note (General): application/pdf; The precise mechanism of prolonged thrombocytopenia following living donor liver transplantation (LDLT) remains unclear. To determine risk factors associated with prolonged thrombocytopenia following LDLT, with a focus on the activity of ADAMTS13 (a disintegrin-like and metalloproteinase with thrombospondin type-1 motifs member 13) and the influence of splenectomy. Adult LDLT patients were divided into two groups on the basis of platelet counts (100 x 10(3)/mu L) on POD 14: high and low platelet (HP and LP) groups. Survival analysis was performed in the 100 patients, and ADAMTS13 activity and von Willebrand factor (VWF) levels in the plasma were measured in 65 adult recipients. The 6-month survival rate was significantly lower in the LP group (n = 36) than in the HP group (n = 62) (61.1 vs. 93.5 %). ADAMTS13 activity had been significantly lower in the LP group (n = 23) than in the HP group (n = 42). The VWF/ADAMTS13 ratio was significantly higher in the LP group than in the HP group. The independent risk factors for thrombocytopenia on POD14 were preoperative AT levels and ADAMTS13 activity on POD14. TPO levels on POD14 were significantly higher in the LP group than in the HP group, while those on POD28 in the LP group were significantly decreased, despite the low platelet levels. Irrespective of splenectomy history, platelet counts and ADAMTS13 activity in the LP group remained low until POD28, while VWF/ADAMTS13 ratio significantly increased until POD28. These results suggest that prolonged thrombocytopenia after LDLT was associated with not only a decrease in ADAMTS13 due to sinusoidal endothelial cell injury, but also low TPO production due to hepatocyte dysfunction, irrespective of history of splenectomy.; 本文 / Department of Hepatobiliary-Pancreatic and Transplant Surgery, Mie University Graduate School of Medicine, Tsu, Mie, Japan; 42p; http://link.springer.com/article/10.1007/s12185-014-1543-9
• DOI: info:doi/10.1007/s12185-014-1543-9; https://doi.org/info:doi/10.1007/s12185-014-1543-9
• Persistent ID (NDL): info:ndljp/pid/9529695; https://dl.ndl.go.jp/pid/9529695
• Collection: 障害者向け資料
• Collection (Materials For Handicapped People:1): テキストデータ
• Collection (particular): 国立国会図書館デジタルコレクション > デジタル化資料 > 博士論文; https://dl.ndl.go.jp/collections/A00014
• Acquisition Basis: 博士論文（自動収集）
• Date Accepted (W3CDTF): 2015-11-01T14:53:18+09:00
• Date Created (W3CDTF): 2017-02-18
• Format (IMT): application/pdf
• Access Restrictions: 国立国会図書館内限定公開
• Service for the Digitized Contents Transmission Service: 図書館・個人送信対象外
• Availability of remote photoduplication service: 可
• Related Material (URI): http://link.springer.com/article/10.1007/s12185-014-1543-9
• Periodical Title (URI): http://hdl.handle.net/10076/14714; https://mie-u.repo.nii.ac.jp/records/7823
• Data Provider (Database): 国立国会図書館 : 国立国会図書館デジタルコレクション; https://dl.ndl.go.jp

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