Masayuki Sawa

The beneficial effect of dibutyryl cyclic adenosine monophosphate on warm ischemic injury of the rat liver induced by cardiac arrest.

Dibutyryl cAMP (DBcAMP) has a high membrane permeability, and maintenance of the intracellular cAMP concentration may improve the viability of organs. In this study, the effect of DBcAMP pretreatment on warm ischemic injury of rat livers was evaluated. Warm ischemic liver injury was induced in adult Wistar rats weighing 250-280 g by leaving them at room temperature (22-25 degrees C) after cardiac arrest. The hepatic cAMP concentration, %ATP, and trypan blue-positive nuclear ratio were determined after different durations of warm ischemia. In addition, transaminase and endothelin-1 (ET-1) release into the perfusate were examined during 60 min of isolated liver perfusion with Krebs-Henseleit solution. The optimal dose and time of DBcAMP pretreatment were determined to be 15 mg/kg and 60 min prior to warm ischemia, respectively. Data on the trypan blue-positive nuclear ratio and the release of transaminases and ET-1 revealed that warm ischemia first damaged the endothelial cells and then the hepatocytes. DBcAMP pretreatment appeared to protect the liver from warm ischemic injury by increasing the intracellular cAMP concentration and stabilizing the cell membranes of endothelial cells and hepatocytes.

Metastatic seeding of bile duct carcinoma in the transhepatic catheter tract: Report of a case

We describe herein the case of a 51-year-old woman in whom metastatic tumor seeding of the percutaneous transhepatic biliary drainage tract occurred following a pancreatoduodenectomy for carcinoma of the distal common bile, duct. An abdominal computed tomography scan done 6 months after the initial operation detected a hepatic lesion located at the site of the previous percutaneous transhepatic biliary drainage tract. Implantation of bile duct carcinoma in the drainage tract was diagnosed, and the recurrent tumor was successfully resected by performing a subsegmentectomy of segment 3 and removal of the adjacent abdominal wall. At present, 5 years and 4 months after the second resection, the patient is in good health without any signs of recurrence. This case report demonstrates that an aggressive surgical approach should be performed for tumor seeding of a transhepatic biliary catheter tract.

Beneficial Effect of Hepatic Stimulatory Substances on the Survival of Intrasplenically Transplanted Hepatocytes

Intrasplenic hepatocyte transplantation has been demonstrated to have a tentative role in treating experimental liver disease, but methods for promoting the rapid proliferation of intrasplenic hepatocytes are still quite limited. In this study, hepatic stimulatory substances (HSS) obtained from regenerating porcine livers were injected directly into the subcutaneously translocated spleens of recipient rats that had received intrasplenic hepatocyte transplantation. The clusters of intrasplenic hepatocytes contained more than 100 cells, and formed cord structures at 2 wk after transplantation, and the hepatocytes still survived at 6 wk in the HSS-treated rats. In contrast, the clusters contained less than 10 hepatocytes at 2 wk after transplantation, and no surviving hepatocytes was observed at 4 and 6 wk in control rats. Additionally, marked proliferation of bile ductular-like structures appeared around the clusters of surviving hepatocytes in the splenic red pulp of the HSS-treated rats, but were not found in control rats at 4 and 6 wk after transplantation.

A study of liver regeneration using fetal rat liver tissue transplanted into the spleen

The liver morphology of fetal hepatic tissue transplanted into an ectopic location was investigated over one year period. Fetal liver fragments prepared from a maternal rat on the 18th or 19th day of pregnancy were injected into the splenic parenchyma of syngeneic rats using a 21 gauge needle. Histologically, the fetal liver did not essentially show any apparent lobular architecture or cord structure. The transplanted fetal hepatic tissues survived and formed hepatic cords in the spleen instead of undergoing degeneration and necrosis. Three characteristic features became complete during the 4 weeks following transplantation, namely; clumps of hepatocytes with obvious hepatic cords and sinusoids, markedly proliferating bile ducts and proliferating individual hepatocytes. Macroscopic nodules of the hepatocytes on the spleen were seen at about 6 months after transplantation. When the differentiation of the transplanted fetal hepatic tissue was compared with the development of a normal neonatal liver after birth, it was delayed by only about one week, while there was no proliferation of bile ducts in the normal neonatal liver. This experimental model provides a useful system for investigating liver regeneration and the mechanism of cell growth.

Multilocational hepatocyte transplantation for treatment of congenital ascorbic acid deficiency rats

We attempted multilocational hepatocyte transplantation (HCTx) including hepatocyte-bearing polyurethane foam (PUF) to treat congenitally ascorbic acid (AsA) biosynthetic enzyme-deficient (ODS-od/od) rats. Hepatocytes isolated from the liver of congeneic rats were transplanted into the portal vein (Pv), spleen (Sp), omentum (Om), and mesentery (Ms). Hepatocyte-bearing PUF was transplanted into the Om and Ms. Experimental groups were divided into four groups (group I; Pv + Sp, group II; Pv + Sp + Om + Ms, group III; Pv + Sp + hepatocyte-bearing PUF, group IV; control). The average serum AsA level of the surviving rats in group II and III was significantly higher than that in group I 3 mo after HCTx. Histological examination showed small foci of surviving hepatocytes in the Om and Ms tissues and in the connective tissue in the PUF. ODS-od/od rats survived for a long time by multilocational HCTx.

Immobilization of rat hepatocytes on multiporous microcarriers with larger pores and their metabolic activity

We have investigated the availability of multiporous microcarriers (MCs) for immobilizing isolated rat hepatocytes, but the pore size of MCs was too small (35 microns) for hepatocyte immobilization. In this study, we immobilized isolated rat hepatocytes on MCs with larger pores, and evaluated their metabolic activity. Isolated hepatocytes were immobilized on MCs precoated with collagen by the intermittent stirring method and by aspiration, and the cell-protein content per 100 mg MCs was determined for comparison of these methods. Metabolic activity was evaluated by analyzing NH3 metabolism, urea nitrogen synthesis and glucose synthesis. The aspiration method immobilized significantly more of hepatocytes on MCs than the intermittent stirring method (p < 0.05). A stationary culture of hepatocytes immobilized on MCs showed a similar NH3 metabolism to monolayer cultured hepatocytes, and hepatocytes immobilized on MCs in a floating culture showed significantly higher NH3 metabolism than those in a stationary culture (p < 0.01). However, monolayer cultured hepatocytes showed higher glucose synthesis than hepatocytes immobilized on MCs in a stationary culture (p < 0.01). In conclusion, hepatocytes immobilized on MCs proved to be useful as a bioreactor in a hybrid artificial liver.

Allogeneic hepatocyte transplantation: contribution of Fas-Fas ligand interaction to allogeneic hepatocyte rejection.

Hepatocyte transplantation is a potential therapeutic modality for overcoming the shortage of liver donors, and the clinical application of allogeneic hepatocyte transplantation has been considered. However, there are two major problems with allogeneic hepatocyte transplantation: protection of transplanted hepatocytes from rejection and stimulation of the rapid proliferation of surviving cells. Without immunosuppression, allogeneic hepatocytes are rapidly rejected within a few days after transplantation, even though it is relatively easy to induce immunotolerance after allogeneic whole liver transplantation. Accordingly, different rejection mechanisms seem to operate after allogeneic hepatocyte transplantation and whole liver transplantation. To overcome the rejection of transplanted hepatocytes, induction of donor‐specific unresponsiveness to graft without compromising the host immune system would be ideal. We previously reported that the Fas‐Fas ligand system plays a critical role in the CD28‐independent pathway of hepatocyte rejection. Therefore, blockade of rejection using CTLA4 immunoglobulin (CTLA4Ig) or anti‐CD80/86 monoclonal antibodies and anti‐FasL monoclonal antibody may prolong the survival of transplanted allogeneic hepatocytes. Furthermore, administration of hepatocyte growth factor (HGF) can promote the proliferation of allogeneic hepatocytes and this may lead to the development of a functioning liver substitute.

Developmental expression of cytochrome P450S within intrasplenically transplanted fetal hepatocytes.

Fetal hepatocytes were harvested at day 20 of gestation from spontaneously hypertensive rats (SHR) and then transplanted into recipient adult SHR spleens. Morphological examination of the recipient spleens revealed that, after 4 and 10 wk, large masses of hepatocytes were present in the red pulp with apparent cord-like structures. Larger batches of hepatocytes were observed in the spleens at 10 wk after than at 4 wk after transplantation. Of major significance was the fact that hepatocyte transplanted spleens were able to express several families of cytochrome P450 (cyto P450) proteins 2-10 wk after transplantation. Immunochemical determinations revealed that cytos P450 IA1, P450 IIB1, P450 p, P450 HLp, and P450 LA omega could be detected without any prior induction. All were intensely expressed 6 wk after transplantation; however, P450 IA1 and P450 IIB1 did not appear to be expressed by 2 wk after transplantation. Although cytos P450 p and P450 HLp did not appear to be expressed by 10 wk after transplantation, they were induced with dexamethasone at that time. Cyto P450 LA omega and peroxisomal acyl CoA oxidase were expressed 6 wk after transplantation in a 70% hepatectomized host. These results demonstrate that fetal hepatocytes can be successfully transplanted into the spleens of recipients and that the fetal hepatocytes appear to grow and develop cyto P450 metabolizing systems.

Transplantation for liver cancer

Primary liver cancer patients usually have a poor prognosis due to the expandable nature of the disease, however, considerable progress has been achieved in the treatment of lesions in the last ten years. Recent advances in screening for tumor markers, imaging techniques, and better understanding of the disease have enabled more frequent and earlier detection of tumors as small as 2 cm in diameter even though they are usually asymptomatic. Therefore, a higher resect ability rate has been achieved. Furthermore, refined patient selection, perioperative patient care, and surgical techniques have also contributed to a lower mortality and better long-term survival [1].

Cryopreservation of fetal rat liver tissue--a morphological investigation.

The present study was undertaken to define optimal conditions for cryopreservation of fetal rat liver tissue fragments. First, various cooling rates (1, 4, 10, 20 and 30°C/min) and preserving temperatures (−20, −80 and −196°C) were examined. Next, various concentrations of Me2SO (5, 10, 20 and 30 per cent vol/vol) were examined by freezing at a rate of 4°C/min to −80°C before transfer to −196°C. All samples were preserved for at least one week. After recovery from cryopreservation, the fragments were transplanted into the spleens of syngeneic rats. Histological assessment of the grafts was made one month after transplantation. Consequently, the optimal cryopreserving conditions for fetal rat liver fragments were defined as follows: (i) cooling rate was 1 to 10°C/min, (ii) preserving temperature was at −196°C, (III) concentration of Me2SO was 20 per cent (final concentration: 10 per cent). In the long term observation, the stored liver fragments could be differentiated into adult hepatocytes and the surviving hepatocytes showed little difference from the nonfrozen controls, either histochemically or ultrastructurally. The surviving hepatocytes in the stored transplants were less numerous than in the nonfrozen ones and hepatic cell plates and sinusoids were nil.