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Status epilepticus as an initial manifestation of hepatic encephalopathy:A case report

World Journal of Clinical Cases 2020年第24期8卷 6480-6486页

作者： Bin Cui Lin Wei Wei Qu zhi-Gui zeng Ying Liu zhi-Jun zhu Li-Ying Sun Liver Transplantation Center National Clinical Research Center for Digestive DiseasesBeijing Friendship HospitalCapital Medical UniversityBeijing 100050China Liver Transplantation Center National Clinical Research Center for Digestive DiseasesIntensive Care UnitBeijing Friendship HospitalCapital Medical UniversityBeijing 100050China

BACKGROUND Status epilepticus in patients with hepatic encephalopathy (HE) is a rare butserious condition that is refractory to antiepileptic drugs, and current treatmentplans are vague. Diagnosis may be difficult without a clear history of *** transplantation (LT) is effective to alleviate symptoms, however, there arefew reports about LT in the treatment of status epilepticus with HE. To ourknowledge, this is the first report of status epilepticus present as initialmanifestation of *** SUMMARY A 59-year-old woman with a 20-year history of heavy drinking was hospitalizedfor generalized tonic-clonic seizures. She reported no history of episodes of HE,stroke, spontaneous bacterial peritonitis, ascites or gastrointestinal *** examination revealed a comatose patient, without *** examination suggested liver cirrhosis. Plasma ammonia levels uponadmission were five times normal. Brain computed tomography (CT) was normal,while abdominal CT and ultrasound revealed mild ascites, liver cirrhosis andsplenomegaly. Electroencephalography (EEG)showed diffuse slow waves rhythm,consistent with HE, and sharp waves during ictal EEG corresponding to clinicalsemiology of focal tonic seizures. The symptoms were reversed by continuousantiepileptic treatment and lactulose. She was given oral levetiracetam, and focalaware seizures occasionally affected her 10 mo after *** Status epilepticus could be an initial manifestation of HE. Antiepileptic drugs combined with lactulose are essential for treatment of status epilepticus with HE,and LT is effective to prevent the relapse.

关键词： Status epilepticus Hepatic encephalopathy Decompensated alcoholic liver cirrhosis Antiepileptic drugs Liver transplantation Case report

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Is sinusoidal obstructive syndrome a recurrent disease after liver transplantation? A case report

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World Journal of Clinical Cases 2021年第2期9卷 489-495页

作者： Ying Liu Li-Ying Sun zhi-Jun zhu Lin Wei Wei Qu zhi-Gui zeng Liver Transplantation Center Beijing Friendship HospitalCapital Medical UniversityBeijing 100050China Intensive Care Unit Beijing Friendship HospitalCapital Medical UniversityBeijing 100050China

BACKGROUND Sinusoidal obstructive syndrome(SOS)is a disease that damages hepatic sinusoidal endothelial cells,resulting in progressive occlusion and fibrosis of the lobular central vein and the occurrence of intrahepatic sinusoidal portal ***,SOS after liver transplantation(LT)is uncommon and potentially ***,we report a rare case of second-time recurrence of SOS after liver retransplantation(rLT).CASE SUMMARY A 22-year-old woman received a living donor LT due to *** years later,she developed abdominal distention and ascites with no apparent *** was diagnosed with recurrence of SOS and underwent *** 2 mo post rLT,the patient suffered from aggravated jaundice and ascites *** was diagnosed with second-time recurrence of SOS post-rLT according to computed tomography and liver *** treatment with warfarin anticoagulation and immunosuppressant conversion,she gradually recovered with improvement of liver function and liver *** the 17-mo follow-up period,she was in good condition with normal liver function and no *** SOS can be a recurrent disease after LT,and autoimmune antibody and genetic sequencing should be screened before *** susceptible patients,anticoagulant drugs should be used for an extended period,and tacrolimus or other pathogenic agents should be *** diagnosis and treatment can improve the prognosis of patients and avoid graft failure or death.

关键词： Sinusoidal obstructive syndrome Liver transplantation Recurrence Sinusoidal dilatation and congestion Patchy enhancement Case report

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Novel approach for the diagnosis of occult cytomegalovirus cholangitis after pediatric liver transplantation:A case report

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World Journal of Clinical Cases 2020年第12期8卷 2597-2602页

作者： Ying Liu Li-Ying Sun zhi-Jun zhu Wei Qu Liver Transplantation Center National Clinical Research Center for Digestive DiseasesBeijing Friendship HospitalCapital Medical UniversityBeijing 100050China Intensive Care Unit Beijing Friendship HospitalCapital Medical UniversityBeijing 100050China

BACKGROUND Cytomegalovirus(CMV)infection is a common infection in liver transplant recipients,which is related to chronic rejection and biliary *** is often diagnosed based on serum CMV-DNA or CMV *** our knowledge,this is the first report of the successful treatment of occult CMV cholangitis in a pediatric liver transplantation(LT)*** SUMMARY A 7-mo-old baby girl received LT due to biliary atresia and cholestasis *** 1 mo following LT,the patient suffered from aggravated jaundice with no apparent *** imaging results showed intrahepatic and extrahepatic bile duct dilatation,the patient was diagnosed with biliary complications and percutaneous cholangiography and biliary drainage was ***,there was little biliary drainage and her liver function ***-DNA was isolated from the bile with the surprising outcome that 3×106 copies/mL were present,whereas the CMV-DNA in serum was *** antiviral therapy with ganciclovir,she gradually recovered and bilirubin decreased to normal *** the 4-year follow-up period,her liver function remained *** Bile CMV sampling can be used for the diagnosis of occult CMV infection,especially in patients with negative serum CMV-DNA and CMV *** for CMV in the biliary tract may serve as a novel approach for the diagnosis of cholestasis *** diagnosis and treatment will decrease the risk of graft loss.

关键词： Occult cytomegalovirus cholangitis Biliary complications Pediatric Liver transplantation Bile cytomegalovirus-DNA detection Case report

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Laparoscopic left lateral sectionectomy in pediatric living donor liver transplantation by single-port approach:A case report

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World Journal of Clinical Cases 2020年第23期8卷 6103-6109页

作者： Hong-Yu Li Lin Wei zhi-Gui zeng Wei Qu zhi-Jun zhu Liver Transplantation Center Beijing Friendship HospitalCapital Medical UniversityBeijing 100050China

BACKGROUND Single-port laparoscopy has been used in a variety of abdominal *** report the first case of single-port laparoscopic left lateral sectionectomy in pediatric laparoscopic living donor liver *** SUMMARY A 28-year-old man volunteered for living liver donation to his daughter who was diagnosed with liver cirrhosis and portal hypertension after the Kasai procedure for biliary *** body mass index was 20.5 kg/*** dynamic computed tomography showed:(1)Left lateral graft volume of 232.76 cm3 with a graft-torecipient weight ratio of 2.59%;and(2)Right hepatic artery derived from the superior mesenteric artery.A single-port access system was placed through a transumbilical incision,including four trocars:two 12-mm ports for a camera and endoscopic stapler and two 5-mm working *** parenchyma was dissected by a Harmonic and Cavitron Ultrasonic Surgical Aspirator,while bipolar was used for *** bile duct was transected above the bifurcation by indocyanine green fluorescence *** specimen was retrieved from the umbilical *** total operation time was 4 h without blood *** final graft weight was 233.6 g with graft-torecipient weight ratio of 2.60%.The donor was discharged uneventfully on postoperative day *** Single-port laparoscopic left lateral sectionectomy is feasible in pediatric laparoscopic living donor liver transplantation in an experienced transplant center.

关键词： Pediatric living donor liver transplantation Laparoscopy Single-port approach Intraoperative indocyanine green fluorescence cholangiography Treatment Case report

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Liver transplantation for severe portopulmonary hypertension: A case report and literature review

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World Journal of Clinical Cases 2019年第21期7卷 3569-3574页

作者： Xiao-Jie Chen zhi-Jun zhu Li-Ying Sun Lin Wei zhi-Gui zeng Ying Liu Wei Qu Liang zhang Liver Transplantation Center National Clinical Research Center for Digestive DiseasesBeijing Friendship HospitalCapital Medical UniversityBeijing 100050China Clinical Center for Pediatric Liver Transplantation Capital Medical UniversityBeijing 100050China Beijing Key Laboratory of Tolerance Induction and Organ Protection in Transplantation Beijing 100050China Department of Intensive Care Unit Beijing Friendship HospitalCapital Medical UniversityBeijing 100050China

BACKGROUND Portopulmonary hypertension(PoPH) is not uncommon in patients waiting for liver transplantation(LT).Severe PoPH has a very high perioperative mortality rate and is still considered a contraindication for *** patients with liver disease require but cannot receive LT due to severe PoPH and eventually *** report a patient with severe PoPH who underwent successful LT and had near normal pulmonary pressure without drug *** SUMMARY A 39-year-old woman was hospitalized with the chief complaint of jaundice and exertional dyspnea and *** disease and liver cirrhosis was diagnosed 6 years *** liver disease met the criteria for ***, right heart catheterization showed that her mean pulmonary artery pressure was increased at 50 mmHg, pulmonary vascular resistance was 460 dyn?s/cm^5 and pulmonary artery wedge pressure was 20 mmHg, which may have been the reasons for her chief *** patient was diagnosed with severe PoPH and was not listed for LT *** 5 mo of pharmacotherapy, her severe PoPH was moderate, and she underwent successful *** artery pressure steadily decreased according to post-operative echocardiographic monitoring and drugs have been discontinued for a *** The safety of LT can be greatly improved by reducing mean pulmonary artery pressure to a low level, and LT may cure PoPH.

关键词： Portopulmonary hypertension Pharmacotherapy Liver transplantation Pulmonary hypertension crisis Treatment Case report

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