Research advances of liver machine perfusion / 中华器官移植杂志

This review evaluated the current research status and the latest advances of liver machine perfusion, aiming to provide references for researchers and clinicians in related fields.

Liver transplantation for liver metastasis of unresectable rectal cancer: one case report / 中华器官移植杂志

This report described one case of applying liver transplantation (LT) in for liver metastases of unresectable rectal cancer.The recipient had multiple intrahepatic metastases upon a diagnosis of colorectal cancer.FOLFOX chemotherapy plus bevacizumab targeted therapy were offered after a resection of primary lesion.Two years later, intrahepatic metastases expanded while no extrahepatic metastasis or in situ recurrence was noted.After LT, tacrolimus + sirolimus immunosuppression regimen and chemotherapy of rhatitrexed were prescribed.Tumor recurred at 3 years after LT and the survival time was 6 years.For patients with unresectable liver metastases of colorectal cancer, LT in the absence of orthotopic recurrence and other distant metastases may improve patient quality-of-life and achieve better outcomes.

Dopaminergic Neurons in the Ventral Tegmental-Prelimbic Pathway Promote the Emergence of Rats from Sevoflurane Anesthesia / 神经科学通报·英文版

Dopaminergic neurons in the ventral tegmental area (VTA) play an important role in cognition, emergence from anesthesia, reward, and aversion, and their projection to the cortex is a crucial part of the "bottom-up" ascending activating system. The prelimbic cortex (PrL) is one of the important projection regions of the VTA. However, the roles of dopaminergic neurons in the VTA and the VTADA-PrL pathway under sevoflurane anesthesia in rats remain unclear. In this study, we found that intraperitoneal injection and local microinjection of a dopamine D1 receptor agonist (Chloro-APB) into the PrL had an emergence-promoting effect on sevoflurane anesthesia in rats, while injection of a dopamine D1 receptor antagonist (SCH23390) deepened anesthesia. The results of chemogenetics combined with microinjection and optogenetics showed that activating the VTADA-PrL pathway prolonged the induction time and shortened the emergence time of anesthesia. These results demonstrate that the dopaminergic system in the VTA has an emergence-promoting effect and that the bottom-up VTADA-PrL pathway facilitates emergence from sevoflurane anesthesia.

Awareness of risk factors for gastric cancer among residents / 中华全科医师杂志

Objective:To survey the awareness status of risk factors for gastric cancer and related factors among residents in Shijiazhuang city.Methods:From October to November 2020, residents aged>18 years were selected through convenience sampling from Xinhua District and Yuhua District in Shijiazhuang for a face-to-face questionnaire survey. The demographic characteristics and awareness levels of risk factors for gastric cancer among 1 490 subjects were analyzed. The multivariate linear regression model was applied to analyze the related factors.Results:There were 522 male participants (35.0%) and 968 female participants (65.0%). The mean knowledge score of risk factors of gastric carcinoma in the respondents was 5.0 (1.0, 11.0). There were 57.0% (849/1 490) of the participants who had a low knowledge level about risk factors of gastric cancer. The more highly recognized risk factors were irregular diet (47.4%, 706/1 490), consumption of pickled foods (45.2%, 674/1 490), consumption of smoked foods (45.0%, 671/1 490); the less-recognized risk factors included physical inactivity (14.8%, 221/1 490), male sex (17.3%, 258/1 490) and older age (19.5%, 291/1 490). Only 26.8% (400/1490) of the participants regarded H. pylori infection as a risk factor of gastric cancer. Univariate analysis showed that educational level ( Z=39.34), marital status ( Z=53.31), monthly income ( Z=11.82), family member or friend ever having stomach problem ( H=-2.98), and family history of gastric cancer ( H=-2.34) were significantly associated with the knowledge score of risk factors for gastric cancer ( P<0.05). Multivariate analysis showed that compared to participants with educational levels of primary school or below, those with educational level of junior high school ( β=0.27, P<0.001), high school ( β=0.23, P<0.001), or college ( β=0.16, P<0.001) had a higher levels of knowledge of risk factors for gastric cancer; compared to unmarried participants, awareness of risk factors was significantly better in those who were married ( β=0.16, P<0.001), divorced ( β=0.05, P=0.039), or widowed ( β=0.06, P=0.027); compared to participants with monthly income<3 000 yuan, the subjects with monthly income from 5 000 to 10 000 yuan ( β=0.07, P=0.020) had a higher knowledge score; compared to participants with no family history of gastric cancer, subjects with family history had higher knowledge level of risk factors for gastric cancer ( β=0.06, P=0.029). Conclusion:The knowledge levels of risk factors for gastric cancer are generally low among residents in Shijiazhuang city. Educational initiatives are required to improve the awareness of risk factors for gastric cancer, and interventions need to be implemented concurrently to change unhealthy behaviors among residents in Shijiazhuang city.

Comparative analysis of economics of hypothermic mechanical perfusion versus static cold preservation for kidney transplantation / 中华器官移植杂志

Objective:An assessment of domestic and foreign literatures regarding the medical expenses of kidney hypothermic machine perfusion(HMP)versus cold storage(CS)to provide guidance for clinical decision-making.Methods:Relevant literatures were retrieved from PubMed, CENTRAL(Cochrane Library), Web of Science, EMBASE, CNKI, Wanfang, etc.The literatures and according data were finally enrolled based on the inclusion and exclusion criteria.The results were reported descriptively.Results:A total of 10 literatures reporting the costs of HMP and CS were included.The results show that HMP can reduce the cost of first hospitalization compared with CS in expanded criteria donor.HMP may also reduce long-term costs compared to CS.The lower cost may be associated with the lower incidence of delayed graft function(DGF).Conclusions:HMP may bring medical and economic benefits to patients.The cost advantage of HMP over CS may be related to the improved quality of donor kidney and a lower incidence of DGF.

Establishment of a genomic model for predicting the likelihood of poor early graft function after liver transplantation / 中华器官移植杂志

Objective:To explore the poor early liver graft function(PEGF)-related biomarkers and establish a genomic model for PEGF prediction specific to liver transplantation(LT)with allografts of donation after brain death(DBD).Methods:By data-mining a public GSE23649 dataset from the database of Gene Expression Omnibus(GEO), key PEGF-related genes in DBD liver biopsies after 2h reperfusion were identified by differential expression analysis.And LASSO-penalized Logistic regression model was utilized for selecting an optimal gene set.Receiver operating characteristic curves with its area under the curve(AUC)and a nomogram were generated for evaluating and visualizing its predictive capability for PEGF.Gene set enrichment analysis(GSEA) was performed for exploring the biological pathways underlying PEGF.Results:Six key PEGF-related genes in DBD-LT were initially identified, including 4 up-regulated genes(HBB, PFDN5, RPS3A & RPS5)and 2 down-regulated genes(RPL22 & FAM62B). A six-mRNA-based risk-scoring model was further established with an excellent predictive capability(AUC=1.000, P=0.0008). Four PEGF-related biological pathways in DBD livers, such as "VEGF" and "natural killer cell-mediated cytotoxicity" , were identified by GSEA(all P<0.05). Conclusions:The genomic model may effectively predict the likelihood of PEGF immediately after DBD-LT or even prior to transplantation in the context of normothermic machine perfusion.

High tibial osteotomy plus arthroscopic surgery for medial gonarthrosis / 中华创伤骨科杂志

Objective:To evaluate the clinical efficacy of high tibial osteotomy(HTO) plus arthroscopic surgery in the treatment of medial gonarthrosis.Methods:From January 2017 to May 2018, 40 patients were treated at Department of Joint Orthopaedics, Wujin Hospital Affiliated to Jiangsu University and at Department of Joint Orthopaedics, The First Affiliated Hospital to China Medical University for medial gonarthrosis. They were divided into 2 groups according to their different treatment methods. Group A was treated by HTO plus arthroscopic surgery; there were 20 cases, 8 males and 12 females with an age of 59.7 years ± 5.5 years. Group B was treated by only HTO; there were also 20 cases, 10 males and 10 females with an age of 58.2 years ± 4.3 years. The 2 groups were compared in terms of Hospital for Special Surgery (HSS) knee score, visual analogue scale (VAS), hip knee ankle angle (HKA), medial proximal tibia angle (MPTA) and posterior tibial slope angle (PTSA) at 6, 12 and 24 months postoperatively and at the last follow-up.Results:The 2 groups were comparable because there were no significant differences between them in the preoperative general data ( P>0.05). The HSS and VAS scores at 6 months after operation in group A (82.7±2.4 and 1.7±0.7) were significantly better than those in group B (78.4±2.6 and 2.2±0.8) ( P<0.05); the HSS score at 12 months after operation in group A (88.1±1.8) was significantly better than that in group B (82.9±1.7) ( P<0.05). There were no significant differences between the 2 group in the VAS score at 12 months after operation, or in the HSS or VAS scores at 24 months or at the last follow-up ( P>0.05). There were no significant differences either in the HKA, MPTA or PTSA scores between postoperative 6, 12, 24 months and the last follow-up ( P>0.05). Conclusion:In the treatment of medial gonarthrosis, high tibial osteotomy plus arthroscopic surgery may lead to better short-term outcomes than high tibial osteotomy alone, but the 2 methods may result in similar curative efficacy by 24 months after surgery.

Comparison of predictive value of different risk assessment models for venous thromboembolism in elderly patients with lung cancer / 中华老年医学杂志

Objective:To explore the predictive value of the COMPASS-cancer associated thrombosis(COMPASS-CAT)risk assessment model and the modified Khorana risk assessment model for the risk of venous thromboembolism(VTE)in elderly patients with lung cancer.Methods:A retrospective analysis was conducted on clinical data of 276 hospitalized lung cancer patients aged 60 years and over in the Cancer Hospital of the Chinese Academy of Medical Sciences and Peking Union Medical College from March 2013 to March 2017.Patients were divided into the VTE group(n=39)and the non-VTE group(n=237). The COMPASS-CAT model and the modified Khorana model were used to evaluate the risk of venous thromboembolism in the two groups.The sensitivity, specificity and Youden index of the two models were calculated.The receiver-operating characteristics(ROC)curves of the two evaluation models were drawn.The predictive effect and influence of two evaluation models on VTE risk in elderly lung cancer patients were compared by using Medcalc software analysis and multivariate Logistic regression analysis.Results:The incidence of VTE was 14.13%(39/276). The sensitivity, specificity, Youden index and the AUC under ROC curves of the COMPASS-CAT model and the modified Khorana model were 0.718 and 0.795, 0.861 and 0.527, 0.524 and 0.348, and 0.789 and 0.661, respectively.Using the Medcalc software to compare the two models, the area under the curve of the COMPASS-CAT risk assessment model was increased by 0.128, compared with the modified Khorana model( Z=2.676, P=0.0075). Multivariate Logistic regression analysis showed that COMPASS-CAT≥7 points and Khorana≥2 points were independent risk factors for VTE in elderly patients with lung cancer( P<0.05). Conclusions:The modified Khorana model can predict the risk of VTE in elderly patients with lung cancer, but the accuracy of prediction is low.The COMPASS-CAT model has a higher predictive value for VTE risk assessment than the modified Khorana model and is more suitable for elderly patients with lung cancer.

Two cases of liver transplantation donor withschistosomiasis and literature review / 中华器官移植杂志

Objective:There are few domestic reports of liver transplantation from schistosomiasis donors. Two schistosomiasis donor livers were employed for liver transplantation. The relevant experiences were summarized along with a literature review.Methods:Two unexpectedly discovered donor livers infected by schistosomiasis were successfully transplanted. And long-term follow-ups were conducted for recipients.Results:The recipients were followed up for 77 and 14 months respectively without recurrence.Conclusions:Non-cirrhotic donor livers infected with schistosome may safely employed for transplantation. A positive donor should be treated with praziquantel. However, a recipient has no indication for preventive deworming.

Effect of leukoaraiosis on prognoses and enlarged hematoma in patients with spontaneous supratentorial intracerebral hemorrhage / 中华神经医学杂志

Objective:To explore the effect of leukoaraiosis (LA) severity on prognoses and enlarged hematoma in patients with spontaneous supratentorial intracerebral hemorrhage.Methods:Three hundred and forty-five patients with spontaneous supratentorial intracerebral hemorrhage admitted to our hospital from January 2018 to February 2019 were chosen in our study. The van Swieten scale (vSS) was performed on baseline brain CT images to evaluate the LA severity; and according to the vSS scores, these patients were divided into absent-to-moderate LA group (0-2, n=288) and severe LA group (3-4, n=57); the percentage of patients with good prognosis (modified Rankin scale scores≤2 90 d after discharge) and incidence of enlarged hematoma (hematoma volume increased by 12.5 mL or >33% of original volume as compared with that at admission) were compared between the two groups 90 d after discharge. According to the prognoses and enlarged hematoma, these patients were further divided into good prognosis group ( n=161) and poor prognosis group ( n=184), and non-hematoma expansion group ( n=303) and hematoma expansion group ( n=42), respectively; univariate analysis, multivariate Logistics regression analysis, and multi-classification Logistic regression analysis were used to evaluate the influence of LA severity in prognoses, mRS scores, and enlarged hematoma. Results:As compared with the absent-to-moderate LA group, the severe LA group had significantly lower percentage of patients having good prognosis (50.0% vs. 29.8%) and significantly higher incidence of enlarged hematoma (9.4% vs. 26.3%, P<0.05). Multivariate Logistic regression analysis showed that severe LA was an independent risk factor for poor prognosis ( OR=0.390, 95%CI: 0.163-0.933, P=0.034). Multi-classification Logistic regression analysis showed that patients with severe LA had high mRS scores ( OR=3.243, 95%CI: 1.775-5.923, P=0.000). Multivariate Logistic regression analysis showed that severe LA was not an independent risk factor for enlarged hematoma ( P>0.05). Conclusion:The severity of LA affects the prognoses 90 d after discharge, but not increase the risk of enlarged hematoma in patients with spontaneous supratentorial intracerebral hemorrhage.

170donors infection distribution and risk factor analysis of donor-derived infection in kidney transplantation / 中华器官移植杂志

Objective The epidemiological investigation of donor infection and the investigation of donor-derived infection(DDI)events in kidney transplantation to provide a basis for the prevention and treatment of donor infection and donor-derived infection events .Methods We retrospectively reviewed 170 donors and corresponding 316 kidney recipients between January 2014 with December 2017 ,pre-harvest blood ,sputum ,urine positive and negative culture were systematically recorded .We also collected donors/recipients demographics ,transplant characteristics and recipients infection data within one month and focused on patient data of DDI events .Outcomes were followed up 6 months after surgery .Results Infection rate in 170 donors was 67 .6 ％ ,the positive rate of Gram-negative bacteria ,Gram-positive bacteria and fungal were 48 .3 ％ ,41 .2 ％ and 10 .4 ％ .Nine of 170 donors were DDI(5 .29 ％ ) .Positive blood culture ,urine culture and donor age were independent risk factors for DDI .Conclusions The incidence of donor infection is high .Although a few DDI events occur ,the survival rate decreased .The positive blood culture and urine culture were important risk factors for the occurrence of DDI events . Therefore ,it is necessary to focus on the monitoring of some high-risk strains and donors infected by high-risk infection sites .

Health coaching improves interventional effects in high-risk population of stroke / 中华全科医师杂志

Objective To assess the effect of health coaching on interventional effect in high-risk population of stroke. Methods A baseline survey was conducted among 897 residents aged 40 years and above selected by cluster sampling method in a community of Shijiazhuang city from January 2016 to June 2016, and 178 subjects were identified as high risk population of stroke. The high-risk subjects were randomly divided into two groups: the control group (n=89) was given routine health education, while the intervention group (n=89) received health coaching based on motivational interview for 13 months. The behavioral risk factors and self-efficacy scores were compared between two groups before and after intervention. Results There were no significant differences in behavioral risk factors between the two groups:for hypertension 72 vs. 74 cases (χ2=0.152,P=0.67),for hyperglycocemia 44 vs.48 cases (χ2=0.360,P=0.55), for dyslipidemia 62 vs. 60 cases (χ2=0.104,P=0.75), for smoking 35 vs.32 cases (χ2=0.215,P=0.64), for obesity 50 vs. 52 cases (χ2=0.092, P=0.76), for lack of exercises 72 vs. 70 cases (χ2=0.139, P=0.71), for atrial fibrillation 14 vs. 16 cases (χ2=0.160,P=0.19). And there was no significant difference in self-efficacy scores between the two groups [(5.3 ± 1.2) vs. (5.6 ± 2.0), t=0.997, P=0.32]. After intervention, there were significant differences between the two groups in behavioral risk factors:for hypertension 25 vs. 34 cases(χ2=19.984, P<0.05), for hyperglycaemia 16 vs. 32 cases(χ2=8.448, P<0.05), for dyslipidemia 30 vs. 48 cases(χ2=13.216, P<0.05),for smoking 20 vs.28 cases(χ2=7.583,P<0.05),for obesity 18 vs.38 cases(χ2=14.158,P<0.05),for lack of exercises 28 vs. 36 cases(χ2=10.235,P<0.01),for atrial fibrillation 5 vs. 13 cases (χ2=6.451,P<0.05). And the self-efficacy scores of intervention group were higher than those of control group[(8.4±2.1) vs. (6.8±2.2), t=4.852, P<0.01]. Conclusion Health coaching based on motivational interview is beneficial to reduce risk factors and improve self-efficacy in high risk population of stroke, which is worthy of popularization.

Health coaching improves interventional effects in high-risk population of stroke / 中华全科医师杂志

Objective@#To assess the effect of health coaching on interventional effect in high-risk population of stroke.@*Methods@#A baseline survey was conducted among 897 residents aged 40 years and above selected by cluster sampling method in a community of Shijiazhuang city from January 2016 to June 2016, and 178 subjects were identified as high risk population of stroke. The high-risk subjects were randomly divided into two groups: the control group (n=89) was given routine health education, while the intervention group (n=89) received health coaching based on motivational interview for 13 months. The behavioral risk factors and self-efficacy scores were compared between two groups before and after intervention.@*Results@#There were no significant differences in behavioral risk factors between the two groups: for hypertension 72 vs. 74 cases (χ2=0.152, P=0.67), for hyperglycocemia 44 vs.48 cases (χ2=0.360, P=0.55), for dyslipidemia 62 vs. 60 cases (χ2=0.104, P=0.75), for smoking 35 vs.32 cases (χ2=0.215, P=0.64), for obesity 50 vs.52 cases (χ2=0.092, P=0.76), for lack of exercises 72 vs.70 cases (χ2=0.139, P=0.71), for atrial fibrillation 14 vs. 16 cases (χ2=0.160, P=0.19). And there was no significant difference in self-efficacy scores between the two groups [(5.3±1.2) vs. (5.6±2.0), t=0.997,P=0.32]. After intervention, there were significant differences between the two groups in behavioral risk factors: for hypertension 25 vs. 34 cases (χ2=19.984, P<0.05) , for hyperglycaemia 16 vs.32 cases (χ2=8.448, P<0.05) , for dyslipidemia 30 vs. 48 cases (χ2=13.216, P<0.05) , for smoking 20 vs.28 cases (χ2=7.583, P<0.05) , for obesity 18 vs.38 cases (χ2=14.158, P<0.05) , for lack of exercises 28 vs. 36 cases (χ2=10.235, P<0.01) , for atrial fibrillation 5 vs. 13 cases (χ2=6.451, P<0.05) . And the self-efficacy scores of intervention group were higher than those of control group[ (8.4±2.1) vs. (6.8±2.2), t=4.852, P<0.01].@*Conclusion@#Health coaching based on motivational interview is beneficial to reduce risk factors and improve self-efficacy in high risk population of stroke, which is worthy of popularization.

170donors infection distribution and risk factor analysis of donor-derived infection in kidney transplantation / 中华器官移植杂志

Objective@#The epidemiological investigation of donor infection and the investigation of donor-derived infection(DDI)events in kidney transplantation to provide a basis for the prevention and treatment of donor infection and donor-derived infection events.@*Methods@#We retrospectively reviewed 170 donors and corresponding 316 kidney recipients between January 2014 with December 2017, pre-harvest blood, sputum, urine positive and negative culture were systematically recorded. We also collected donors/recipients demographics, transplant characteristics and recipients infection data within one month and focused on patient data of DDI events. Outcomes were followed up 6 months after surgery.@*Results@#Infection rate in 170 donors was 67.6 %, the positive rate of Gram-negative bacteria, Gram-positive bacteria and fungal were 48.3 %, 41.2 % and 10.4 %. Nine of 170 donors were DDI(5.29 %). Positive blood culture, urine culture and donor age were independent risk factors for DDI.@*Conclusions@#The incidence of donor infection is high. Although a few DDI events occur, the survival rate decreased. The positive blood culture and urine culture were important risk factors for the occurrence of DDI events. Therefore, it is necessary to focus on the monitoring of some high-risk strains and donors infected by high-risk infection sites.

Injury of aldehyde dehydrogenase 2 in organ ischemia-reperfusion injury through autophagy / 中华肝胆外科杂志

With the rapid development of organ transplantation in China,the donation after cardiac death (DCD) donor organs are widely used.However,the quality of these organs is relatively poor,so the way to preserve and maintain organ still remains a severe problem.Among them,ischemic reperfusion injury (IRI) impairs the organs severely.Acetaldehyde dehydrogenase 2 (ALDH2) protects organs from stress conditions,including ischemia-reperfusion injury,and the activation and autophagy inhibition also protects the organs from stress conditions as well.Recent studies showed that ALDH2 can regulate autophagy to inhibit the organ injury during ischemia-reperfusion.Our study aims to discuss the new findings in this mechanism.

Epidemiology of nosocomial infection in recipients after renal transplantation: a single-center analysis / 器官移植

Objective To investigate the epidemiological characteristics of renal transplantation recipients, effective prevention and control measures. Methods A total of 456 renal transplant recipients were monitored from January 2014 to December 2017. Postoperative infection including baseline data, infection site and infectious pathogen type was analyzed. Results Among 456 renal transplant recipients, 78 cases (17.1%) developed nosocomial infection. Postoperative infection time was 9(3-21) d. Infection sites mainly included the lower respiratory tract, urinary system and blood infection. Infection pathogens consisted of Staphylococci (n=13), Enterococcus faecium (n=6), fungi (n=6), Stenotrophomonas maltophilia (n=4), Acinetobacter baumannii (n=4), Pseudomonas aeruginosa (n=4), Staphylococcus epidermidis (n=4), Klebsiella pneumoniae (n=1), Escherichia coli (n=1) and other negative bacteria (n=9). Among them, 11 cases (14%) were infected with multi-drug resistant bacteria, and 4 cases died. Conclusions In renal transplant recipients, the incidence of nosocomial infection is relatively high, with early postoperative onset, common multiple drug-resistant bacterial infection and high mortality. Preoperative preparations should be fully implemented, postoperative lower respiratory tract infection should be actively prevented and prevention and treatment measures for multidrug-resistant bacteria should be standardized.

Research advancement on the electric stimulation in the ischemia and reperfusion injury / 中华肝胆外科杂志

Ischemia and reperfusion injury has a serious effect on the organs’function. How to protect organs from injury and reduce organ damage during ischemia-reperfusion period is the main concerns of many researches. It is reported that electrical stimulation can alleviate ischemia and reperfusion injury of some organs. In this paper, we will review the effect of electric stimulation on organ ischemia-reperfusion injury and analyze the mechanism of electric stimulation and provide new ideas for the prevention and treatment of clinical organ ischemia-reperfusion injury.

Clinical retrospective analysis in delayed graft function morbidity of kidney transplantation recipients and gender factors in both donors and recipients / 中华器官移植杂志

Objective To explore the effects of donor/recipients' gender on delayed graft function (DGF) .Methods A retrospective analysis was performed for clinical data of donors (n=174) and recipients (n=265) during renal transplantation between May 1 ,2012 and December 31 ,2017 . Types of China donation after citizen's death ,age ,last creatinine level ,height ,weight ,body mass index (BMI) and protopathy of donors were collected .And pre-dialysis method ,dialysis time ,HLA mismatch ,post-creatine at Day 7 ,whether dialysis after transplantation ,height ,weight and BMI of recipients were analyzed .The data were checked by t and chi square tests and P<0 .05 was deemed as statistically significant .Results Donor gender had no correlation with DGF occurrence rate ( P=0 .689) while DGF occurrence rate among female recipients was evidently lower than that among males (P=0 .036);Female recipients selected peritoneal dialysis therapy more than male recipients (P=0 .023);Cerebral hemorrhage female donors were more than male donors (P= 0 .034);BMI (P<0 .001) and postoperative creatinine (P= 0 .001) among female recipients were evidently lower than that among males .Conclusions DGF occurrence rate is significantly lower among female receptors than that among males after kidney transplantation .

Treatment of hypersplenism in patients with portal hypertension of hepatic cirrhosis / 中华肝胆外科杂志

Hypersplenism is a common clinical manifestation of portal hypertension in hepatic cirrhosis.Clinical treatment of hypersplenism includes splenectomy,partial splenic embolization and liver transplantation.Splenectomy and partial splenic embolization are effective for hypersplenism,but the main complications are portal / splenic vein thrombosis (PSVT) and infection.Liver transplantation is an ideal method for the treatment of hypersplenism caused by cirrhosis,but patients with liver transplantation may still have persistent hypersplenism.Simultaneous splenectomy or partial splenic embolization which is performed with liver transplantation is a therapy of persistent hypersplenism.It can improve the function of graft but also increase the risk of infection.

Research progress on machine perfusion to reduce the incidence of non-anastomotic biliary stricture after liver trans-plantation / 中华肝胆外科杂志

Liver transplantation has become the most effective treatment for end-stage liver diseases.Due to the shortage of organ,more and more extended criteria donors (ECD) grafts had been used,which expand the liver pool.However,a series of complications post transplantation were caused by ischemia,hypoxia,steatosis and so on.The non-anastomotic biliary strictures after liver transplantation is one of the major complications when the ECD donors was be used in clinic.The study on the protective effect of machine perfusion on liver donors is too numerous to list,and existing studies have found that MP can reduce the incidence of NAS after liver transplantation.This review provides an overview of the pathogenesis of NAS and the reduction incidence of NAS by MP.