ABSTRACT
Objective To systematic evaluation the therapeutic effects on patients with ABO-incompatibility liver transplantation (ILT),and compare the curative effect with ABO-compatible liver transplantation (CLT). Methods The literatures of comparison in clinical efficacy between ILT and CLT were collected at home and abroad by computer search in PubMed database,Embase database,Cochrane database,Medline database,Web of science database,CNKI,Wanfang database,VIP database,et al,and the quality of literatures were accessed. Meta analysis was carried out by fixed effect model and random effect model with RevMan5.3 software. Results A total of 18 papers were included. The results of Meta analysis showed that there was no significant difference in the survival rates of recipient between ILT group and CLT group at 1 ,3 and 5 years after operation (all P>0.05 ). Compared with CLT group,the survival rates of grafts were significantly decreased in ILT group at 1 ,3 and 5 years after operation,and the difference was statistically significant (all P<0.05 ). The incidences of postoperative biliary complication and acute rejection in ILT group were significantly higher than those in CLT group,the difference was statistically significant (both P<0.05 ). Conclusions Compared with CLT, the curative effect of ILT is weaker but still can be used as a new choice for critical condition of the recipient or waiting for the donor liver for a long time.
ABSTRACT
Pancreatic head carcinoma could easily invade the neighboring vessels due to its own biological features and anatomical location,which increases the technique difficulty and risk,leading to low resection rate.Recently,with the progress on the surgical techniques and perioperative management,and the emergence of neoadjuvant chemoradiation,vascular invasion is no longer the surgical contraindications and pancreaticoduodenectomy combined with vascular resection has saved many patients ' lives.However,the preoperative assessment,the timing of surgery,the vessel management during the surgery,and the prevention and treatment of the postoperative complications remain controversial.In order to achieve a clear understanding on the application of pancreaticoduodenostomy combined with vascular resection,here we review the recent publications and share the experiences on pancreaticoduodenectomy with portal and/or superior mesenteric vein resection from our center,which may help improve the safety and resection rate of pancreatic carcinoma and enhance the overall therapeutic efficacy of treating pancreatic cancer.
ABSTRACT
Acute rejection is one of the serious early postoperative complications after liver transplantation.Many studies have shown that acute rejection was mainly mediated by T cells,while humoral factors were responsible for chronic rejection.However,accumulating evidences have demonstrated that humoral immune factors also played an important role in early acute rejection and usually resulted in severe adverse events.Here we clarify the role of humoral immunity in liver transplant rejection,which may help guide the clinical management of such patients with humoral rejection after liver transplantation.