ABSTRACT
<p><b>OBJECTIVES</b>To summarize the results of liver transplantation for various end-stage liver diseases at the Sun Yat-Sen University of Medical Sciences (SUMS), define the role of liver transplantation in the treatment of hepatocellular carcinoma and fulminant hepatitis B, and assess the efficiency of lamivudine on preventing HBV recurrence.</p><p><b>METHODS</b>Seventy liver transplants performed at the SUMS between April 1993 and December 2000 were retrospectively analyzed. The main indications for liver transplant were hepatocellular carcinoma (26 cases), liver cirrhosis (21 cases), fulminant hepatitis B (12 cases), sclerosing cholangitis (4 cases) and other terminal liver diseases (7 cases). Lamivudine was used in twelve patients suffering from fulminant hepatitis B. Logistic multivariate regression analysis was applied to determine the risk factors predicting liver transplantation outcomes.</p><p><b>RESULTS</b>Fifty-four patients survived for more than one month, and 16 patients died within 30 days after orthotopic liver transplantation (OLT). The overall hospital survival rate was 77.1%. The hospital survival rates in the Child's A and B patients were 87.5% and 83.3%, respectively. Those rates were superior to those of the Child's C patients (P < 0.05). The outcome of patients with small hepatocellular carcinoma (HCC) was superior to that of patients with large HCC. Preoperative APACE III scores, the severity of ascites and serum creatine level had independent influence on outcome. Of the patients with fulminant HBV infection, 9 recipients survived for a follow-up period of 2 - 24 months. Treatment with lamivudine monotherapy was both well tolerated and efficacious in patients with fulminant hepatitis B.</p><p><b>CONCLUSIONS</b>The results indicate that orthotopic liver transplantation could provide long-term cure and palliation for patients with HCC, and that patient selection is extremely important in predicting outcome. The results support the continued application of liver transplantation as a therapeutic modality for various end-stage liver diseases and that lamivudine is an effective and safe monotherapy in OLT for patients with HBV infection.</p>
Subject(s)
Adolescent , Adult , Child , Child, Preschool , Female , Humans , Infant , Male , Middle Aged , Carcinoma, Hepatocellular , Mortality , General Surgery , China , Cholangitis, Sclerosing , Mortality , General Surgery , Follow-Up Studies , Hepatitis B , Mortality , General Surgery , Liver , Pathology , General Surgery , Liver Cirrhosis , Mortality , General Surgery , Liver Neoplasms , Mortality , General Surgery , Liver Transplantation , Schools, Medical , Survival Rate , Treatment OutcomeABSTRACT
【Objective】To investigate the relationship between the expression of lymphocyte function-associated antigen-1 (LFA-1) on peripheral lymphocytes and acute rejection after orthotopic liver transplantation (OLTx) in rat.【Methods】Adult male rats were divided into 2 groups.In the non-rejection group,40 SD rats were used as both donors and recipients.In the rejection group,20 Wistar rats were used as donors and 20 SD rats as recipients.Blood samples were collected through the tail vein 1 day before transplantation and on days 1、3、5、7 after OLTx.The expression of LFA-1 (CD11a) on peripheral lymphocytes was analyzed by using indirect immunofluorescent marker-flow cytometry.【Results】The expression level of LFA-1 on peripheral lymphocytes in recipient rats after orthotopic liver transplantation was markedly lower than that before operation (P<0.01);The expression level of LFA-1 on peripheral lymphocytes in rats with acute liver rejection was significantly higher than that in the non-rejection group (P<0.01).【Conclusion】Monitoring the expression level of LFA-1 on peripheral lymphocytes may be helpful to the diagnosis of acute graft rejection.
ABSTRACT
Objective To investigate the relationship between the intercellular adhesion molecule-1(ICAM-1) and lymphocyte function associated with antigen-1( LFA-1) and acute rejection of liver transplantation in rats. Methods SD rats and Wistar rats were randomly divided into normal control group, isograft group, and allograft group. Liver biopsies from the recipients were obtained on the day 2,4, and 7 postoperatively to examine the expression level of ICAM-1 and LFA-1 in liver grafts. Samples were firstly stained with specific monoclonal antibodies using immunohistochemistry stain and then applied to image semiquantitive analysis. Results The expression levels of ICAM-1 and LFA-1 in allograft group were obviously higher than those in both isograft group and normal group. Moreover, the expression levels of ICAM-1 and LFA-1 were correlated positively with the degree of acute liver rejection. Conclusions Detecting the expressions of ICAM-1 and LFA-1 in liver graft tissue may be helpful to the diagnosis of acute rejection after liver transplantation.