RESUMO
<p><b>OBJECTIVE</b>To summarize the clinical data in preventing HBV recurrence after liver transplantation and explore a optimal individual protocol in prophylaxis of HBV recurrence.</p><p><b>METHODS</b>We retrospected outcomes in 195 recipients who underwent a liver transplantation for HBV-related liver disease between June 2004 and July 2008. According to the anti-virus protocol these recipients are divided into two groups as following: group A received a protocol of combination treatment of lamivudine with HBIG, and group B with combination treatment of adefovir with HBIG. With mean follow-up of 23.7 months, HBV recurrent rate was observed in overall and each group separately.</p><p><b>RESULTS</b>A total of 195 liver transplant recipients were identified that met the study criteria. At the sixth and eleventh month after operation, HBV recurrence appeared in 2 recipients, each in two groups, which were due to LAM cessation and HBV mutation respectively. Recurrent rate was 0.6% in group A, 3.7% in group B and 1% in total. There was no significant difference in HBV recurrent rate between group A and B.</p><p><b>CONCLUSION</b>Lamivudine combined with HBIg should be considered as a reliable method in preventing HBV recurrence after liver transplantation. Better outcomes can be achieved by individual anti-virus protocol and HBIg administration according to HBV status in recipient.</p>
Assuntos
Adolescente , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Adulto Jovem , Antibioticoprofilaxia , Antivirais , Usos Terapêuticos , Hepatite B , Cirurgia Geral , Vírus da Hepatite B , Fisiologia , Lamivudina , Usos Terapêuticos , Transplante de Fígado , RecidivaRESUMO
<p><b>BACKGROUND</b>The multidrug resistance (MDR) associated with the expression of the mdr1 gene and its product P-glycoprotein is a major factor in the prognosis of hepatocellular carcinoma cell (HCC) patients treated with chemotherapy. Our study was to establish a stable HCC MDR cell line where a de novo acquisition of multidrug resistance specifically related to overexpression of a transgenic mdr1.</p><p><b>METHODS</b>The 4.5-kb mdr1 cDNA obtained from the plasmid pHaMDR1-1 was cloned into the PCI-neo mammalian expression vector, later was transferred by liposome to human hepatocarcinoma cell line HepG2. Then the transfected HepG2 cells resisting G418 were clustered and cultured and the specific fragment of mdr1 cDNA, mRNA and the P-glycoprotein (Pgp) in these HepG2 cells were detected by PCR, RT-PCR and flow cytometry, respectively. The accumulation of the daunorubicin was determinated by flow cytometry simultaneously. The nude mice model of grafting tumour was established by injecting subcutaneously HepG2/mdr1 cells in the right axilla. When the tumour diameter reached 5 mm, adriamycin was injected into peritoneal cavity. The size and growth inhibition of tumour were evaluated.</p><p><b>RESULTS</b>The mdr1 expression vector was constructed successfully and the MDR HCC line HepG2/mdr1 developed. The PCR analysis showed that the specific fragment of mdr1 cDNA in HepG2/mdr1 cells, but not in the control group HepG2 cells. Furthermore, the content of the specific fragment of mdr1 mRNA and Pgp expression in HepG2/mdr1 cells were (59.7 +/- 7.9)% and (12.28 +/- 2.09)%, respectively, compared with (16.9 +/- 3.2)% and (3.07 +/- 1.06)% in HepG2 cells. In the nude mice HCC model, the tumour genes of both groups were identified. After ADM therapy, the mean size of HepG2 cell tumours was significantly smaller than HepG2/mdr1 cell tumours.</p><p><b>CONCLUSION</b>The approach using the transfer of mdr1 cDNA may be applicable to the development of MDR hepatocarcinoma cell line, whose MDR mechanism is known. This would provide the experimental basis of MDR research.</p>
Assuntos
Animais , Feminino , Humanos , Camundongos , Membro 1 da Subfamília B de Cassetes de Ligação de ATP , Genética , Metabolismo , Carcinoma Hepatocelular , Tratamento Farmacológico , Genética , Patologia , Linhagem Celular Tumoral , Doxorrubicina , Farmacologia , Usos Terapêuticos , Resistência a Múltiplos Medicamentos , Genética , Resistencia a Medicamentos Antineoplásicos , Genética , Citometria de Fluxo , Vetores Genéticos , Genética , Neoplasias Hepáticas Experimentais , Tratamento Farmacológico , Genética , Patologia , Camundongos Nus , Mitomicina , Farmacologia , Usos Terapêuticos , Reação em Cadeia da Polimerase Via Transcriptase Reversa , Ensaios Antitumorais Modelo de Xenoenxerto , MétodosRESUMO
Objective To explore the causes of biliary complications related with liver donor fol- lowing liver transplantation.Methods Ninty-nine patients with improved liver donor treatment during liver transplantation from May 2005 to April 2006 were followed up and the clinical data were ana- lyzed.At the same time,the rate of biliary complications was compared with that occurring on 43 pa- tients with unimproved liver donor treatment.Results Only 4 in 99 patients with improved liver donor treatment had biliary leakage with the rate of biliary complications being 4% in comparison with 11% in those with unimproved liver donor treatment.Conclusion The improvement of liver donor treat- ment,including shortening heat-ischemia time,completely washing bile duct and remaining the whole blood supply of bile duct,can decline the occurrence of biliary complications.