Adult-to-adult living-related donor liver transplantation: report of 2 cases / 南方医科大学学报

<p><b>OBJECTIVE</b>To investigate the feasibility and safety of adult-to-adult living-related donor liver transplantation using a right lobe graft.</p><p><b>METHODS</b>The clinical data of 2 cases of living-related donor liver transplantation performed between July, 2010 and November, 2010 were analyzed.</p><p><b>RESULTS</b>Liver transplantation was performed using a right lobe graft including the middle hepatic vein in one case and a right lobe graft without the middle hepatic vein in the other. The ratio of graft volume to standard liver volume was 46.2% and 47.3% in the two cases, with GR/WR of 0.83 and 0.80, and donor residue liver of 42.1% and 39.5%, respectively. The donor operation lasted for 6.5 h and 5 h in the two cases with blood loss of about 200-250 ml without blood transfusion. The donors recovered uneventfully without any surgical complications, whose liver function was normal 7 days after the operation, and were discharged 14 days and 16 days after the surgery, respectively. The recipient operation lasted for 8 h and 7 h with blood loss of about 800-1000 ml. The right hepatic vein, hepatic artery, portal vein and bile duct reconstruction were performed by end-to-end anastomoses in the 2 recipients. Bile duct anastomosis stricture occurred in the first recipient 2 months after transplantation and was treated with percutaneous transhepatic cholangiography and drainage. The second recipient recovered smoothly without any complications. The recipients have so far survived 9 months and 5 months, respectively.</p><p><b>CONCLUSION</b>Adult-to-adult living-related donor liver transplantation is a safe and effective option for treatment of end-stage liver diseases in the context of cadaveric liver graft shortage.</p>

Glucocorticoid treatment for early postoperative cholangiole cholestasis hyperbilirubinemia after liver transplantation / 南方医科大学学报

<p><b>OBJECTIVE</b>To study the therapeutic effect of glucocorticoid on early postoperative cholangiole cholestasis hyperbilirubinemia after liver transplantation.</p><p><b>METHODS</b>Thirteen liver transplantation recipients with serum total bilirubin above 171 micromol/L at two weeks to one month postoperatively were enrolled in this study. After exclusion of liver blood supply anomalies, bile duct complications, and acute rejection and establishment of a pathological diagnosis of cholangiole cholestasis by hepatic biopsy, hydrocortisone sodium succinate was infused. The liver functions of the patients were tested at 1 day before and 1 day and 1 week after the treatment. Hepatic biopsy was performed before and 1 week after the treatment to observe histopathological changes.</p><p><b>RESULTS</b>The serum levels of total bilirubin decreased significantly after the treatment with glucocorticoid. Pathology of the hepatic biopsy demonstrated the resolution of cholangiole cholestasis 1 week after the treatment.</p><p><b>CONCLUSION</b>Glucocorticoid treatment is effective for early postoperative cholangiole cholestasis hyperbilirubinemia after liver transplantation.</p>

Clinical research of donor liver procurement and preparation in liver transplantation / 南方医科大学学报

<p><b>OBJECTIVE</b>To summarize the experience of donor liver procurement and preparation in liver transplantation.</p><p><b>METHODS</b>One hundred and twenty-six cases of donor liver and kidney procurement and 105 cases of donor liver preparation from August, 2004 to December, 2006 were analyzed. The 105 donor liver grafts were all used for orthotopic liver transplantation.</p><p><b>RESULTS</b>The warm ischemia time of the graft ranged from 1 to 8.5 min with a mean of 4 min. The time of graft procurement ranged from 19 to 28 min (mean 22.5 min). Donor liver preparation lasted for 38 to 102 min in the 105 cases, with a mean of 51 min. The cold ischemia time of the donor liver was 5.5 to 13 h (mean 8 h). Anatomical variations were identified in 8 of the donor liver grafts.</p><p><b>CONCLUSIONS</b>Cold perfusion of the donor liver and repair of the hepatic artery are important procedures in donor liver procurement and preparation. Hemorrhage due to the donor graft should be prevented and the procedures should be performed in close cooperation with the recipient operation.</p>

Review of 105 cases of orthotopic liver transplantation and the prospect / 南方医科大学学报

<p><b>OBJECTIVE</b>To summarize the experience with orthotopic liver transplantation (OLT).</p><p><b>METHODS</b>A retrospective analysis of 105 cases of liver transplantation in our hospital was carried out.</p><p><b>RESULTS</b>All the 105 OLT operations were performed successfully and the operation time ranged from 210-350 min (mean 250 min), with anhepatic phase ranging from 35-65 min (mean 53.5 min) and blood transfusion during operation ranging from 0-6600 ml (mean 400 ml). Ninety-five patients recovered smoothly while the rest 10 died, with the success rate of OLT of 90.5%. Postoperative complications included biliary tract complication (12 cases, 11.4%) and abdominal bleeding (6 cases).</p><p><b>CONCLUSIONS</b>Reducing hemorrhage during operation is the most important factor to ensure successful OLT. Thorough hemostasis during operation and sufficient blood supply to the bile duct can significantly reduce postoperative bile duct complications.</p>

Inhibition of nuclear translocation and binding activity of nuclear factor-kappaB by oligodeoxynucleotides in THP-1 cells / 南方医科大学学报

<p><b>OBJECTIVE</b>To observe the inhibitory effect of oligodeoxynucleotides (ODN) on nuclear translocation and nuclear binding activity of nuclear factor (NF)-kappaB in THP-1 cells.</p><p><b>METHODS</b>Oligodeoxynucleotides were transfected via liposome into THP-1 cells followed by stimulation of the cells with lipopolysaccharide (LPS). Immunocytochemistry, electrophoretic mobility shift assay (EMSA) and reverse transcription (RT)-PCR were performed to detect the nuclear translocation and nuclear binding activity of NF-kappaB.</p><p><b>RESULTS</b>Immunocytochemical results showed that after LPS stimulation of the ODN-transfected cells, NF-kappaB expression was still localized in cytoplasma. EMSA demonstrated inhibited nuclear binding activity of NF-kappaB in the ODN-transfected cells, and ODN inhibited the mRNA expression of tumor necrosis factor (TNF)-alpha, a NF-kappaB-associated inflammatory factor, as shown by RT-PCR.</p><p><b>CONCLUSION</b>ODN can inhibit the nuclear translocation and binding activity of NF-kappaB in THP-1 cells, whereby the transcription and expression of the related inflammation factor genes is suppressed, which shed light on a new solution for clinical treatment of acute pancreatitis.</p>