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이식 간의 급성거부반응 기간중 혈중 콜레스테롤의 변화

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Author(s)
조원현임태진김인호강구정강영우안성훈박관규우성구
Alternative Author(s)
Cho, Won HyunLim, Tae JinKim, In HoKang, Koo JeongKang, Young WooAhn, Sung HoonPark, Kwan KyuWoo, Seong Ku
Publication Year
1995
Abstract
Various histochemical analysis are performed to monitor the allografted liver function. Among them, scrum cholesterol which is synthesized, esterified and excreted by the liver can be checked easily and can detect the impairment or restoration of liver function simply. We experienced a typical changes of serum cholesterol level in 4 cases of orthotopic liver transplantation which were performed in our hospital. The early increase of serum bilirubin after liver transplantation was considered as hepatic ischemic injury but continuous rapid increase of serum bilirubin was suspected as acute rejection when we excluded mechanical obstruction at biliary trees and portal vessels. That pathology was confirmed by serial liver biopsy. Serum cholesterol level was abruptly dropped down to the level of 20~40 mg/ml al the early period of acute rejection and maintained during the rejection episode but began to increase when the grafted liver was responded to the steroid pulse therapy. That kind of changes were started before the changes of bilirubin or other liver function parameters. The Cholesterol/HDL(high density lipoprotein) ratio which was checked every 3rd day showed evidence of increase at the early stage of acutre rejection. These findings suggested that serum cholesterol level and Cholesterol/HDL ratio might be used as a diagnostic test of acute rejection in early liver transplantation period.
간이식 수술후 발생하는 황달과 간 기능 혈액검사치의 변화를 보기 위해 본 대학에서 실시한 4예의 간이식환자를 대상으로 병력지와 간 생검소견, 방사선 및 검사소견등을 종합해서 분석하였다. 간 이식 초기에 경험했던 거부반응은 혈중 빌리루빈치 의 증가와 함께 시작되었으며 담관촬영, 간 스캔, 간 단층촬영등으로 담도폐쇄나 수술합병증을 제외 시킨 상태에서 혈중 콜레스테를치의 감소가 두드러지게 나타났다. 감소되었던 콜레스테롤치는 거부반응치료제에 이식 간이 반응하여 기능을 회복하기 시작하자 다시 증가하는 양상을 보였다. 그러나 간 효소치는 이런 변화를 보여주지 못했다. 결론적으로 이식간의 초기 혈중 클레스테롤치의 저하는 간담도 의 기계적 폐쇄가 아닌 이식 간의 거부반응과 같은 면역학적 원인에 의한 간 기능저하를 의미하며 좀 더 정확한 관계를 알기 위해서는 콜레스테롤의 전구물질들과 관여효소에 대한 혈액화학적 분석이 필요하리라 생각된다.
Alternative Title
Changes of Serum Cholesterol during the Acute Rejection Episode after Liver Transplantation
Department
Dept. of Surgery (외과학)
Dept. of Internal Medicine (내과학)
Dept. of Pathology (병리학)
Dept. of Radiology (영상의학)
Publisher
School of Medicine
Citation
대한이식학회지, Vol.9(1) : 171-180, 1995
Type
Article
ISSN
1598-1711
URI
http://kumel.medlib.dsmc.or.kr/handle/2015.oak/38430
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