ABSTRACT
Objective To explore the liver transplantation in end stage liver disease with portal vein thrombosis (PVT). Methods Computer Tomography and color Doppler examinations were performed on the recipients to be subject to liver transplantation. Four male cases were found having PVT, received orthotopic liver transplantation and thrombectomy. Cell Saver auto transfusion blood and venous by-pass was also conventionally used. By reason of one case with residual thrombosis, a catheter with heparin cap was inserted into the branch of superior mesentery vein, followed by perfusion of urokinase for thrombus dissolution. Anti-coagulation treatments with low molecule heparin and Prostaglandtin E1 after operation were carried on in all of the patients. Results Surgical management of PVT were successful only one time in 3 patients. One patient with PVT extending over the entrance of spleen vein and left and right portal vein branches had portal vein residual thrombosis postoperation. After dissolution and anti-coagulation for 28 days, the residual thrombus disappeared. One cured patient with PVT died 48 days after operation from lung infection due to multiocular effusion resulting from chest cavity bleeding after pleuracentesis, and other 3 patients were cured in 2 months. Conclusion The PVT is not an absolute contraindication to liver transplantation; Thrombectomy combined with thrombus dissolution and anticoagulation can cure PVT; Prevention of bleedings in the patients with PVT is very importance postoperation.
ABSTRACT
Objective To investigate the reversal of the multidrug resistant gene mdr1 in vivo by antisense oligodeoxynucleotide (ASODN) on the basis of study in vitro. Methods The cultured drug-resistant human hepatocellular carcinoma cells were injected under the skin of axilla to establish the tumor model of nude mice. mdr1 ASODN accompanied by Lipofectamine were injected locally and ADM was injected intraperitoneally. Control 1 and control 2 were locally injected by Lipofectamine and normal saline separately, and ADM was also injected intraperitoneally. Results As time went on the tumor size increased and from the 5th day on alterations were marked, tumor size in different time phase showed marked difference to the prior time phase with significant difference (P 0.05). The results suggested that SODN and Lipofectamine showed no marked effect on tumor growth of nude mice and ASODN had marked inhibition effect on tumor growth.Conclusion mdr1 ASODN can also reverse multidrug resistance of drug-resistant human hepatocellular carcinoma cells in vivo. After the treatment the tumor’s growth in nude mice will slow down in a range of time.