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Objective To introduce the birth and development of model of end-stage liver disease(MELD) and evaluate its effect on liver transplantation(LT) as a new scoring system.Methods Literatures of MELD applied in LT were analyzed retrospectively.Results MELD scoring system was used for predicting the prognosis of patients with end-stage liver disease and the death risk of candidates on waiting LT extensively and the order of organ sharing was determined by its predicable results.Conclusion MELD has been had a successful initial implementation for predicting the short-term survival probability and mortality in patients with end-stage liver disease,and meeting the goal of providing a system of allocation that emphasizes the urgency of the candidate while diminishing the reliance on waiting time,which has been proven to be a powerful tool for auditing the liver allocation system.
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At present, the immunological tolerance in transplantation induced by multi-mechanisms, to inhibit the chronic graft rejection, represents an important trend in the field of transplantation. This review summarizes the new researches about immune and non-immune factors in this field. At the same time, this review also discusses that the high-dose vitamin E, through changing the ratio of Th/Ts in vivo and not improving the level of specific-antibody, regulates the immune system. In addition, the potent antioxidation of vitamin E has advantage to release the oxidate press of tissue and the damage of blood vessels. In the end, the reporter prospects the signification of vitamin E to inhibit the chronic graft rejection and points out the potential questions.
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UW solution has bean considered the gold standard for abdominal organ preservation. Celsior solution and HTK solution, with low potassium and low viscosity, are becoming more widely used in the preservation of the kidney, liver and pancreas, and are gradually accepted as an ideal alternative for UW solution. Recent studies have found that addition of trophic factors can attenuate hypothermic ischemic injury to the donor organ, thus improving the preservation outcome. This paper reviews the progress in laboratory research and looks foward to the clinical application of multi-organ preservation solution.