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Potential etiopathogenesis of seventh day syndrome following living donor liver transplantation:ischemia of the graft?

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Hepatobiliary & Pancreatic Diseases International 2010年第1期9卷 22-26页

作者： Lan, Xiang Li, Bo Wang, Xiao-Fei Wei, Yong-Gang Yan, Lu-Nan Zhao, Ji-Chun Sichuan Univ W China Hosp Div Liver Transplantat Chengdu 610041 Peoples R China Sichuan Univ W China Hosp Div Vasc Surg Chengdu 610041 Peoples R China

BACKGROUND: Seventh-day syndrome (7DS) is an early serious complication following liver transplantation with a high mortality because of its unknown etiopathogenesis. This study aimed to analyze the potential etiopathogenesis of 7DS. METHODS: A retrospective analysis of 98 consecutive living donor liver transplants performed from 2001 to 2007 at our center revealed that 5 patients had suffered from 7DS; their age, MELD score, portal vein inflow and other parameters were compared with those of the other recipients. RESULTS: The 5 patients showed common features: (a) initial uneventful recovery, and a dramatic rise of serum liver enzyme levels I to 2 weeks later; (b) decreased inflow in the portal vein accompanied by augmentation of serum creatinine and urea nitrogen level; and (c) serial liver biopsy findings of apoptosis and ischemic necrosis of hepatocytes. Four of the 5 patients died. Age, waiting time to transplantation, MELD score, operation time, cold ischemic time, portal interceptive time and diameter of the portal vein were not significantly different between the 2 groups, but a difference was found in the flow rate of the portal vein (t=3.234, Pnecrosis, and renal failure. Hence, hypoperfusion of the liver graft was considered to be the etiopathogenesis of 7DS, for which, however sufficient evidence is lacking. More studies of 7DS are needed.

关键词： seventh-day syndrome living donor liver transplantation ischemic hepatitis etiopathogenesis hepatocellular necrosis

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Circulating adhesion molecules in patients with virus-related chronic diseases of the liver

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World Journal of Gastroenterology 2005年第29期11卷 4566-4569页

作者： Cosimo Marcello Bruno Claudio Sciacca Danila Cilio Gaetano Bertino Anna Elisa Marchese Gaetana Politi Lucia Chinnici Department of Internal Medicine and Systemic Diseases University of Catania Italy Lucia Chinnici Clinical Laboratory Analysis S. Bambino Hospital Catania Italy

AIM: In the inflammatory state, intercellular adhesion molecule-1 (ICAM-1) and vascular cellular adhesion molecule-1 (VCAM-1) play a key role in promoting migration of immunological cells from the circulation to target *** of our study was to investigate soluble forms of these molecules in patients with virus-related chronic liver diseases, to assess their behavior in different pathologies and correlation with severity of liver ***: Circulating ICAM-1 and VCAM-1 were assayed by EIA commercial kits (R&D System Co.,Abington, UK) in 23 patients with chronic active hepatitis (CH), 50 subjects affected by liver cirrhosis (LC) and 15 healthy controls comparable for sex and age. In patients, serum alanine aminotransferase (ALT) and aspartate aminotransferase (AST) were also detected by ***: LC patients had significantly higher ICAM-1 values than CH patients (38.56±7.4 ng/mL vs 20.89±6.42 ng/mL; P＜0.001) and these ones had significantly higher values than controls (12.92±1.08 ng/mL; P＜0.001). In CH group, ICAM-1 levels were significantly related to inflammatory activity (P= 0.041) and ALT values (r= 0.77;P＜0.05). VCAM-1 values were significantly increased only in LC patients (P＜0.001) and related to severity of liver ***: These findings suggest that the determination of serum ICAM-1 can be considered as an additional useful marker of hepatocellular necrosis and inflammatory activity in chronic hepatitis, while serum VCAM-1 is an indicator of liver fibrogenesis and severity of disease in cirrhosis.

关键词： ICAM-1 VCAM-1 Chronic liver diseases hepatocellular necrosis Liver fibrosis

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