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Hepatobiliary & Pancreatic Diseases International 2012年第4期11卷 360-371页

作者： Xu-Bo Wu Department of General Surgery,Central hospital of Minhang District,ruijin Medical Group,shanghai 201199,china Ran Tao center for organ transplantation,Department of General Surgery,ruijin hospital,shanghai jiaotong university school of medicine,shanghai 200025,china Department of General Surgery Central Hospital of Minhang District Ruijin Medical Group Shanghai 201199 China center for organ transplantation Department of General Surgery Ruijin Hospital Shanghai Jiaotong University School of Medicine Shanghai 200025 China

BACKGROUND:Liver cell transplantation and bioartificial liver may provide metabolic support of liver function temporary and are prospective treatments for patients with liver *** stem cells(MSCs) are expected to be an ideal cell source for transplantation or liver tissue engineering,however the hepatic differentiation of MSCs is still insufficient for clinical *** SOURCES:A PubMed search on 'mesenchymal stem cells','liver cell' and 'hepatocyte differentiation' was performed on the topic,and the relevant articles published in the past ten years were ***:Hepatocyte-like cells differentiated from MSCs are a promising cell source for liver regeneration or tissue *** it is still a matter of debate as to whether MSC-derived hepatocytes may efficiently repopulate a host liver to provide adequate functional substitution,the majority of animal studies support that MSCs can become key players in liver-directed regenerative *** the clinical application of human stem cells in the treatment of liver diseases is still in its ***:Future studies are required to improve the efficacy and consistency of hepatic differentiation from *** is necessary to better understand the mechanism to achieve transdifferentiation with high *** clinical trials are warranted to prove their efficacy in the management of patients with liver failure.

关键词： hepatocyte differentiation mesenchymal stem cells

Preparation and characterization of chitosan porous microcarriers for hepatocyte culture

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Hepatobiliary & Pancreatic Diseases International 2011年第5期10卷 509-515页

作者： Xu-Bo Wu, Cheng-Hong Peng, Fang Huang, Jie Kuang, Song-Lin Yu, Ya-Dong Dong and Bao-San Han center of organ transplantation, ruijin hospital, shanghai jiaotong university school of medicine, shanghai 200025, china Department of General Surgery, Central hospital, Minhang District, shanghai 201100, china center of organ transplantation Ruijin Hospital Shanghai Jiaotong University School of Medicine Shanghai 200025 China Department of General Surgery Central Hospital Minhang District Shanghai 201100 China

BACKGROUND: The bioartificial liver (BAL) is considered a possible alternative method for treating liver failure. The core of the BAL system is culturing liver cells in vitro with high density and activity. Microcarrier culture is a mode of high-density culture. We set out to prepare a novel porous microcarrier to improve the activity of liver cells in vitro. METHODS: Chitosan was used to prepare a novel porous spherical microcarrier with interconnected structure. The chitosan porous microcarriers (CPMs) were modified with gelatin to improve their biocompatibility. CPMs were co-cultured with liver cells, HL-7702 (L-02), to evaluate their effect on cell culture. RESULTS: The average size of the CPMs was about 400 μm in diameter and their apertures were less than 30 μm. The pores of the microcarrier were interconnected. After fixation by sodium tripolyphosphate, the structure of the first freeze-dried CPMs was stable. To further improve the biocompatibility, the surface of CPMs was modified with gelatin through chemical crosslinking (GM-CPMs). Comparing the proliferation curves of L-02 cells cultured on simple CPMs, GM-CPMs and tissue culture polystyrene (TCPS, a mode of planar cell culture), the proliferation rates were similar in the first 5 days and the cells proliferated until day 8 in culture with microcarriers. The OD value of liver cells cultured on GM-CPMs was 1.97-fold higher than that on TCPS culture at day 8. Levels of urea and albumin in supernatants of cells cultured on GM-CPMs increased steadily for 8 days, and were clearly higher than those of cells cultured on TCPS (P<0.05).CONCLUSIONS: The novel CPMs were promising microcarriers for hepatocyte culture and the GM-CPM seemed better. Porous microcarrier culture was beneficial for hepatocyte function and activity.

关键词： porous microcarrier chitosan gelatin, liver cells cell culture

Computed tomography perfusion study of hemodynamic changes and portal hyperperfusion in a rabbit model of small-for-size liver

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Hepatobiliary & Pancreatic Diseases International 2012年第1期11卷 74-80页

作者： Zhi-Guo Zhuang,Jian-Rong Xu,Li-Jun Qian,Qiang Xia and Jia-Chang Chi Department of Radiology,and center of transplantation,Renji hospital,shanghai jiaotong university school of medicine,shanghai 200127,china Department of Radiology Shanghai Jiaotong University School of Medicine Shanghai 200127 Shanghai China center of transplantation Renji Hospital Shanghai Jiaotong University School of Medicine Shanghai 200127 Shanghai China

BACKGROUND:Portal hyperperfusion in the small-for-size (SFS) liver can threaten survival of ***,it is important to understand the hemodynamic changes in the SFS ***:Twenty rabbits were divided into two groups:a control group and a modulation *** control group underwent an extended *** modulation group underwent the same procedure plus splenectomy to reduce portal blood *** perfusion examinations were performed on all rabbits before and after *** parameter values,especially portal vein perfusion (PVP),were ***:PVP in the modulation group was lower than in the control group after operation (P=0.002).In the control group,postoperative PVP increased by 193.7±55.1% compared with preoperative PVP.A weak correlation was found between the increased percentage of PVP and resected liver-to-body weight ratio (RLBWR) (r=0.465,P=0.033).In the modulation group,postoperative PVP increased by 101.4±32.5%.No correlation was found between the increased percentage of PVP and RLBWR (r=0.167,P=0.644).Correlations were found between PVP and serum alanine aminotransferase,aspartate aminotransferase,and total bilirubin after surgery (P<0.05).CONCLUSION:We successfully evaluated the characteristics of hemodynamic changes as well as the effects of splenectomy in the SFS liver in rabbits by the CT technique.

关键词： computed tomography perfusion portal vein perfusion hemodynamics hepatectomy small-for-size liver

Extended hepatectomy with segments Ⅰand Ⅶ as resection remnant:a simple model for small-for-size injuries in pigs

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Hepatobiliary & Pancreatic Diseases International 2008年第6期7卷 601-607页

作者： Qiang Xia,Tian-Fei Lu,Zhi-Hua Zhou,Ling-Xiang Hu,Jun Ying,De-Zhong Ding, Xiao-Song Chen and Jian-Jun Zhang transplantation center and Department of Clinical Laboratory ,Renji hospital,school of medicine,shanghai jiaotong university,shanghai 200127,china Tyco Clinical Institute,shanghai 200040,china transplantation center Renji Hospital School of Medicine Shanghai Jiaotong University Shanghai 200127 China. xiaqiang@***

BACKGROUND:Small-for-size(SFS)syndrome is an important clinical problem after living donor liver transplantation,split liver transplantation or extended *** uncertainty of the mechanisms and treatments of SFS syndrome urges surgeons to establish effective models for SFS syndrome. METHODS:A new porcine model for SFS syndrome based on extended hepatectomy was *** pressure gradient was observed before and after the surgery,and venous sampling for estimation of alanine aminotransferase, total bilirubin,and international normalized ratio was continued on a daily basis. RESULTS:Although the external morphology of the porcine liver differs from that of human being,segmental anatomy is remarkably similar in term of its vascularity and biliary *** hepatectomy with segmentsⅠand Ⅶas resection remnant(about 20%of total liver volume) resulted in similar survival rates,blood liver function tests,and elevated portal pressure gradient as clinical SFS syndrome. CONCLUSIONS:The extended hepatectomy based new model can easily be reproduced,with few costs and surgical *** SFS syndrome can easily be simulated by this new model,which is a useful tool for studying SFS syndrome-related liver injuries,especially portal overperfusion and hypertension.

关键词： hepatectomy small-for-size syndrome

Clinical features of nonalcoholic fatty liver disease-associated hepatocellular carcinoma

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Hepatobiliary & Pancreatic Diseases International 2012年第1期11卷 18-27页

作者： Xiao-Yan Duan, Liang Qiao and Jian-Gao Fan Department of Gastroenterology, Xinhua hospital, shanghai jiaotong university school of medicine, shanghai 200092, china Storr Liver Unit at the Westmead Millennium Institute, the university of Sydney at Westmead hospital, Westmead, NSW 2145, Australia Department of Gastroenterology Xinhua Hospital Shanghai Jiaotong University School of Medicine Shanghai 200092 China Storr Liver Unit at the Westmead Millennium Institute the University of Sydney at Westmead Hospital Westmead NSW 2145 Australia

BACKGROUND: Nonalcoholic fatty liver disease (NAFLD), especially nonalcoholic steatohepatitis, is a recognized risk factor for hepatocellular carcinoma (HCC). However, detailed analysis of the clinical features in patients with NAFLD and their association with HCC is lacking. This study aimed to update the clinical features of patients with NAFLD-associated HCC. DATA SOURCES: The clinical data of patients with NAFLD- associated HCC from 25 studies published between 1990 and 2010 in the Pubmed database were comprehensively reviewed. RESULTS: In a total of 169 patients with NAFLD-associated HCC, 72.8% were male. The median age at abnormal liver function tests and diagnosis of NAFLD and HCC was 60, 64 and 67 years, respectively. Most patients were obese (75%) and diabetic (59.8%), 32.3% had dyslipidemia, and 53% had hypertension. Nearly all patients (98.6%, 71/72) were complicated with at least one metabolic disorder. The majority (76%) of the HCC patients had a solitary tumor nodule, with the tumor size ranging from 0.8 to 20 cm in diameter (mean 3.4 cm). Most (61.1%) of the patients had moderately-differentiated HCC. In 40.2% of the patients, HCC occurred in the absence of cirrhosis. Among 130 patients, 57.7% underwent hepatectomy and 14.6% received liver transplantation. The mean follow-up of the treated patients for 25 months showed that 32.4% (24/74) died and 18.8% (9/48) had recurrence. CONCLUSIONS: Patients with NAFLD-associated HCC are usually accompanied with metabolic disorders. Regular surveillance in patients with NAFLD for HCC is necessary, especially for elderly men with metabolic syndrome.

关键词： obesity diabetes mellitus dyslipidemia nonalcoholic fatty liver disease nonalcoholic steatohepatitis hepatocellular carcinoma

CYP3A5 rather than MDR1 gene polymorphism of recipient is related to tacrolimus individual dose requirement in Chinese liver transplant patients

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CYP3A5 rather than MDR1 gene polymorphism of recipient is re...

Living donor liver transplantation in 43 children with biliary atresia: a single-center experience from the mainland of china

中国药理学会临床药理学专业委员会会议暨第十次全国临床药...

作者： JIN Zhao~1 ZHANG Wei-xia~1 CHEN Bing~1 MAO An-wei~2 CHEN Hao~2 GU Zhi-dong~3 CAI Wei-min~1 1 Department of Pharmacy,Rui Jin hospital,school of medicine,shanghai Jiao Tong university,shanghai 200025,china 2 organ transplantation center,Rui Jin hospital,school of medicine,shanghai Jiao Tong university,shanghai 200025,china 3 Department of Laboratory medicine,Rui Jin hospital,school of medicine,shanghai Jiao Tong university,shanghai 200025,china

AIM:Tacrolimus shows considerable interindividual phar- macokinetic variability,therapeutic drug monitoring of trough blood concentration is necessary to avoid adverse ef- ***3A5 and P-glycoprotein(P-gp,encoded by MDR1)are involved in tacrolimus’ metabolism and ab- sorption *** study is to investigate whether ta- crolimus dosage adjustment is affected by the polymorphism in CYP3A5 and MDR1 in Chinese liver transplant pa- tients. METHODS:Forty-nine liver transplant patients treated with tacrolimus were enrolled in this *** chain reaction-restriction fragment length polymorphism (PCR-RFLP)analysis was applied to determine the geno- type of CYP3A5 and *** blood tough con- centration was measured by FPIA,and concentration/dose ratio(C/D)was investigated at day 7,day 14 and 1 month after liver transplantation. RESULTS:The CD ratios in recipient with CYP3A5*1/ *1(*1/*3)were significantly lower than those of CYP3A5*3/*3 patients after liver transplantation,and the C/D ratios of CYP3A5*1/s 1,*1/s 3 and*3/ *3 were shown as follows:76,82±18,164±51 at 7 days;32,76±19,132±31 at 14 days;36,65±25, 122±32 at 1 *** significant difference was found among the MDR1 G2677T/A and C3435T genotype. CONCLUSION:There was no relationship between MDR1 gene polymorphism(C3435T,G2677T/A)and ta- crolimus C/D ratio in Chinese liver transplantation pa- ***3A5*3 polymorphism is correlated with the whole blood concentration of tacrolimus and dose require- *** intestinal CYP3A5 plays an important role in the metabolism of orally administered tacrolimus in the first month after liver transplantation.

关键词： tacrolimus CYP3A5 MDR1 polymorphism liver transplantation

来源： cnki会议评论

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Hepatobiliary & Pancreatic Diseases International 2012年第3期11卷 250-255页

作者： Jian-Jun Zhu, Qiang Xia, Jian-Jun Zhang, Feng Xue, Xiao-Song Chen, Qi-Gen Li and Ning XuAuthor Department of Liver Surgery, Renji hospital, shanghai jiaotong university school of medicine, shanghai 200127, china Department of Liver Surgery Renji Hospital Shanghai Jiaotong University School of Medicine Shanghai 200127 China

BACKGROUND: There is no large-cohort report on living donor liver transplantation (LDLT) for biliary atresia (BA) patients from the mainland of china. This single-center study describes our initial experience with 43 LDLTs for BA patients aged two years or younger. METHODS: In this study, the eligibility criteria were BA as the primary diagnosis and two years of age or younger. From October 2006 to December 2010, the clinical data of 43 LDLTs, including pre-operative evaluations, surgical techniques, postoperative complications and outcomes of donors and recipients, were retrospectively analyzed. RESULTS: Donor graft type was the left lateral segment with compatible ABO blood groups. Forty-three recipients were selected in this study. The median patient age at operation was 9 months (range 6-24), and the median body weight was 8 kg (range 5.7-12.5). Fourteen (32.6%) recipients received Kasai operations before liver transplantation. The overall one- and two-year cumulative survival rates for grafts and recipients were 81%, 81% and 76%, 76%, respectively. No donor mortality was encountered, with a minimal morbidity and no long- term sequelae. Nine out of 43 recipients died. Postoperative complications of recipients were biliary leakage and refluxing cholangitis (11/43, 25.6%), hepatic artery thrombosis (4, 9.3%), pulmonary infections (4, 9.3%), portal vein thrombosis (3, 7.0%), wound disruption (3, 7.0%), acute rejection (3, 7.0%), cytomegalovirus infection (2, 4.7%), and intra-abdominal bleeding (1, 2.3%).CONCLUSION: Despite the relatively low survival rates due to lack of experience initially, LDLT still provides encouraging outcomes for pediatric recipients with BA, even small children under two years old.

关键词： living donor liver transplantation biliary atresia children

Feasibility of orthotopic fetal liver transplantation:an experimental study

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Hepatobiliary & Pancreatic Diseases International 2012年第2期11卷 143-147页

作者： Xian-Ping Zhou,Xue-Ping Zhou,Wei-Hua Pan,Wei Gong,Cheng-Ren Shi and Zhi-Wei Quan Department of General Surgery and Department of Pediatric Surgery , Xinhua hospital, shanghai jiaotong university school of medicine, shanghai 200092, china Department of General Surgery Xinhua Hospital Shanghai Jiaotong University School of Medicine Shanghai 200092 China Shanghai China Department of Pediatric Surgery Xinhua Hospital Shanghai Jiaotong University School of Medicine Shanghai 200092 China Shanghai China

BACKGROUND:The use of livers from nonviable fetuses is particularly attractive for its potential to solve the current limitations of organ availability for the pediatric ***,it is essential to study the feasibility of orthotopic fetal liver ***:We measured the hepatic and extra-hepatic anatomical structures of fetal and neonatal lambs and established an orthotopic liver transplantation model of the fetal ***:Mean weight of the liver of fetal lambs at 142 to 145 days gestation was 34.75 g and the mean diameter of the portal vein was 3.03 mm,the supra-hepatic vena cava was 5.88 mm,and the infra-hepatic vena cava was 4.00 mm,which matched the corresponding sizes in neonatal lambs aged up to 2 *** standard surgical procedures we completed the vascular inosculation of fetal ***,all the newborn lamb recipients survived less than 24 ***:Orthotopic transplantation of the fetal liver is anatomically and technically ***,perioperative issues need to be resolved prior to clinical application.

关键词： surgical anatomy operative surgery survival time experimental surgery

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活体肝移植的进展与展望

胃肠病学 2009年第11期14卷 650-651页

作者：夏强上海交通大学医学院附属仁济医院器官移植科 200127

活体肝移植(LDLT)可扩大供肝来源,有效缓解供体紧缺局面,尤其是对儿童、急性肝功能衰竭患者和无法长期等待的肝癌患者有着十分重要的意义。为尽可能减少LDLT潜在的手术风险,尤其是供者的风险,应由肝病内外科医师共同进行严格的供受体术... 详细信息

活体肝移植(LDLT)可扩大供肝来源,有效缓解供体紧缺局面,尤其是对儿童、急性肝功能衰竭患者和无法长期等待的肝癌患者有着十分重要的意义。为尽可能减少LDLT潜在的手术风险,尤其是供者的风险,应由肝病内外科医师共同进行严格的供受体术前评估和准备,选择恰当的手术方案。中国应稳步开展LDLT,并积极拓展尸体和脑死亡供体肝移植,进一步发展儿童LDLT和劈离式肝移植(SLT)以提高器官利用率。在第六届上海国际胃肠病学会议期间,国内外肝病专家就LDLT的现状作了相关报道,本文就此次会议的有关内容和最新进展作一简要介绍。

关键词：肝移植肝病肝肿瘤