ABSTRACT
<p><b>BACKGROUND</b>Since January 2002, adult-to-adult living donor liver transplantation (AALDLT) has gained increasing popularity in China in response to the shortage of cadaveric donor livers. This study presents a detailed analysis of the outcomes of AALDLT in a single center.</p><p><b>METHODS</b>A total of 70 patients underwent AALDLT at our center between January 2002 and January 2007. Among these, 67 patients received a right lobe graft without the middle hepatic vein and 3 patients received dual grafts. Three-dimensional volumetric computed tomography, magnetic resonance imaging with angiography and cholangiography were performed preoperatively. Recipient operation time, intraoperative transfusion requirement, length of intensive care unit stay, length of hospital stay, liver function tests, coagulation tests and surgical outcomes were routinely investigated throughout this study.</p><p><b>RESULTS</b>All donors survived the procedure with an overall complication rate of 15.3%. Overall recipient 1-year survival and complication rates were 87.1% and 34.2%, respectively. Among the 70 cases, average graft recipient weight ratio was 0.94% (0.72% - 1.43%) and average graft volume/standard liver volume ratio was 46.42% (31.74% - 71.68%). All residual liver volumes exceeded 35%. Liver function and coagulation recovered rapidly within the first 7 days after transplantation.</p><p><b>CONCLUSIONS</b>AALDLT is a safe procedure for the donors and an effective therapy for patients with end-stage liver disease. Patient selection and timely decision-making for transplantation are essential in achieving good outcomes. With accumulation of experience in surgery and clinical management, timely feedback and proper modification, we foresee better outcomes in the future.</p>
Subject(s)
Adolescent , Adult , Aged , Female , Humans , Male , Middle Aged , Young Adult , Liver Transplantation , Methods , Living Donors , Treatment OutcomeABSTRACT
<p><b>OBJECTIVE</b>To detect the expression of liver-type fatty acid-binding protein (L-FABP) and vascular endothelial growth factor (VEGF) in human hepatocellular carcinoma (HCC) and its adjacent liver tissues, and investigate the correlation between the expressions of L-FABP and VEGF and their role in the occurrence and progression of HCC.</p><p><b>METHODS</b>Reverse transcriptase-polymerase chain reaction (RT-PCR) and immunohistochemical (IHC) staining were employed to examine the expression of L-FABP and VEGF in HCC and its adjacent liver tissues obtained from the surgical specimens of 61 HCC patients who underwent liver resections in West China hospital.</p><p><b>RESULTS</b>The results of RT-PCR showed that the expression level of L-FABP and VEGF in HCC was significantly higher than that in its adjacent liver tissues (L-FABP: 0.97-/+0.12, 0.83-/+0.14, t=5.21, P<0.05; VEGF: 0.92-/+0.11, 0.59-/+0.15, t=11.79, P<0.05). L-FABP tended to co-express with VEGF (P<0.05). IHC staining revealed that the expression of L-FABP and VEGF was mainly located in the cytoplasm, and the gray scale of L-FABP expression was significantly higher than that in the adjacent liver tissues (92.73-/+7.67, 82.83-/+6.90, t=7.44, P<0.05). The number of L-FABP- and VEGF-positive cells in HCC was significantly lower than that in the adjacent liver tissues (L-FABP: 92.18-/+4.44, 84.52-/+6.43, t=5.94, P<0.05; VEGF: 88.69-/+5.56, 77.64-/+5.93, t=8.72, P<0.05). Co-expression of L-FABP and VEGF observed in RT-PCR and also in IHC (P<0.05).</p><p><b>CONCLUSION</b>Both L-FABP and VEGF expressions are up-regulated in HCC. L-FABP gene may be involved in the carcinogenesis of human HCC. Expression of L-FABP is associated with VEGF expression, suggesting that L-FABP promotes the growth of blood vessels by taking up the fatty acids from the bloodstream, and both of them produce a marked effect on energy metabolism in HCC.</p>