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| 1 | Changes of gut bacteria and immune parameters in liver transplant recipients显示文摘BACKGROUND: Liver transplantation is one of the most effective therapeutic options for patients with end-stage liver diseases, and gut microbiota is actively involved in potential infections in pretransplant and posttransplant patients. However, the diversity of gut microbiota and its relationship with the immune parameter of liver transplantation recipients are not well understood. METHODS: We collected fresh feces and blood samples from 190 participants in China from November 2004 to May 2008, including 28 healthy volunteers, 51 cirrhotic patients and 111 liver-transplanted patients. Six interesting gut bacteria, plasma endotoxin, serum cytokines (i.e., tumor necrosis factor alpha and interleukin-6) and fecal secretory IgA (SIgA) were investigated by real-time quantitative PCR, chromogenic limulus amoebocyte assay, sandwich-type enzyme-linked immunosorbent assay and radioimmunoassay, respectively. RESULTS: All Eubacteria, Bifidobacterium spp., Faecalibacterium prausnitzii and Lactobacillus spp. were significantly lower in the liver transplantation recipients while Enterobacteriaceae and Enterococcus spp. were significantly higher (P<0.05). Except for Enterococcus spp., other bacteria showed a tendency to restore to normal level along with the time after liver transplantation. Plasma endotoxin, interleukin-6 and fecal SIgA in cirrhotic patients increased significantly, but not in liver transplantation recipients. Plasma endotoxin and interleukin-6 were negatively correlated with all Eubacteria and the Bacteroides-Prevotella group, while tumor necrosis factor alpha was not significantly correlated with these six gut bacteria in cirrhotic patients.CONCLUSIONS: Our study demonstrates that abundant gut bacteria were altered significantly in both cirrhotic and liver transplantation patients, while plasma endotoxin and interleukin-6 increased remarkably in cirrhotic patients, showing significant correlations with gut microbiota. Interestingly, our data show a tendency for these gut bacteria to restore to normal levels in liver transplantation recipients. | Zhong-Wen Wu, Zong-Xin Ling, Hai-Feng Lu, Jian Zuo, Ji-Fang Sheng, Shu-Sen Zheng and Lan-Juan Li State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, Department of Infectious Diseases Key Lab of Combined Multiorgan Transplantation, Ministry of Public Health, Key Lab of Organ Transplantation and Department of Hepatobiliary and Pancreatic Surgery , First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China | 2012 | Hepatobiliary & Pancreatic Diseases International2012，11，1： | 37 |
| 2 | Sorafenib in treatment of patients with advanced hepatocellular carcinoma:a systematic review显示文摘BACKGROUND: Sorafenib has become the standard first-line treatment for patients with advanced hepatocellular carcinoma (HCC). This study aimed to assess the efficacy and safety of sorafenib in advanced HCC patients and explore its true value for specific subgroups. DATA SOURCES: A computer-based systematic search from January 2005 to June 2011 with 'sorafenib' and 'advanced hepatocellular carcinoma' as search terms was performed for possible clinical trials. Hazard ratios (HR) and their 95% confidence intervals (CI) for overall survival (OS) and time to progression (TTP), rates of partial response (PR), rates of toxicity effects, and details of subgroup analysis were extracted. Meta-analyses were done using the software Review Manager (version 5.0). RESULTS: Six trials with 1164 patients were included. Based on three randomized controlled trials, the pooled HR (sorafenib/ placebo) was 0.66 for OS (95% CI: 0.56-0.78; P<0.00001) and 0.57 for TTP (95% CI: 0.47-0.68; P<0.00001). The pooled odds ratio (OR) for PR was 2.96 (95% CI: 0.96-9.15; P=0.06). For three single-arm trials, the pooled HR was 0.69 for OS (95% CI: 0.56-0.84; P=0.0002) and 0.64 for TTP (95% CI: 0.52-0.78; P<0.00001). The pooled OR for PR in three single-arm trials was 3.56 (95% CI: 1.22-10.39; P=0.02). Subgroup analysis indicated that sorafenib was less effective in patients with extrahepatic spread (with: P=0.13 vs without: P<0.0001), with normal alpha-fetoprotein level (AFP) (P=0.15 vs elevated: P=0.0006), and with elevated level of serum bilirubin (P=0.06 vs normal: P=0.0009). Sorafenib-based therapy significantly increased the risk of grade 3/4 hand-foot skin reaction, diarrhea, fatigue, and rash/desquamation.CONCLUSIONS: Sorafenib-based therapy benefits advanced HCC patients. Meanwhile, sorafenib is less effective for patients with extrahepatic spread, with normal AFP level and with elevated level of bilirubin. | Xin Zhang, Xin-Rong Yang, Xiao-Wu Huang, Wei-Min Wang, Ruo-Yu Shi, Yang Xu, Zheng Wang, Shuang-Jian Qiu, Jia Fan ,Jian Zhou Liver Cancer Institute, Zhongshan Hospital, Fudan University, Shanghai Key Laboratory for Organ Transplantation, Shanghai 200032, China,Institute of Biomedical Sciences, Fudan University, Shanghai 200032, China | 2012 | Hepatobiliary & Pancreatic Diseases International2012，11，5： | 29 |
| 3 | 他克莫司在临床肝移植中的应用指南显示文摘1984年,他克莫司的有效成分首次在日本从土壤真菌的肉汤培养基中提取出来,实验室命名为FK506,通用名为他克莫司(Tarolimus,Tac)。1993年,Tac首先于日本上市,1994年在美国和英国等国家上市,1999年在中国上市,商品名为普乐可复。 | Chinese Society of Organ Transplantation,Chinese Medical Association | 2015 | 临床肝胆病杂志2015，31，9： | 27 |
| 4 | Risk factors and incidence of acute pyogenic cholangitis显示文摘BACKGROUND: Acute cholangitis varies from mild to severe form. Acute suppurative cholangitis (ASC), the severe form of acute cholangitis, is a fatal disease and requires urgent biliary decompression. Which patients are at a high risk of ASC and need emergency drainage is still unclear. The present study aimed to identify the factors for determining early-stage ASC and distinguishing ASC from acute cholangitis. METHODS: We analyzed 359 consecutive patients with acute cholangitis who had been admitted to the First Affiliated Hospital, Zhejiang University School of Medicine from January 2004 to May 2011. Emergency endoscopic retrograde cholangiopancreatography (ERCP) was carried out in all patients to decompress or clear the stones by experienced endoscopists Clinical and therapeutic data were collected, and univariate and multivariate analyses were performed to identify the potential risk factors of ASC. RESULTS: Of the 359 patients, 1 was excluded because of failure of ERCP drainage. Of the remaining 358 patients with an average age of 62.7 years (range 17-90), 162 were diagnosed with ASC, and 196 with non-ASC. ENBD catheters were placed in 343 patients (95.8%), of whom 182 patients had stones removed at the same time, and plastic stent was placed in 25 patients (7.0%) Clinical conditions were improved quickly after emergency biliary drainage in all patients. Complications were identified in 11 patients (3.1%): mild pancreatitis occurred in 8 patients and hemorrhage in 3 patients. There was no mortality. Univariate analysis showed that several variables were associated with ASC: age, fever, decreased urine output, hypotension, tachycardia abnormal white blood cell count (WBC), low platelet, high C reactive protein (CRP), and duration of the disease. Multivariateanalysis revealed that advanced age, hypotension, abnormal WBC, high CRP, and duration of the disease were independent risk factors for ASC. CONCLUSIONS: This study demonstrates that advanced age, hypotension, abnormal WBC, high CRP, and long duration of antibiotic therapy are significantly associated with ASC. We recommend decompression by ERCP should be carried out in patients as early as possible. | Yun-Sheng Qin, Qi-Yong Li, Fu-Chun Yang , Shu-Sen Zheng Division of Hepatobiliary and Pancreatic Surgery Key Laboratory of Combined Multi-organ Transplantation, Ministry of Public Health Key Laboratory of Organ Transplantation Zhejiang Province, First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China | 2012 | Hepatobiliary & Pancreatic Diseases International2012，11，6： | 18 |
| 5 | Prevention and treatment of hepatic artery thrombosis after liver transplantation显示文摘BACKGROUND: Hepatic artery thrombosis (HAT) which is a serious complication after orthotopic liver transplanta- tion (OLT) remains a significant cause of graft loss. The purpose of this study was to sum up our experiences in the prevention, diagnosis and management of HAT after liver transplantation. METHODS: From April 1993 to September 2003, a total of 198 patients underwent OLT at our hospital. The hepatic artery was anastomosed using 7/0 prolane with running continuous suture in 96 patients (group 1) and with inter- rupted suture in 102 (group 2). Ultrasonography was per- formed every day in two weeks after operation and selec- tively afterwards. RESULTS: HAT occurred in 6 patients (6.3%, 6/96) of group 1, and in 1 (1%, 1/102) of group 2 (x2=4.027, P= 0.045). Six patients received emergency thrombectomy, and 1 conservative therapy but died from tumor recurrence eventually. Biliary complication developed in 3 patients af- ter thrombectomy of whom 2 died of liver failure and one waited for retransplantation. In the other 3 patients after thrombectomy, 1 died of renal failure, and 2 survived. The mortality of patients with HAT was 57.1% (4/7). CONCLUSIONS: The technique of hepatic arterial anasto- mosis is the key factor for the prevention of HAT. Routine ultrasonography is very important in early detection of HAT after OLT. Biliary complication is a severe outcome secondary to HAT. | Shu-Sen Zheng, Zhi-Yong Yu, Ting-Bo Liang, Wei-Lin Wang, Yan Shen, Min Zhang, Xiao Xu and Jian Wu Hangzhou, China Centre of Organ Transplantation and Department o Hepatobiliary and Pancreatic Surgery, First Affiliated Hospital of Medica College, Zhcjiang University, Hangzhou 310003, China | 2004 | Hepatobiliary & Pancreatic Diseases International2004，3，1： | 18 |
| 6 | Expression of HLA-G in patients with hepatocellular carcinoma显示文摘BACKGROUND:Human leukocyte antigen G(HLA-G)is a non-classical major histocompatibility complex class I molecule that has multiple immune regulatory functions including the induction of immune tolerance.The detection of HLA-G expression might serve as a clinical marker in the prediction of clinical outcomes for certain types of carcinoma.Currently, we investigated whether or not HLA-G is also expressed in patients with hepatocellular carcinoma(HCC),and whether the expression has clinical value. METHODS:Serum levels of secreted HLA-G(sHLA-G)were measured by ELISA in 36 patients with HCC,25 patients with liver cirrhosis(LC)and 25 healthy individuals.The expression of HLA-G in liver tissue was further studied using Western blotting in 36 patients with HCC and 25 with LC.The correlations between HLA-G status and various clinicopathological parameters including survival were analyzed. RESULTS:The ELISA assay showed that the serum levels of sHLA-G in the HCC,LC and healthy groups were 132.6± 31.4,63.5±22.1,and 47.0±15.5 U/ml,respectively.Analysis of variance was used for inter-group comparison and differences were found between the HCC group and the other two groups (both P<0.01),while no difference was found between the LC group and the healthy group(P=0.112).HLA-G protein expression in liver tissue was found in 66.7%(24/36)of the primary sites of HCC,but not in benign lesions(LC). Further,the HLA-G expression in tumors had no significant correlation with the parameters of age,gender,histological grade and alpha-fetoprotein level.However,patients with HLA-G-positive tumors had a shorter postoperative survival time than those with HLA-G-negative tumors(P=0.014).Also, univariate analysis showed that HLA-G was an independent prognostic factor.CONCLUSION:Our results indicated that the expression of HLA-G was a characteristic feature of HCC and patients with positive expression of HLA-G in malignant liver tissue had a poor prognosis. | Yan Wang,Zhou Ye,Xue-Qin Meng and Shu-Sen ZhengDivision of Hepatobiliary and Pancreatic Surgery Key Laboratory of Combined Multi-organ Transplantation,Ministry of Public Health and Key Laboratory of Organ Transplantation Zhejiang Province, First Affiliated Hospital,Zhejiang University School of Medicine,Hangzhou 310003,China | 2011 | Hepatobiliary & Pancreatic Diseases International2011，10，2： | 17 |
| 7 | Enteral supplementation with glycyl-glutamine improves intestinal barrier function after liver transplantation in rats显示文摘BACKGROUND:Most patients after liver transplantation (LT) suffer from intestinal barrier dysfunction.Glycyl-glutamine (Gly-Gln) by parenteral supplementation is hydrolyzed to release glutamine,which improves intestinal barrier function in intestinal injury.This study aimed to investigate the effect of GlyGln by enteral supplementation on intestinal barrier function in rats after allogenetic LT under immunosuppressive therapy.METHODS:Twelve inbred Lewis rats were selected randomly as donors,and 24 inbred Brown Norway (BN) rats as recipients of allogenetic LT.The recipients were divided into a control group (Ala,n=12) and an experimental group (Gly-Gln,n=12).In each group,6 normal BN rats were sampled for normal parameters on preoperative day 3.The 6 recipients in the control group received alanine (Ala) daily by gastric perfusion for 3 preoperative days and 7 postoperative days,and the 6 recipients in the experimental group were given Gly-Gln in the same manner.The 12 BN recipients underwent orthotopic LT under sterile conditions after a 3-day fast and were given immunosuppressive therapy for 7 days.They were harvested for sampling on postoperative day 8.The following parameters were assessed:intestinal mucosal protein content,mucosal ultrastructure,ileocecal sIgA content,portal plasma levels of endotoxin and TNF-α,and bacterial translocation.RESULTS:All recipients were alive after LT.On preoperative day 3,all parameters were similar in the two groups.On postoperative day 8,all parameters in the two groups were remarkably changed from those on preoperative day 3.However,compared to the Ala group,supplementation withGly-Gln increased the levels of intestinal mucosal protein and ileocecal sIgA,improved mucosal microvilli,and decreased portal plasma levels of endotoxin and TNF-α as well as bacterial translocation.CONCLUSION:Enteral supplementation with Gly-Gln improved intestinal barrier function after allogenetic LT in rats. | Jian-Wen Jiang,Zhi-Gang Ren,Lu-Yan Chen,Li Jiang,Hai-Yang Xie,Lin Zhou and Shu-Sen Zheng Key Laboratory of Combined Multi-organ Transplantation,Ministry of Public Health Department of Hepatobiliary and Pancreatic Surgery,First Affiliated Hospital,Zhejiang University School of Medicine,Hangzhou 310003,China | 2011 | Hepatobiliary & Pancreatic Diseases International2011，10，4： | 17 |
| 8 | Postreperfusion syndrome during orthotopic liver transplantation:a single-center experience显示文摘BACKGROUND: Marked hemodynamic alteration, commonly referred to as postreperfusion syndrome (PRS), often occurs after revascularization of the donor organ during orthotopic liver transplantation (OLT) and is associated with poor outcomes. This study aimed to investigate the incidence, predictive factors and clinical outcomes of PRS in Chinese patients following OLT at a liver transplantation center in China. METHODS: Over a 5-year period, 330 consecutive patients who had undergone OLT for hepatocellular carcinoma or cirrhosis were included in this retrospective study. PRS was defined as a >30% decrease in the mean arterial pressure compared with that before revascularization for more than 1 minute during the first 5 minutes of graft reperfusion. The patients were divided into 2 groups according to the development of PRS: group 1 (patients with PRS, n=56) and group 2 (patients without PRS, n=274). The demographic characteristics, operative and postoperative courses, and outcomes of the patients were analyzed using SPSS version 18.0. RESULTS: Multivariate regression analysis showed that left ventricular diastolic dysfunction determined by echocardiography and prolonged cold ischemia time were the independent risk factors for PRS. More patients in group 1 showed postoperative renal dysfunction than those in group 2 (19.23% vs 8.4%). Moreover, patients in group 1 also had higher intraoperative (7.14% vs 0%) and postoperative mortalities (26.92% vs 12.04%).CONCLUSION: Left ventricular diastolic dysfunction and prolonged cold ischemia time contribute to a high incidence of PRS, which is associated with adverse outcomes in Chinese patients following OLT. | Zhen-Dong Xu, Hai-Tao Xu, Hong-Bin Yuan, Hao Zhang, Rui-Hua Ji, Zui Zou, Zhi-Ren Fu and Xue-Yin Shi Department of Anesthesiology, Huashan Hospital, Fudan University, Shanghai 200040, China Department of Anesthesiology Organ Transplantation Center , Changzheng Hospital, Second Military Medical University, Shanghai 200003, China | 2012 | Hepatobiliary & Pancreatic Diseases International2012，11，1： | 15 |
| 9 | Prognostic factors in the surgical treatment of caudate lobe hepatocellular carcinoma显示文摘AIM:To evaluate the short-and long-term outcomes of liver resection for caudate lobe hepatocellular carcinoma (HCC).METHODS:We retrospectively analyzed 114 consecutive patients with HCC,originating from the caudate lobe,who underwent resection between January 2001 and January 2007.Univariate and multivariate analyses were performed on several clinicopathologic variables to determine the factors affecting long-term outcome and intrahepatic recurrence.RESULTS:Overall mortality and morbidity were 0% and 18%,respectively.After a median follow-up of 31 mo (interquartile range,11-66 mo),tumor recurrence had occurred in 76 patients (66.7%).The 1-,3-,and 5-year disease-free survival rates were 65.7%,38.1%,and 18.4%,respectively.The 1-,3-,and 5-year overall survival rates were 76.1%,54.7%,and 31.8%,respectively.Univariate analysis showed that subsegmental location of the tumor (45.7% vs 16.2%,P=0.01),liver cirrhosis (12.3% vs 47.9%,P=0.03),surgical margin (18.5% vs 54.6%,P=0.04),vascular invasion (37.9% vs 23.2%,P=0.04) and extended caudate resection (42.1% vs 15.4%,P=0.04) were related to poorer long-term survival.Multivariate analysis showed that only subsegmental location of the tumor,liver cirrhosis and surgical margin were significant independent prognostic factors.CONCLUSION:Hepatectomy was an effective treatment for HCC in the caudate lobe.The subsegmental location of the tumor,liver cirrhosis and surgical margin affected long-term survival. | Peng Liu,Jia-Mei Yang,Wen-Yang Niu,Tong Kan,Feng Xie,Dian-Qi Li,Ye Wang,Yan-Ming Zhou,Department of Special Treatment and Liver Transplantation,Eastern Hepatobiliary Surgery Hospital,Second Military Medical University,Shanghai 200438,China Peng Liu,Department of Hepatobiliary Surgery,Navy General Hospital,Beijing 100037,China | 2010 | World Journal of Gastroenterology2010，16，9： | 15 |
| 10 | Adenovirus-mediated CTLA4Ig gene inhibits infiltration of immune cells and cell apoptosis in rats after liver transplantation显示文摘AIM: To investigate the role of adenovirus-mediated CTLA4Ig gene therapy in inhibiting the infiltration of macrophages and CD8+T cells and cell apoptosis after liver transplantation. METHODS: The rat orthotopic liver transplantation model was applied. The rats were divided into three groups: group I: rejection control (SD-to-Wistar); group Ⅱ: acute rejection treated with intramuscular injection of CsA 3.0 mg/(kg·d) for 12 d (SD-to-Wistar+CsA); groupⅢ: injection of 1×10^9 PFU adenovirus-mediated CTLA41g gene liquor in dorsal vein of penis 7 d before liver transplantation (SD-to-Wistar+CTLA4Ig). Immunohistochemistry and transferase-mediated dUTP nick-end labeling (TUNEL )were used to analyze the expression of CTLA4Ig gene in liver, infiltration of macrophages and CD8+T cells, cell apoptosis in grafts at different time-points after liver transplantation. Histopathological examination was done. RESULTS: CTLA4Ig gene expression was positive in liver on d 7 after administering adenovirus-mediated CTLA4Ig gene via vein, and remained positive until day 60 after liver transplantation. Infiltration of macrophages and CD8+T cells in CTLA4Ig-treated group was less than in rejection control group and CsA-treated group. The apoptotic index of rejection group on d 3, 5, and 7 were significantly higher than that of CTLA4Ig-treated group. A good correlation was found between severity of rejection reaction and infiltration of immune activator cells or cell apoptotic index in grafts. CONCLUSION: CTEA4Ig gene is constantly expressed in liver and plays an important role in inducing immune tolerance, | Guo-Ping Jiang, Zhen-Hua Hu, Shu-Sen Zheng, Chang-Ku Jia, Ai-Bin Zhang, Wei-Lin Wang, Department of Hepatobiliary Pancreatic Surgery, Key Laboratory of Combined Multi-Organ Transplantation, Ministry of Public Health, The First Affiliated Hospital, College of Medicine, Zhejiang University, 79 Qingchun Road, Hangzhou 310003, Zhejiang Province, China | 2005 | World Journal of Gastroenterology2005，11，7： | 14 |
| 11 | Impact of personality and coping mechanisms on health-related quality of life in liver transplantation recipients显示文摘With the great development of liver transplantation in China, long survival and quality of life after liver transplantation have been matters of growing interest. This study was designed to investigate the impact of personality and coping skills on the quality of life after liver transplantation. METHODS:Fifty-five outpatients who had been followed up after liver transplantation at our center were assessed by general quality of life inventory (GQOLI-74 ), a medical coping modes questionnaire (MCMQ), an eysenck personality questionnaire (EPQ), and a general condition questionnaire (GCQ). RESULTS: The score for material well-being was the lowest (63.22±12.67) and for psychological well-being the highest (73.43±12.60) in 4 dimensions of the GQOLI in post transplantation patients. Their main coping method was confrontation (21.40±3.70). The main characteristics of their personality were extraversation (E score 12.96±4.13) and neuroticism (N score 8.20±4.90) . The total score of the GQOLI was positively correlated with confrontation and E score, and it was negatively correlated with acceptance and N score. The physical well-being positively associated with the E score. The psychological well-being was positively correlated with confrontation and L score, and was negatively correlated with acceptance, P and N score. Social well-being was positively correlated with confrontation and E score, and was negatively correlated with acceptance and N score. Material well-being was not correlated with coping methods and personality. CONCLUSION:The quality of life in post liver transplantation patients is associated with their psychological characteristics. | Sai-Jun Zhang, Li-Hua Huang, Yan-Ling Wen, Zhen-Hua Hu, Jing Jin, Li-Hua Shen and Li-Xia Cai Liver Transplantation Center, First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China | 2005 | Hepatobiliary & Pancreatic Diseases International2005，4，3： | 13 |
| 12 | Liver transplantation for patients with hepatolithiasis显示文摘Because of its complicated pathological features such as repeated cholangitis and multiple operations, hepatolithiasis is difficult to treat and often lead to portal hypertension, and liver failure. The aim of this study was to investigate the indications of orthotopic liver transplantation ( OLT) for patients with hepatolithiasis and the improvement of operative techniques and the treatment of postoperative complications. METHODS:The data of 4 patients with hepatolithiasis who had undergone OLT at our department in recent years were reviewed retrospectively. RESULTS:The 4 patients with hepatolithiasis complicated with secondary biliary cirrhosis in end-stage liver disease included 1 woman and 3 men. One patient underwent OLT using veno-venous bypass prior to the mobilization of the liver. Two patients were subjected to liver transplantation with improved piggyback technique without bypass. One patient received OLT without bypass. All patients were operated on successfully and recovered uneventfully. Patient 1 had bleeding from the digestive tract on the postoperative day 6. Patient 2 had hemorrhage from the digestive tract and a leakage of end-to-side intestinal anastomosis on the postoperative day 44. Patient 4 was reoperated on because of hemorrhage from the anastomotic stoma of the hepatic artery on the postoperative days 8 and 10. In the 4 patients the mean operative time was 7.9 hours and blood loss was 910 ml. Postoperative pathological analysis revealed biliary liver cirrhosis. Follow-up of all patients showed good conditions. CONCLUSIONS:Hepatolithiasis with secondary biliary liver cirrhosis in patients with end-stage liver disease is indicated for liver transplantation. Veno-venous bypass prior to the mobilization of the liver and improved piggyback tech- nique can lower the incidence of intraoperative bleeding, the duration of surgery and postoperative complications. | Guang-Dong Pan, Lu-Nan Yan, Bo Li, Shi-Chun Lu, Yong Zeng, Tian-Fu Wen, Ji-Chun Zhao, Nan-Sheng Cheng, Yu-Kui Ma, Wen-Tao Wang, Jia-Yin Yang and Zhi-Hui Li Center of Liver Transplantation, West China Hospital, Sichuan University, Chengdu 610041 , China | 2005 | Hepatobiliary & Pancreatic Diseases International2005，4，3： | 13 |
| 13 | Apoptosis and proliferation of intrahepatic bil educt after ischemia-reperfusion injury显示文摘BACKGROUND: In orthotopic liver transplantation, ische-mic-reperfusion is one of the most important factors thatcause the incidence of biliary complicance. The aim of thisstudy was to investigate the effects of ischemia reperfusionon epithelial cells apoptosis and proliferation of intrahepaticbile duct (IBD) (>20 μm).METHODS: 30-minute warm ischemia was applied to ratlivers respectively, and experiment was performed on days2,7, 14, 28 after reperfusion. Apoptosis was determined insitu by morphology and TUNEL, and cholangiocyte proli-feration was evaluated in situ by morphometry of liver sec-tions stained for cytokeratin-19 ( CK-19) and by prolifera-ting cellular nuclear antigen staining in liver sections.RESULTS: Two days after ischemia reperfusion, apoptosisof cells was observed in large intrahepatic bile ducts (>20μm) (5.6%±1.2%) , but the number of large intrahepaticbile ducts reduced (0.32 ±0.06). Seven days after ischemiareperfusion, the apoptosis index of cholangiocytes de-creased to 1.2%±0.3%, and the number of intrahepatic bileducts began to proliferate and returned to nearly normal onday 28.CONCLUSION: Ischemia reperfusion causes a decrease inthe number of intrahepatic bile ducts (>20 μm) as a resultof a higher rate of apoptosis and absence of initial prolifera-tion. | Wen-Hui Xu, Qi-Fa Ye and Sui-Sheng Xia Institute of Organ Transplantation, Tongji Hospital,Tongji Medical College, Huazhong University of Science and Technology,Wuhan 430030, China | 2004 | Hepatobiliary & Pancreatic Diseases International2004，3，3： | 13 |
| 14 | Enteral feeding of glycyl-glutamine dipeptide improves the structure and absorptive function of the small intestine after allogenetic liver transplantation in rats显示文摘BACKGROUND: Recipients of liver transplantation could have postoperative structural injury and declined absorptive function in the gastrointestinal tract. Glutamine (Gln) is a special nutrient of small intestinal mucosa and of various kinds of cells proliferating rapidly. But Gln could form a kind of poisonous pyroglutamic acid in water solution, which is the limitation of Gln in clinical practice. Glycyl-glutamine (Gly-Gln) is highly soluble and can be hydro-lyzed to release glutamine. This study was undertaken to observe the effect of Gly-Gln dipeptide by enteral feeding on the intestinal structure and absorptive function after allogenetic liver transplantation in rats. METHODS: Twelve male inbred Lewis rats were selected randomly as donors, and 24 male inbred BN rats as recipients of allogenetic liver transplantation. The recipients were also randomly divided into two groups; control group (ALA group, n = 12 ) and experimental group ( GLN group , n =12). In each group, 6 normal BN rats were sampled as the normal parameter on the 3rd preoperative day. The 6 recipients in the control group received alanine 0. 6 g/kg daily for 3 days before operation and 7 days after operation by gastric perfusion, and the 6 recipients in the experimental group were given Gly-Gln 0.6 g/kg daily the same way. The 12 BN recipients underwent 3-day fasting (free access to water with 0. 23% sodium chloride) and ortho-topic liver transplantation in aseptic conditions and were given subcutaneous injection of CsA 2 mg/kg daily after the operation. The 12 BN recipients were sampled on the 8th postoperative day. All of the 24 BN rats were subjected to examination of mucosal structure, activities of Na + -K + - ATP and disaccharidase, and D-xylose absorption test. RESULTS: The 12 BN recipients were alive after liver transplantation. On the 3rd preoperative day, mucosal structure , activities of Na + -K -ATP and disaccharidase and D-xylose absorption in the two groups were not significantly different. On the 8th postoperative day, the parameters of the two groups were markedly changed compared with those on the 3rd preoperative day. However, the parameters of GLN group were remarkably higher than those of ALA group. CONCLUSION: Enteral feeding of Gly-Gln could improve the structure and absorptive function of the small intestine after liver transplantation in rats. | Jian-Wen Jiang, Shu-Sen Zheng, Fei Xue, Iiang-Hui Gao, Guo-Ping Jiang and Hai-Yang Xie Department of Hepatobiliary Pancreatic Surgery, Key Lab of Combined Multi-organ Transplantation, Ministry of Public Health, First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China | 2006 | Hepatobiliary & Pancreatic Diseases International2006，5，2： | 11 |
| 15 | Effect of 1,25-dihydroxyvitamin D3 on preventing allograft from acute rejection following rat orthotoic liver transplantation显示文摘AIM: To study the mechanism and the preventive role of 1,25-dihydroxyvitamin D3 in acute rejection following orthotopic liver transplantation.METHODS: Rats were randomly divided as donors or recipients for orthotopic liver allotransplantation model. Four groups were designed in the study, Group Ⅰ: syngenic control (Wistar to Wistar); Group Ⅱ: acute rejection (SD to Wistar);Group Ⅲ: acute rejection treated with cyclosporine A, and Group Ⅳ: acute rejection treated with 1,25-(OH)2D3. Liver function, rejection activity index and mRNA of IFN-γ, IL-10intragraft in recipients were measured on day t, 5, 7, 15,30 posttransplant for assessing graft function, severity of acute rejection and immune state of recipients.RESULTS: Survival time of recipients in Group Ⅳ was significantly prolonged (4/6 recipients survived for over 100days. vs Group Ⅱ, P<0.001; vs Group Ⅲ, P>0.05). After treatment with 1,25-(OH)2 D3, mean value of all the assay tested on each experimental time was compared, liver function in group Ⅳ was significantly improved (AST 127±41U/L-360±104 U/L, BIL 13±5 mmol/1-38±11 mmol/l; vs Group Ⅱ, P<0.05; vs Group Ⅲ, P>0.05. Rejection activity index was significantly decreased (0-3.3±1.6; vsGroup Ⅱ, P<0.05;vsGroup Ⅲ, P>0.05). Level of hepatic IFN-γ, mRNA in group Ⅳ was decreased, while level of hepatic IL-10 mRNA was increased (vs Group Ⅱ, P<0.05; vs Group Ⅲ, P>0.05).CONCLUSION: Our results indicated that 1,25-(OH)2D3induced the secretion of cytokine toward to Th2 type, which would alleviate acute rejection, protect liver function and prolong survival of recipient after orthotopic liver transplantation. | Ai-Bin Zhang Shu-Sen Zheng Chang-Ku Jia Yan Wang Department of Hepatobiliary Pancreatic Surgery,The First Affiliated Hospital of Medicine School,Zhejiang University,Key Lab of Combined Multi-Organ Transplantation,Ministry of Public Health,Hangzhou 310003,Zhejiang Province,China | 2003 | World Journal of Gastroenterology2003，9，5： | 11 |
| 16 | Intramuscular hepatitis B immune globulin combined with lamivudine in prevention of hepatitis B recurrence after liver transplantation显示文摘BACKGROUND: Combined hepatitis B immune globulin (HBIg) and lamivudine in prophylaxis of the recurrence of hepatitis B after liver transplantation has significantly improved the survival of HBsAg positive patients. This study was undertaken to evaluate the outcomes of liver transplantation for patients with hepatitis B virus (HBV). METHODS: A retrospective chart analysis and a review of the organ transplant database identified 51 patients (43 men and 8 women) transplanted for benign HBV-related cirrhotic diseases between June 2002 and December 2004 who had survived more than 3 months. HBIg was administered intravenously during the first week and intramuscularly thereafter. RESULTS: At a median follow-up of 14.1 months, the overall recurrence rate in the 51 patients was 3.9% (2/51). The overall patient survival was 88.3%, and 82.4% after 1 and 2 years, respectively. A daily oral dose of 100 mg lamivudine for 2 weeks before transplantation for 10 patients enabled 57.1% (4/7) and 62.5% (5/8) of HBV-DNA and HBeAg positive patients respectively to convert to be negative. Intramuscular HBIg was well tolerated in all patients. CONCLUSION: Lamivudine combined with intramuscular HBIg can effectively prevent allograft from the recurrence of HBV after liver transplantation. | Mao-Lin Yan, Lu-Nan Yan, Bo Li, Yong Zeng, Tian-Fu Wen, Wen-Tao Wang, Jia-Yin Yang, Ming-Qing Xu, Zhi-Hui Li and Yong-Bing Chen Liver Transplantation Group of Transplantation Center, West China Hospital, Sichuan University, Chengdu 610041, China | 2006 | Hepatobiliary & Pancreatic Diseases International2006，5，3： | 10 |
| 17 | Liver transplantation and artificial liver support in fulminant hepatic failure显示文摘INTRODUCTIONFulminant hepatic failure(FHF)is a severe disease with devastating consequences;the incidence is high in China.Before the availability of liver transplantation,the mortality rate was more than 80%[1,2].The advent of liver transplantation revolutionized the outcome of FHF[3,4].However,many patients were unwilling to accept liver transplantation until very late,hence most of them died because of donor shortage and urgency of the disease[5-7],To overcome he problems,we performed orthotopic liver transplantation(OLT)in combination with artificial liver support(ALS) in the treatment of FHF in the past 2 years with satisfactory results.Our experience was reported below. | Xiao-Feng Zhu Gui-Hua Chen Xiao-Shun He Min-Qiang Lu Guo-Dong Wang Chang-Jie Cai Yang Yang Jie-Fu Huang Transplantation Center,The Affiliated First Hospital,Sun Yat-Sen University of Medical Sciences,510080 Guangzhou,Guangdong Province,China | 2001 | World Journal of Gastroenterology2001，7，4： | 10 |
| 18 | Panax notoginseng saponins preconditioning protects rat liver grafts from ischemia/reper- fusion injury via an antiapoptotic pathway显示文摘BACKGROUND: Ischemia/reperfusion (I/R) injury is a major cause of primary graft dysfunction and renders an al- lograft more immunogenic in orthotopic liver transplanta- tion (OLT). Panax notoginseng saponins (PNS) has been re- ported to exert protective effects against I/R injury to vari- ous organs. The objective of this study is to investigate whether PNS preconditioning protects rat liver grafts from I/R injury via an antiapoptotic pathway. METHODS: Male Sprague-Dawley rats were used as donors and recipients of orthotopic liver transplantation ( OLT) and were divided into PNS preconditioning group (group P) and normal saline control group (group N) randomly according to whether PNS (50 mg/kg) was injected intra- venously 1 hour before liver grafts harvesting, and sham group (group S). The animals were separately killed 2, 6 and 24 hours after reperfusion. Plasma samples were collect- ed for test of alanine amino-transferase (ALT) and aspartate aminotransferase (AST). Liver tissues were collected to de- tect histological changes, apoptosis and the expression of TNF-α, Bcl-2 and Caspase-3 mRNA. RESULTS: The serum levels of ALT and AST and the apop- tosis index (AI) of liver tissue in group P were lower than in group N significantly 2, 6 and 24 hours after reperfusion. Compared with group N, the expression of TNF-a and Caspase-3 mRNA was reduced significantly in group P 2 and 6 hours after reperfusion and the expression of Bcl-2 mRNA was enhanced significantly in group P 6 and 24 hours after reperfusion. CONCLUSIONS: PNS preconditioning protects liver grafts from I/R injury effectively in rat OLT via an antiapoptotic pathway. The antiapoptotic mechanisms of PNS may in- clude inhibiting the expression of TNF-a and Caspase-3 and enhancing the expression of Bcl-2. | Yi Zhang, Qi-Fa Ye, Li Lu, Xian-Lin Xu, Ying-Zi Ming and Jian-Sheng Xiao Wuhan, China Institute of Organ Transplantation, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China Xiangya Transplantation Medical Academy, Third Xiangya Hospital, Xiangya Medi- cal College, Central South University, Changsha 410013, China | 2005 | Hepatobiliary & Pancreatic Diseases International2005，4，2： | 9 |
| 19 | Advances in prophylaxis and treatment of recurrent hepatitis B after liver transplantation显示文摘BACKGROUND: In the 1990s, liver transplantation for hepatitis B virus (HBV) related-liver diseases was a very controversial issue because the graft was inevitably recurrent after liver transplantation. Significant progress has been made in the prophylaxis and treatment of recurrent hepatitis B after liver transplantation. This review covers the mechanisms, prophylaxis, and treatment of hepatitis B recurrent after liver transplantation. DATA SOURCES: Searching MEDLINE (1995-2004) for articles on liver transplantation. RESULTS: HBV reinfection after liver transplantation results from HBV particles in circulation or other extrahepatic sites. Hepatitis B immune globulin ( HBIG) was effective in reducing HBV reinfection and improving graft survival after liver transplantation. Lamivudine has also dramatically reduced the recurrence of HBV in the patient undergoing liver transplantation. CONCLUSIONS: Combination HBIG and lamivudine is the most effective porphylatic regimen. Lamivudine and adefovir are highly effective in treatment of HBV recurrence. HBV-related liver disease is no longer a contraindication for liver transplantation. | Zi-Fa Wang, Zhi-Jun Zhu and Zhong-Yang Shen Tianjin, China Onental Organ Transplantation Center, Tianjm First Central Hospital, Tianjin 300191, China | 2005 | Hepatobiliary & Pancreatic Diseases International2005，4，4： | 9 |
| 20 | Preconditioning effects on expression of proto-oncogenes c-fos and c-jun after hepatic ischemia/reperfusion in rats显示文摘BACKGROUND: Ischemia/reperfusion is the main cause of hepatic damage in liver transplantation. Immediate early genes (IEGs) encode proteins can regulate expression of cellular response genes after injury, and is associated with tissue repair and cell apoptosis. The purpose of this re- search was to investigate the effects of preconditioning on expression of immediate early genes c-fos and c-jun follow- ing hepatic ischemia/reperfusion (IR) and its roles in cellu- lar regeneration and apoptosis. METHODS: Ninety-six Wistar rats were randomly divided into IR group and hepatic ischemic preconditioning (IPC) group, and each group was further divided into eight sub- groups (n =6). The model of partial liver ischemia/reper- fusion was used. The rats were subjected to 60-minute liver ischemia, preceded by 10-minute preconditioning. After 0-, 0.5-, 1-, 2-, 4-, 8-, 12-, 24-hour reperfusion, the se- rum and liver tissue in each group were collected to detect the level of serum ALT/AST, liver histopathology, expres- sion of c-fos, and c-jun mRNA. Flow cytometer was used to detect Ki67 and Sub-G1 as the quantity indicators of cell regeneration and apoptosis respectively. RESULTS: Compared with IR group, IPC group showed a significantly lower ALT/AST level in 0. 5-hour sub-group to 8-hour sub-group (P<0.05). Ki67 elevated significantly at 0.5, 1, 2 hours, but decreased significantly at 24 hours ( P < 0 . 05). Ap index decreased significantly after 1-hour reperfusion(P<0.05). Expressions of c-fos and c-jun mR- NA were low, especially c-jun at 0.5, 1 and 2 hours after reperfusion. CONCLUSION: Ischemic preconditioning can protect liver cells against ischemia/reperfusion injury, and this protec- tive effect may be related to influence transcription levels of c-fos and c-jun. | Jian-Sheng Xiao, Fang-Gang Cai, Ying Niu, Yi Zhang, Xian-Ling Xu and Qi-Fa Ye Wuhan, China Research Institute of Organ Transplantation, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China Department of General Surgery, First Affiliated Hospital, Fujian Medi- cal College, Fuzhou 350005, China and Xiangya Medical Trans- plantation Academy of Central South University, Changsha 410013, China | 2005 | Hepatobiliary & Pancreatic Diseases International2005，4，2： | 8 |
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