Comparison of the metastatic characteristics of HCCLM3 cells and SMCC-7721 cells in nude mice model / 中华肝脏病杂志

<p><b>OBJECTIVE</b>To compare the metastatic characteristics of HCCLM3 cells and SMCC-7721 cells in nude mice model.</p><p><b>METHODS</b>Nude mice were divided into two groups (n = 8, each), mice were transplanted with HCCLM3 cells (group A) and SMMC-7721 cells (group B). Tumor size, metastasis rate and other clinical parameters were compared between the two groups. Statistical analysis was performed with the help of SPSS 16.0 for Windows computer software (SPSS, Inc., Chicago, IL). P values of less than 0.05 were considered statistically significant.</p><p><b>RESULTS</b>Intrahepatic metastases rate was 100% (8 / 8), mean intrahepatic primary tumor volume was (6954+/-1945) mm(3) in group A, Intrahepatic metastases rate was 62.5% (5/8), and mean intrahepatic primary tumor volume was (6034+/-2035) mm(3) in the group B. There was no statistical difference in the primary liver tumor size and intrahepatic metastases rate (P = 0.20; t = 6.38, P = 0.37, respectively). The numbers of intrahepatic metastases and the involved lobes, and the volume of tumor were 4.5 (median), 3, and 975 mm(3) (median) respectively, in group A, and these were 1 (median), 1 and 274 mm(3) (median) respectively in group B. The difference between two groups was statistically significant (Z values, -2.818, -2.289, and -1.975, respectively).The rate of lung metastasis and other organ metastasis in the A group was significantly higher than that in group B (P less than 0.001, P less than 0.041, respectively).</p><p><b>CONCLUSION</b>HCCLM3 cells have higher metastatic potential than SMMC-7721 cells in nude mice.</p>

Analysis of risk factors for marginal donors in living donor liver transplantation / 中华肝脏病杂志

<p><b>OBJECTIVE</b>To analyze risk factors of marginal donors in living donor liver transplantation.</p><p><b>METHODS</b>98 living donor liver transplantation (LDLT) patients over the 7-year period from 2001 to 2007 in our transplantation center were retrospected. Potential risk factors, including donor age, gender-mismatch, steatotic donors and graft-recipient weight ratio (GRWR), and their relationship with 6-month patient survival rate were analyzed.</p><p><b>RESULTS</b>The 4 patients received livers with more than 30% steatosis died within 6 months, and 6-month survival rate was 91.7% in patients received livers with less than 30% steatosis. The 6-month survival rate was 86.9% and 87.8% in patients with grafts of GRWR more than 0.8% and in patients with graft of GRWR less than 0.8%, respectvely (x2=0.022, P more than 0.05), however, middle hepatic vein reconstruction significantly affected the survival rate of small-size-liver recipients (x2=10.612, P less than 0.01). Donor age and gender-mismatch were not associated with the survival rate of recipients (P more than 0.05).</p><p><b>CONCLUSIONS</b>Steatosis is an important risk factor in living donor liver transplantation. Lower GRWR is not a limitation but we must reconsider its importance in liver transplantation. The donor age and gender-mismatch are not associated with the survival rate of recipients.</p>

Feasibility of small size graft following living donor liver transplantation / 中华外科杂志

<p><b>OBJECTIVE</b>To analyze the complication rate and survival rate of the patients whose graft-recipient weight ratio (GRWR) less than 0.8% following living donor liver transplantation (LDLT).</p><p><b>METHODS</b>There were 92 consecutive LDLT patients from January 2001 to December 2007 in West China Hospital, Sichuan University. There were 85 males and 7 females aged from 18 to 65 years old (averaged, 42 years old) and among which 89 patients were involved in the study. There were 15 patients whose GRWR less than 0.8% (group 1), while other 74 recipients were in group 2. Comparing the two groups' complication rates and survival rates and finding out the potential influencing factor of small-size-graft recipients' survival rate.</p><p><b>RESULTS</b>The survival rates of group 1 and group 2 were 73.3% (11/15) and 71.6% (53/74), respectively. The grade II-V complication rates of group 1 and group 2 were 46.7% (7/15) and 48.6% (36/74), respectively. There were no difference in survival rates (chi(2) = 0.058, P = 0.811) and complication rates (chi(2) = 0.000, P = 1.000) between the two groups. Ascites volume of group 1 and group 2 were (1532 +/- 322) ml and (1466 +/- 110) ml, respectively (t = 0.234, P = 0.815). The condition of the graft's middle hepatic vein had significant influence on small-size-liver recipients' survival rates (chi(2) = 6.821, P = 0.009).</p><p><b>CONCLUSIONS</b>GRWR < 0.8% is not the limitation of the living donor liver transplantation but the outflow tract of the graft must be unobstructed.</p>

Outcomes of adult-to-adult living donor liver transplantation: a single center experience / 中华医学杂志(英文版)

<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>

Analysis of the post-operative pulmonary infection in adult-to-adult living donor liver transplant recipients / 中华肝脏病杂志

<p><b>OBJECTIVE</b>To study the incidence, etiology, outcome, and risk factors of early (is less than or equal to 30 days) pulmonary infection following adult-to-adult living donor liver transplantation (AALDLT).</p><p><b>METHODS</b>Medical records of 108 AALDLT without pre-operative respiratory disease from 2005 to 2008 were retrospective to evaluate the incidence, etiology, outcome, and risk factors of pulmonary infection following AALDLT. Univariate analysis was used to determine relative risk factors leading to postoperative pneumonia, and significant factors (P less than 0.05) were then used for multivariate logistic regression analysis.</p><p><b>RESULTS</b>The incidence of pneumonia was 22.2 % (n = 24 ); etiology including bacteria (n = 23, 21.3%), gram negative bacteria account for 78.3%, fungi (n = 4, 3.7%) and virus (n = 1, 0.9%), 4 patients were coinfection by bacteria and fungi; 6 among 24 patients (25%) and 4 out of the other 84 patients (4.76%) died early following the AALDLT, respectively (x2 = 6.850, P = 0.009). In univariate analysis, intraoperative volume of whole blood/packed red blood cells transfusion (P less than 0.01), intraoperative volume of fresh frozen plasma transfusion (P = 0.001), total volume of intraoperative transfusion (P = 0.015), mechanical ventilation (P less than 0.01), intensive unit care (ICU) stay (P = 0.012) and acute rejection (P = 0.001) are of statistical significance. Multivariate logistic regression showed only mechanical ventilation (P = 0.023) and acute rejection (P = 0.026) are independent factors predicting pneumonia.</p><p><b>CONCLUSION</b>Gram negative bacteria is the main etiology for pneumonia following AALDLT which has high morbidity and mortality; mechanical ventilation and acute rejection are independent risk factors.</p>

Establishment of formula predicting adult standard liver volume for liver transplantation / 中华外科杂志

<p><b>OBJECTIVE</b>To establish a favorable formula of estimation adult standard liver volume (SLV) based on the data of living donors for liver transplantation.</p><p><b>METHODS</b>From March 2005 to December 2007, 90 Adult-to-Adult living donor liver transplantation were performed. The donors' anthropometric data of gender, year, body weight and body height was collected prospectively. The total liver volume (TLV) of 90 living donors was measured by computed tomography. The correlation between TLV and several factors including body weight index (BMI) and body surface area (BSA) were analyzed. Then multiple stepwise linear regression analysis was performed and a new equation predicting SLV to improve approximate TLV was determined. TLV was then compared with the estimation standard liver volume (ESLV) calculated using our formula and published formulas in literature previously.</p><p><b>RESULTS</b>All the subjects had a mean body weight of (62.4 +/- 8.7) kg. The mean total liver volume was (1319.1 +/- 167.0) ml. There were positively correlated between TLV and body weight (BW), which could be expressed in the equation: TLV (ml) = 12.5 x BW (kg) + 536.4 (r(2) = 0.43, P < 0.01). Compared TLV with ELSV, which were calculated using previously published formulas based on the anthropometric data of the 90 subjects, the difference was be statistically significant.</p><p><b>CONCLUSION</b>A new simple formula is established that might be a more suitable to calculate TLV in Chinese adults.</p>