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Objective To investigate the protective effect and mechanism of irbesartan and edaravone on the rat liver transplantation model using small-for-size graft during acute phase of reperfusion.MethodsWe used 300 S-D rats for small-for-size graft liver transplantation,and the light rats were used as donors.Survived recipients were divided into five groups according table of random number:group A,control group; group B,edaravone treatment group; group C,irbesartan treatment group; group D,irbesartan and edaravone treatment group; group E,sham operation group.The rat 30％ small-for-size graft model was established.Six rats in each group were sacrificed randomly at 6th and 24th h after reperfusion respectively. The survival rate of animals and portal pressure were investigated.The rats in every group were sacrificed and blood samples were collected for liver function measurement.The contents of SOD and MDA in liver tissues were measured.Fresh liver tissue was used to detect the mRNA expression of Egr-1,ET1 and Bax by RT-PCR. Paraffinembedded liver specimens were used to assay apoptosis (TUNEL).Six rats at each time point in each group were studied.Results(1) One-week survival rate in the groups A,B,C,D and E was 8.33％(1/12),33.3％ (4/12),58.7％ (7/12),83.3％ (10/12),and 100％ (12/12),respectively,P＜0.05; (2) There was significant difference in the portal pressure,ALT,AST,MDA,SOD,Egr-1,ET-1,Bax,and the apoptotic index between treatment groups and control group,especially in the group D,P＜0.05 or P＜0.01.Conclusion Irbesartan and edaravone could protect small-for-size graft in partial liver transplantation probably by reducing portal vein pressure and diminishing ischemia reperfusion injury.The combined use of Irbesartan and edaravone is more effective than irbesartan or edaravone used alone.
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ObjectiveTo investigate the clinical significance of admission hemoglobin (Hb) value for posttransplantation early respiratory complications in cirrhotic hepatocellular carcinoma (HCC) patients undergoing liver transplantation (LT).MethodsBetween April 2001 and February 2010,the medical record of 100 consecutive liver recipients at First Affiliated Hospital of Guangxi Medial University were retrospectively reviewed. Pulmonary complications developed in 45 patients after LT. Using bivariate correlation analysis between the admission Hb value and pulmonary complications screened for the threshold value of admission Hb value affecting early-phase pulmonary complications.According to the threshold value of admission Hb,LT recipients could be divided into two groups. Twenty-seven peri-operative clinical parameters were analyzed in the two groups.ResultsAdmission Hb ≤ 100 g/L was the threshold value affecting postoperative pulmonary complications.The duration of time to initial passage of flatus and the ICU length of stay were significantly prolonged in patients with admission Hb values ≤ 100 g/L,in which poorer arterial blood gas analyses were common. ConclusionsThe admission Hb value of patients with cirrhosisassociated hepatocellular carcinoma affects the early-phase prognosis after LT.
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Objective To assess the efficacy of orthotopic liver transplantation (OLT) for hepatocellular carcinoma (HCC) and the effect of recipient selection on postoperative survival. Methods The clinical data of 63 patients with primary HCC receiving OLT in this hospital from June 2000 to February 2007 were retrospectively analyzed. The cumulative survival rate after transplantation was analyzed by the Kaplan-Meier method. Results The 1-, 3- and 5-year cumulative survival rates of the 63 patients were 77.4%, 59.3%, 48. 9%, respectively. The rates in conformation with Milan criteria, UCSF criteria and beyond UCSF criteria were 93.8%, 80.8%, 80.8%; 92.1%, 79.2%,79.2%; 29.2%, 8.3%, 0, respectively. The 1-, 3-, 5-year cumulative recurrent rate of patients meeting Milan criteria, UCSF criteria and beyond UCSF criteria was 6.2%, 15.5%, 19. 2%; 7. 9%,15.9%, 20. 8% ; 70. 8%, 87. 5%, 91.7%, respectively (P＜0.01). However, tumor recurrence and survival rates were similar for patients meeting UCSF and Milan criteria (P＞0. 05). Conclusion Expansion of OLT criteria is justified for HCC and does not adversely impact the posttransplant prognosis by the UCSF criteria as compared with the Milan criteria.