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Abstract BACKGROUND: Looking for the early diagnosis of acute rejection indicators after liver transplantation can assess the risk after liver transplantation quickly and effectively, and T lymphocytes play the significant role in acute rejection. OBJECTIVE:To observe the relationship between acute rejection and variation of expression of T cel subset in blood after liver transplantation in rhesus monkey. METHODS: The sixteen liver transplant models in rhesus monkey which were constructed successfuly by the method of “double-cuff and one support tube” were divided into two groups randomly: experiment group (no treated by immunosuppressant in perioperative period) and control group (treated by immunosuppressant in perioperative period). Then the blood specimen and liver tissue respectively were colected at 6, 12, 24 and 72 hours after operation. The levels of alanine transferase, aspartate aminotransferase, and total bilirubin were detected with the fuly automatic biochemical analyser. The levels of CD4+/CD8+were tested by flow cytometry. The liver tissue in rhesus monkey after liver transplantation was detected by hematoxylin-eosin staining. The degree of acute rejection was evaluated by Banff Score System. RESULTS AND CONCLUSION: Acute rejection appeared in the experiment group at 12, 24, and 72 hours after liver transplantation. Levels of alanine transferase, aspartate aminotransferase, and total bilirubin were significantly higher in the experimental group than in the control group at 24 and 72 hours after transplantation (P < 0.05). The expression of CD4+/CD8+of the experiment group and control group began to rise at 6 hours after surgery, but the experiment group increased the most obvious. CD4+/CD8+ expression was significantly greater in the experimental group than in the control group at 24 and 72 hours after transplantation (P < 0.05). Morphological pathology was severer, and Banff score was higher in the experiment group than in the control group at 72 hours (P < 0.05). These data suggested that the variation of expression of CD4+/CD8+was earlier than the change of liver tissue pathology and the change of liver function in the early acute rejection after liver transplantation. The rise of level of CD4+/CD8+ after liver transplantation indicated the increase of celular immunity in body, which had an important role in the early diagnosis of acute rejection after liver transplantation.
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BACKGROUND:Nuclear factor-κB as an important nuclear transcription factor, is a converge point for various signal transduction pathways, and participate in the regulation of reactive substances gene expression such as the immune cel proliferation, differentiation and apoptosis. The nuclear factor-κB plays an important role in humoral and cel ular immune. OBJECTIVE:To investigate the relationship between the nuclear factor-κB p65 protein expression and acute rejection in transplanted liver tissue of rhesus monkey. METHODS:The rhesus monkey recipients were randomly divided into two groups:acute rejection group and control group. The acute rejection group did not received anti-rejection treatment after liver transplantation, and the control group was given anti-rejection treatment during and after liver transplantation. The blood samples were col ected at 6, 12, 24 and 72 hours after transplantation, and the automatic biochemical analyzer was used to detect the levels of alanine aminotransferase and total bilirubin. Hematoxylin-eosin staining of transplanted liver tissue was performed to observe the morphological structure and rejection. The degree of rejection was evaluated according to the Banff scoring system, and the expression of nuclear factor-κB p65 in the liver tissue was detected with Western blot. RESULTS AND CONCLUSION:When the acute rejection occurred after liver transplantation, the liver function change was observed after liver histopathological examination, the expression of nuclear factor-κB p65 in the liver tissue was up-regulated, and the degree of acute rejection was increased. In the early stage of acute rejection, the liver function and pathology were changed slightly, while the expression of nuclear factor-κB p65 was significantly increased. The results indicate that the detection of nuclear factor-κB p65 in the transplanted liver tissue has great significance for the early diagnosis of acute rejection after liver transplantation, and the nuclear factor-κB may be the new target for control ing the acute rejection.
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BACKGROUND: Various factors contribute to the establishment of liver transplantation models in rhesus monkey, the rate of successful operation and long-term survival are very low. OBJECTIVE: To analyze the cause of early death following liver transplantation in rhesus monkey. METHODS: Liver transplantation models were fabricated with the classical and modified methods in rhesus monkeys. Operation of donor was performed quickly by a big crucial incision of abdomen. The improved double-cuff of the portal vein and inferior vena cava were finished, in addition to stay pipe of biliary tract in the process of repairing donor liver. Operation of the receptor was performed by classical orthotopic liver transplantation. RESULTS AND CONCLUSION: A total of 25 pairs of rhesus monkeys were successfully for establishing liver transplantation models. Seven rhesus monkeys died within early stage of post-operation, including six out of nine monkeys died by using the classical approach and one out of sixteen monkeys died by using the improved approach. There were five of seven monkeys died of intra-abdominal hemorrhage, one died of primary graft nonfunction and one died of respiratory failure. Results indicated that, the major death cause after classical orthotopic liver transplantation in rhesus monkey is abdominal hemorrhage. The improved methods of liver transplantation apparently reduce the hemorrhage and raise early survival rate following liver transplantation.
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Objective To explore the indication and feasibility of laparoscopic hepatectomy. Methods Clinical data of 6 patients undergoing laparoscopic hepatectomy(LH) were collected and retrospectively anallyzed,5 of them with lesions located in surface or edge of Ⅱ -Ⅵ segment,one of them with lesion in Ⅷ segment. These lesions were 5 - 9.6 cm, the average diameter was (6.64 ± 2.60) cm. There were 4 cases of liver cavernous hemangioma, and 2 case of hepatic focal nodular hyperplasia. The liver functions of 6 cases w ere in Child Pugh A . Results All 6 patients were applied laparoscopic hepatetomy successfully, 5 cases were performed partial resection, 1 case underwent laparoscopic hepatic left lateral lobectomy. The average operation time was( 105.17 ± 27.97 )minutes, and the intraoperative average hemorrhage was (247. 50 ± 90.91 ) mL. All of the lesions were completely removed. There were no postoperative complications such as bile leakage or hemorrhage. All patients recovered well. The average postoperative hospitalization was (4.16 ± 1.60)days: Conclusions Laparoscopic hepatectomy is safe and feasible for lesion located in the edge or sur face of liver and left liver.
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Objective To explore improvement of orthotopic liver transplantation model in rhesus monkey.Methods Healthy rhesus monkeys were chosen to perform orthotopic liver transplantation for 10 cases.The model was established by drawing on a variety of animal model methods,and the portal vein cuff method was used to establish stable model of orthotopic liver transplantation in rhesus monkeys.Results Ten orthotopic liver transplantation models in rhesus were performed,and the achievement ratio of operation was 10/10.The time of donor hepatectomy and donor preparation was (20?5) min and (30?7) min,respectively.The operation time of recipient and anhepatic phase were (180?35) min and (17?4) min,respectively.After 24 h of operation 9 cases survived,one case died of intra-abdominal hemorrhage after 9 h of operation.After 72 h of operation 8 cases survived,and one case died of upper gastrointestinal bleeding after 38 h of operation.After one week of operation 5 cases survived,and 3 cases died of rejection after 9,11,and 11 d of operation,respectively.The longest survival time was 32 d,but all of them also died of rejection.No portal vein thrombosis and biliary complications were found in all recipients.Conclusion The improved rhesus monkey model of orthotopic liver transplantation is easy to perform with high achievement ratio of operation.It is an ideal animal model for pre-clinical studies of liver transplantation.