A correlation between pretransplantation model for end-stage liver disease score and degree of hepatic fibrosis in explanted livers / 中华消化杂志

Objective To investigate the probability of assessment of hepatic fibrosis for liver transplantation using model for end-stage liver disease(MELD) by comparing the correlation of MELD score with Ishak pathological grading method. Methods Fifty-eight patients who underwent liver transplantation because of end-stage liver disease from February 2006 to September 2006 were performed quantitative hepatic fibrosis evaluation using computer-assisted digital image analysis. Pathological diagnosis according to the Ishak modified score was also performed. MELD scores were calculated using the original formula based on the clinical examination data collected on the admission days. The correlations among the image analysis method, Ishak grading and MELD scoring method were analyzed using the Spearman's rank correlation analysis. The linear relationship between the MELD scores and the degree of hepatic fibrosis shown from linear regression analysis was used to define the reference criterion. Results The hepatic fibrosis area ratios of the 58 patients were between 23.2 % and 88.4 % with average of 56.7% by computer-assisted digital image analysis. The MELD scores on the admission clays were between 11 and 38 with average of 22.85±9.32. The semi-quantitative Ishak classification showed that there were 0, 2, 7, 12, 18, 12, and 7 cases in each of the 7 grades respectively, the higher the grade the higher the hepatic fibrosis area ratio and the higher the MELD scores. Spearman rank correlation test indicated that there was significant correlation among these three methods(P ＜ 0.01). Linear regression analysis showed that there was a linear relationship between the MELD scores and the degree of hepatic fibrosis. Conclusions Computer-assisted digital image analysis can evaluate objectively the hepatic fibrosis degree and it is significantly correlated to the MELD system. Hepatic fibrosis degree can be evaluated by MELD scores.

Construction of recombinant adenovirus vector carrying human TIMP-1 cDNA and its expression in vitro / 生物医学工程学杂志

The full-length cDNA of hTIMP-1 was obtained from a surgical patient with HCC by the method of RT-PCR. Then it was cloned into the adenoviral shuttle plasmid pAdTrack-CMV, and subsequently cotransformed into competent BJ5183 cells with the adenoviral backbone plasmid pAdEasy-1. Thereupon, a recombinant adenoviral plasmid containing full-length cDNA of hTIMP-1 was generated by homologous recombination in E. coli. The adenoviruses (AdhTIMP-1) were packaged and amplified in adenoviral packaging cells HEK 293. Then the viral titer was checked by green fluorescent protein (GFP), and the expression of hTIMP-1 was detected by the techniques of Western blot and RT-PCR. The recombinant adenovirus vector carrying human TIMP-1 was successfully constructed and expressed in vitro and may pave the way for further application in liver gene therapy.

Prophylaxis and treatment of acute renal failure following orthotopic liver transplantation / 中华器官移植杂志

Objective To summarize the experience of prophylaxis and treatment of acute renal failure (ARF) following orthotopic liver transplantation (OLT). Methods The clinical data of 63 cases of ARF following OLT were analyzed retrospectively. Results Preoperatively, 12 out of 63 patients had renal dysfunction to varying degrees, 28 had serious peritoneal fluid and advanced hyperbil-irubinemia. Postoperatively, complication included pulmonary infection (28 cases), MOSF (26 cases) and intraperitoneal dropsy or empyema (9 cases). Cyclosporin A, mycophenolate and tacrolimus were all used to prevent rejection. Dopamine was used in some patients to improve renal perfusion. Meanwhile, diuretic and albumin, and fresh blood plasma were used to support patients. Twelve severe cases received CRRT. Average treatment duration was 50 h. Twenty-six patients died within one month postoperatively with the mortality rate of this group being 41.27 %. Conclusions The etiology of ARF following OLT is multifactorial. It's important to evaluate renal function preoperatively and to avoid infection, apply immunosuppressant individually and improve renal perfusion postoperatively.