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Evaluation outcomes of donors in living dono liver transplantation: a single-center analysis of 132 donors

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Hepatobiliary & Pancreatic Diseases International 2011年第5期10卷 480-488页

作者： Ding Yuan, Yong-Gang Wei, Bo Li, Lu-Nan Yan, Tian-Fu Wen, Ji-Chun Zhao, Yong Zeng and Ke-Fei Chen Department of liver and Vascular Surgery, liver Transplantation center Department of Hepatopancreatobiliary Surgery, West China Hospital, Sichuan University, Chengdu 610041, China

BACKGROUND: Donor safety has always been a major concern and potential risk to the donor must be balanced against recipient benefit. However, lack of a standardized and uniform evaluation of perioperative complications is a serious limitation of the evaluation of donor morbidity. This study was designed to evaluate the outcomes of donors in adult living donor liver transplantation (LDLT) using the newer Clavien classification system in a single center in China. METHODS: We prospectively analyzed the outcomes of 132 consecutive living liver donors from 2005 to 2008 using the newer Clavien classification system. The preoperative, intraoperative and postoperative data of the donors were collected and analyzed Ordinal regression was used to analyze the ordered grades of complications. RESULTS: Ninety-four (71.2%) of the donors developed postoperative complications of grade I (n=45, 34.1%), grade II (n=39, 29.5%) and grade III (n=10, 7.6%). There was no death or grade IV morbidity. Hepatic functional impairment and pleural effusion were the most frequent morbidities for living donors. Fifty-three donors (40.1%) developed hepatic functional impairment of grade I (n=40, 31.1%) and grade II (n=13, 10.0%). The ICU stay (7.8±1.8 days) and length of hospital stay (17.7±4.6 days) were significantly longer in donors with grade III than others. Furthermore, ordinal logistic regression revealed that donor’s older age (>40 years) and right hepatectomy were associated with morbidity. In addition, only preoperative total bilirubin (within the normal range) and postoperative nadir serum phosphorus were independently associated with hepatic functional impairment. The receiveroperator characteristic curve revealed that preoperative total bilirubin >18.0 μmol/L and postoperative nadir of serum phosphorus <1 mg/dL may lead to more severe hepatic functional impairment. CONCLUSIONS: Despite the fact that donors are relatively safe to undergo hepatectomy, many living donors still experience

关键词： liver transplantation living donor risk factors safety

liver transplantation for the treatment of polycystic liver disease:a single-center analysis

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Liver transplantation for the treatment of polycystic liver ...

Risk of hepatocellular carcinoma after hepatitis C virus cure

2012中国器官移植大会

作者： Bin-sheng Fu,Tong Zhang,Hua Li,Yang Yang,Gui-hua Chen liver Transplant center,Third Affiliated Hospital of Sun Yat-sen University,Transplantation Research Institute of Sun Yat-sen University

【Objectives】To evaluate the effect of liver transplantation for polycystic liver disease and summarize the clinical experience of liver transplantation in the treatment of polycystic liver disease.【Methods】The clinical records of 8 cases of polycystic liver disease who underwent liver transplantation at our center from September 2003 to July 2009 were analyzed retrospectively.

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World Journal of Gastroenterology 2022年第1期28卷 96-107页

作者： Maria Alejandra Luna-Cuadros Hao-Wei Chen Hira Hanif Mukarram Jamat Ali Muzammil Muhammad Khan Daryl Tan-Yeung Lau liver center Division of Gastroenterology and Hepatology Beth Israel Deaconess Medical CenterHarvard Medical SchoolBostonMA 02215United States

Hepatitis C virus(HCV)is a significant cause of hepatocellular carcinoma(HCC).The direct-acting antivirals marked a new era of HCV therapy and are associated with greater than 95%cure *** treatment of chronic hepatitis C greatly reduces the risk of HCC.A proportion of patients,especially those with pre-existing cirrhosis,remain at risk for HCC despite sustained virologic response(SVR).Diabetes mellitus,hepatic steatosis,alcohol consumption and lack of fibrosis regression are associated with risks of HCC after HCV *** modalities such as aspartate aminotransferase to platelet ratio index and fibrosis-4 index and transient elastography have been used to monitor hepatic *** recently,various fibrosis scores have been combined with clinical parameters and other novel biomarkers to predict risks of HCC for patients who achieved *** models still need to be validated and standardized prior to applying to routine clinical care.

关键词： Hepatitis C virus cure Hepatocellular carcinoma Hepatocellular carcinoma risk models Fibrosis markers Transient elastography

Relationship between alcohol consumption and clinical manifestation of patients with fatty liver:a single-center study

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Hepatobiliary & Pancreatic Diseases International 2011年第3期10卷 276-279页

作者： International Health Care center (Wang XF) and Department of Gastroenterology (Yue M),First Affiliated Hospital,Zhejiang University School of Medicine,Hangzhou 310003,China International Health Care center First Affiliated Hospital Zhejiang University School of Medicine Hangzhou 310003 China Department of Gastroenterology First Affiliated Hospital Zhejiang University School of Medicine Hangzhou 310003 China

BACKGROUND:Fatty liver is a common chronic liver disease *** is associated with an increasing morbidity in China in recent *** aim of this study was to analyze the effect of drinking alcohol on the hemoglobin and biochemical values of patients with fatty ***:We investigated the clinical and laboratory data of 669 patients with fatty *** the 669 patients,166 consumed alcohol more than 60 g per week for at least 2 years,and 503 did not have a history of long-term alcohol *** further analyzed the relationship between alcohol consumption and clinical characteristics of these ***:The values of aspartate transaminase (AST),gammaglutamyl transpeptidase (GGT),and hemoglobin in the long-term consumption group were significantly higher than those in the non long-term consumption group (Pliver,suggesting their potential roles in hepatic steatosis.

关键词： alcohol consumption fatty liver hemoglobin aspartate transaminase gamma-glutamyl transpeptidase

Immunosuppressive strategies and management

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中国新药与临床杂志 2008年第12期27卷 942-943页

作者： Shi-hui PAN (center for liver Diseases and Transplantation,Cedars-Sinai Medical center,Los Angeles CA 90048,USA ) centerfor liver Diseases and Transplantation Cedars-Sinai Medwd Center 美国

Advances in immunosuppressive therapy have significantly improved short-term allograft and patient ***,chronic allograft failure,antibody mediated rejection,recurrent diseases and immunosuppressive drug associated adverse effects remain serious barriers to long-term survival and quality of *** immunosuppressive agents and protocols are being evaluated to combat these ***, clinicians must work to manage post-transplant complications and avoid complex medication regimens,which will potentiate drug interactions and non-compliance.

关键词： Immunosuppressive strategies and management

Antiviral therapy with nucleos(t)ide analogues for severe chronic hepatitis B

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Hepatobiliary & Pancreatic Diseases International 2009年第4期8卷 438-439页

作者： Fu-Kui Zhang, liver Research center, Beijing Friendship Hospital, Capital Medical University, Beijing 100050,China Capital Med Univ Beijing Friendship Hosp Liver Res Ctr Beijing 100050 Peoples R China

To the Editor:I read the paper by Chen et al[1]with great *** authors performed a retrospective study to evaluate the short-term efficacy of antiviral therapy with

关键词： CHB HBV Antiviral therapy with nucleos t)ide analogues for severe chronic hepatitis B

Lamivudine treatment of decompensated hepatitis B virus-related cirrhosis

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Hepatobiliary & Pancreatic Diseases International 2006年第1期5卷 10-15页

作者： Fu-Kui Zhang liver Research center, Beijing Friendship Hospital, Capital University of Medical Sciences, Beijing 100050, China liver Research center Beijing Friendship Hospital Capital University of Medical Sciences Beijing 100050 China. frankliver@***

BACKGROUND: Patients with decompensated hepatitis B vires (HBV)-related cirrhosis tend to have low or undetectable HBV replication. However, some patients continue to have high levels of HBV replication and effective suppression of HBV replication with antiviral agents may potentially decrease hepatic necroinflammation and improve or stabilize liver function. This review was to under stand the efficacy and safety of lamivudine in the treatment of decompensated HBV cirrhosis. DATA SOURCES: An English-language literature search (MEDLINE January 1988-July 2005) was performed, and a total of 52 articles/abstracts relevant to the issue were selected. After review of the selected papers, the meaningful results and conclusions were extracted using scientific crite ria. The papers reviewed pertained mainly to the efficacy and safety profiles of lamivudine treatment for decompensated HBV cirrhosis. RESULTS: The ultimate treatment of decompensated HBV cirrhosis is liver transplantation, but lamivudine treatment may lead to rapid suppression of viral replication and improvement of biochemical and clinical parameters, reduced morbidity and hospitalization for complications of liver disease, increased pre-transplant survival as well as reduced need for transplantation. However, viral resistance can develop after prolonged treatment with lamivudine, and breakthrough hepatitis may be fatal in few patients. Adefovir is effective for lamivudine-resistant HBV mutants. CONCLUSIONS: Antiviral therapy with lamivudine for decompensated HBV cirrhosis can be effective. However, some patients may experience a hepatitis flare with the emergence of YMDD mutants resulting in progressive worsening of liver disease, and should be referred for 'rescue' therapy with other nucleoside/nucleotide analogues such as adefovir dipivoxil.

关键词： lamivudine adefovir dipivoxil hepatitis B virus cirrhosis

Interferon-alfa in the treatment of chronic hepatitis B

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Hepatobiliary & Pancreatic Diseases International 2004年第3期3卷 337-340页

作者： Fu-Kui Zhang liver Research center, Beijing Friendship Hospital,Capital University of Medical Sciences, Beijing 100050 , China liver Research center Beijing Friendship Hospital Capital University of Medical Sciences Beijing 100050 China. frankliver@***

BACKGROUND: Interferon-alfa has been used in the treat-ment of chronic hepatitis B for more than 20 years and hasits own advantages including a definite course of therapy,no production of drug-resistant variants, and sustained effi-cacy. This review was to understand the role of interferon-alfa therapy in chronic hepatitis *** RESOURCES: An English-language literature searchusing Medscape and MEDLINE was performed and a totalof 48 articles on the treatment of chronic hepatitis with in-terferon-alfa or pegylated interferon-alfa were ***: Interferon-alfa therapy was associated with ahigher HBV DNA inhibition rate and HBeAg loss rate com-pared with controls, and it may have long-term beneficialeffects in terms of HBV clearance, reduction of hepatocel-lular carcinoma, and prolongation of survival. Pegylatedinterferon-alfa was more effective than conventional inter-feron-alfa in the treatment of chronic hepatitis B as well aschronic hepatitis C, and was also associated with greater ef-ficacy than conventional interferon in difficult-to-treat ***: Interferon-alfa is still regarded as one ofthe first-line drugs for the treatment of chronic hepatitis *** interferon is a more promising therapy than con-ventional interferon-alfa, especially in patients with refrac-tory chronic hepatitis B.

关键词： chronic hepatitis B interferon pegylated interferon lamivudine

Pegylated interferon α-2b up-regulates specific CD8+ T cells in patients with chronic hepatitis B

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World Journal of Gastroenterology 2010年第48期16卷 6145-6150页

作者： Ji Chen,Yan Wang,Xue-Jie Wu,Jun Li,Feng-Qin Hou,Gui-Qiang Wang,Department of Infectious Diseases,center for liver Diseases,Peking University First Hospital,Beijing 100034,China Department of Infectious Diseases Center for Liver Diseases Peking University First Hospital No. 8 Xishiku Street Xicheng District Beijing 10034 China.

AIM:To investigate the effect of pegylated interferon (IFN) α-2b on specific CD8+ T lymphocytes in patients with chronic hepatitis B (CHB). METHODS:Twenty-one patients with CHB were treated with pegylated IFN α-2b. Periphery blood mononuclear cells were isolated from fresh heparinized blood by Ficoll-Hypaque density gradient centrifugation (density:1.077 g/L,Pharmingen) at weeks 0,4,8,12,and 24,respectively. Frequency of circulating hepatitis B virus (HBV) epitope-specific CD8 T cells was detected by flow cytometry. Cytokines were detected by cytometric bead assay. RESULTS:The frequency of circulating HBV core or env-specific CD8 T cells was higher (P < 0.05),the number of HBV core specific CD8 T cells was greater at week 24 (P < 0.05),the level of Th1-type cytokines [interleukin (IL)-12,tumor necrosis factor-α,and IFN-γ] was higher,while that of Th2-type cytokines (IL-4,IL-6,and IL-10) was lower in responders than in nonresponders (P < 0.05) after pegylated IFN α-2b treatment. The IL-6 level was correlated with HBV DNA (r = 0.597,P = 0.04),while the inducible protein-10 (IP-10) level was correlated with serum alanine aminotransferase (ALT) (r = 0.545,P = 0.005). The IP-10 level at week 8 after pegylated IFN α-2b treatment could predict the normalization of ALT in CHB patients (positive predict value = 56%,negative predict value = 92%). CONCLUSION:Pegylated IFN α-2b can enhance the immune response of CHB patients by increasing the frequency of HBV specific CD8+ T cells and regulating the Th1/Th2 cytokines.

关键词： Chronic hepatitis B Pegylated interferon α-2b therapy Immune response Cytokine