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Thrombocytopenia after liver transplantation:should we care?

World Journal of Gastroenterology 2018年第13期24卷 1386-1397页

作者： Kazuhiro Takahashi Shunji Nagai mohamed safwan Chen Liang Nobuhiro Ohkohchi Department of Surgery Division of Gastroenterological and Hepatobiliary Surgery and Organ Transplantation University of TsukubaTsukubaIbaraki 3058575Japan Transplant and Hepatobiliary Surgery Henry Ford HospitalDetroitMl 48202United States

Transient thrombocytopenia is a common phenomenon after liver transplantation. After liver transplantation(LT), platelet count decreases and reaches a nadir on postoperative days 3-5, with an average reduction in platelet counts of 60%; platelet count recovers to preoperative levels approximately two weeks after LT. The putative mechanisms include haemodilution, decreased platelet production, increased sequestration, medications, infections, thrombosis, or combination of these processes. However, the precise mechanisms remain unclear. The role of platelets in liver transplantation has been highlighted in recent years, and particular attention has been given to their effects beyond hemostasis and thrombosis. Previous studies have demonstrated that perioperative thrombocytopenia causes poor graft regeneration, increases the incidence of postoperative morbidity, and deteriorates the graft and decreases patient survival in both the short and long term after liver transplantation. Platelet therapies to increase perioperative platelet counts, such as thrombopoietin, thrombopoietin receptor agonist, platelet transfusion, splenectomy, and intravenous immunoglobulin treatment might have a potential for improving graft survival, however clinical trials are lacking. Further studies are warranted to detect direct evidence on whether thrombocytopenia is the cause or result of poor-graft function and postoperative complications, and to determine who needs platelet therapies in order to prevent postoperative complications and thus improve post-transplant outcomes.

关键词： Thrombocytopenia Liver regeneration Platelet therapy Platelet Thrombopoietin receptor agonist Intravenous immunoglobulin treatment Liver transplantation

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Extrahepatic metastasis of hepatocellular carcinoma to the paravertebral muscle:A case report

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World Journal of Hepatology 2017年第22期9卷 973-978页

作者： Kazuhiro Takahashi Krishna G Putchakayala mohamed safwan Dean Y Kim Transplant and Hepatobiliary Surgery Henry Ford HospitalDetroitMI 48202United States

Identification of extrahepatic metastases(EHM) of hepatocellular carcinoma(HCC) has been paradoxically increasing due to an increase in the survival of HCC patients. However, metastasis of HCC to the skeletal muscle tissue is extremely rare. We describe a unique case of HCC metastasizing to the paravertebral muscle. A 55-year-old man with a history of hepatitis B cirrhosis underwent partial liver resection with complete removal of HCC. Three months later, a computed tomography(CT) scan showed intrahepatic recurrence. The tumors were treated with yttrium-90 microspheres, transcatheter arterial chemoembolization, and sorafenib. Six months later, a CT scan showed an enhancing lesion of the left paravertebral muscle that on biopsy were consistent with metastatic HCC. The tumor was treated with stereotactic hypo-fractionated imageguided radiation therapy(SHFRT). A follow-up scan 3 mo post-radiotherapy revealed a stable appearance of the paravertebral muscle metastasis. Because of the progression in the intrahepatic tumors, the patient was treated with capecitabine, which was changed to dasatinib 6 mo later. The patient passed away three years after the primary surgical resection. Management of EHM poses an extreme challenge. This is the first case of HCC with EHM to the paravertebral muscle in which stability of disease was achieved using SHFRT. This case highlights the importance of early detection of hepatitis B viral infection and initiation of anti-viral therapy to decrease recurrence of HCC and prevent EHM.

关键词： Hepatocellular 癌骨胳的肌肉 Paravertebral 肌肉 Extrahepatic 转移 Stereotactic 低亚硫酸钠分别图象指导了放射治疗肝炎 B 病毒

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Preliminary Study on Tensile and Impact Properties of Kenaf/Bamboo Fiber Reinforced Epoxy Composites

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Journal of Renewable Materials 2018年第5期6卷 529-535页

作者： Ahmad safwan Mohammad Jawaid mohamed T.H.Sultan Azman Hassan Laboratory of Biocomposite Technology Institute of Tropical Forestry and Forest Products(INTROP)Universiti Putra Malaysia43400 UPM SerdangSelangor Darul EhsanMalaysia Department of Aerospace Engineering Faculty of EngineeringUniversiti Putra Malaysia43400 UPM SerdangSelangor Darul EhsanMalaysia Department of Polymer Engineering Faculty of Chemical and PetroleumUniversiti Teknologi MalaysiaSkudaiJohor BharuMalaysia

The application of natural fibers as reinforcement in composite material has increased due to environmental concerns,low cost,degradability and health concerns.The purpose of this study is to identify the best type of bamboo fibers to be used as reinforcement for kenaf(K)/bamboo hybrid composite.There were three types of bamboo fibers evaluated in this study which include bamboo mat(B),bamboo fabric(BF)and bamboo powder(BP).Chemical composition of B,BF,BP and K fibers were analyzed in this study.The effect of different types of bamboo fibers on tensile,impact,and morphological properties were investigated.The B/epoxy composites displayed the highest tensile strength(53.03 MPa)while K/epoxy composite had the highest tensile modulus(4.71 GPa).Scanning electron micrographs of B/epoxy composites displayed better fiber/matrix interfacial bonding in comparison to other studied composites.Results showed that impact strength of BF-based composite was highest(45.70 J/m).In conclusion,the tensile strength of B/epoxy composite is superior to the other bamboo reinforced composites and will be further evaluated in the next study.

关键词： Composite kenaf bamboo natural fiber polymer composite tensile properties impact properties morphological properties

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