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How to apply ex-vivo split liver transplantation safely and feasibly: A three-step approach

World Journal of Gastrointestinal Surgery 2024年第6期16卷 1691-1699页

作者： Dong Zhao Qiu-Hua Xie Tai-Shi Fang Kang-Jun Zhang Jian-Xin Tang Xu Yan Xin Jin Lin-Jie Xie Wen-Gui Xie Department of Liver Surgery and Organ Transplantation Center Shenzhen Third People’s HospitalThe Second Affiliated HospitalSchool of MedicineSouthern University of Science and TechnologyShenzhen 518112Guangdong ProvinceChina Department of Organ Procurement Organizations Shenzhen Third People’s HospitalThe Second Affiliated HospitalSchool of MedicineSouthern University of Science and TechnologyShenzhen 518112Guangdong ProvinceChina

BACKGROUND Given the current organ shortage crisis,split liver transplantation(SLT)has emerged as a promising alternative for select end-stage liver disease *** To introduce an ex-vivo liver graft splitting approach and evaluate its safety and feasibility in *** A retrospective analysis was conducted on the liver transplantation data from cases performed at our center between April 1,2022,and May 31,*** study included 25 SLT cases and 81 whole liver transplantation(WLT)*** ex-vivo liver splitting was employed for SLT graft procurement in three *** outcomes were determined,including liver function parameters,postoperative complications,and perioperative *** comparisons for categorical variables were performed using theχ²-*** In the study,postoperative complications in the 25 SLT cases included hepatic artery thrombosis(n=1)and pulmonary infections(n=3),with no perioperative *** contrast,among the 81 patients who underwent WLT,complications included perioperative mortality(n=1),postoperative pulmonary infections(n=8),abdominal infection(n=1),hepatic artery thromboses(n=3),portal vein thrombosis(n=1),and intra-abdominal bleeding(n=5).Comparative analysis demonstrated significant differences in alanine aminotransferase(176.0 vs 73.5,P=0.000)and aspartate aminotransferase(AST)(42.0 vs 29.0,P=0.004)at 1 wk postoperatively,and in total bilirubin(11.8 vs 20.8,P=0.003)and AST(41.5 vs 26.0,P=0.014)at 2 wk ***,the overall incidence of complications was comparable between the two groups(P>0.05).CONCLUSION Our findings suggest that the total ex-vivo liver graft splitting technique is a safe and feasible approach,especially under the expertise of an experienced transplant *** approach developed by our center can serve as a valuable reference for other transplantation centers.

关键词： Split liver transplantation Transplantation Liver splitting ex-vivo In-situ

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Review of ex-vivo characterisation of corneal biomechanics

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Medicine in Novel Technology and Devices 2021年第3期11卷 40-46页

作者： JunJie Wang XiaoYu Liu FangJun Bao Bernardo T.Lopes LiZhen Wang Ashkan Eliasy Ahmed Abass Ahmed Elsheikh Eye Hospital Wenzhou Medical UniversityWenzhouChina The Institution of Ocular Biomechanics Wenzhou Medical UniversityWenzhouChina Key Laboratory for Biomechanics and Mechanobiology of Ministry of Education School of Biological Science and Medical EngineeringBeihang UniversityBeijingChina Beijing Advanced Innovation Centre for Biomedical Engineering Beihang UniversityBeijingChina School of Engineering University of LiverpoolLiverpoolUK Department of Ophthalmology Federal Univerisity of Sao Paulo(UNIFESP)Sao PauloBrazil National Institute for Health Research(NIHR)Biomedical Research Centre for Ophthalmology Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of OphthalmologyLondonUK

The evaluation of the corneal biomechanical behaviour has important clinical *** name a few,the accuracy of the intraocular pressure measurement,the study of corneal ectatic diseases and the assessment and optimisation of corneal surgical procedures are all highly influenced by corneal *** the last 45 years different ex-vivo methods were developed to study corneal biomechanical *** tissue maintenance,support,loading systems,as well as different monitoring strategies of corneal deformations were *** this review,the most important and commonly used methods are outlined,including strip extensiometry,inflation,compression,indentation and tissue separation *** particularities,applications,pros and cons and main applications are discussed.

关键词： ex-vivo Corneal Biomechanics experimental testing

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Mechanical circulatory support in lung transplantation: Cardiopulmonary bypass, extracorporeal life support, and ex-vivo lung perfusion

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World Journal of Respirology 2015年第2期5卷 78-92页

作者： Shaylyn C Bennett Eliza W Beal Curtis A Dumond Thomas Preston Jim Ralston Amy Pope-Harman Sylvester Black Don Hayes Jr Bryan A Whitson Department of Surgery the Ohio State University Wexner Medical Center Division of Cardiothoracic Surgery Department of Surgerythe Ohio State University Wexner Medical Center Department of Cardiovascular Perfusion and ECMO Nationwide Children’s Hospital Department of Perfusion the Ohio State University Wexner Medical Center Division of Pulmonary AllergyCritical Care and Sleep Medicinethe Ohio State University Wexner Medical Center Division of Transplantation Surgery Department of Surgerythe Ohio State University Wexner Medical Center Department of Pediatric Pulmonology Nationwide Children’s Hospital

Lung transplant is the standard of care for patients with end-stage lung disease refractory to medical management. There is currently a critical organ shortage for lung transplantation with only 17% of offered organs being transplanted. Of those patients receiving a lung transplant, up to 25% will develop primary graft dysfunction, which is associated with an 8-fold increase in 30-d mortality. There are numerous mechanical lung assistance modalities that may be employed to help combat these challenges. We will discuss the use of mechanical lung assistance during lung transplantation, as a bridge to transplant, as a treatment for primary graft dysfunction, and finally as a means to remodel and evaluate organs deemed unsuitable for transplant, thus increasing the donor pool, improving survival to transplant, and improving overall patient survival.

关键词： Lung transplant Cardiopulmonary bypass extracorporeal membrane oxygenation extracorporeal life support extracorporeal lung assist Interventional lung assist ex-vivo lung perfusion

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experimental assessment of regenerative properties of platelet rich plasma on the human skin-a review

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Plastic and Aesthetic Research 2022年第1期9卷 387-393页

作者： Marco Mario Tresoldi Angela Faga Giovanni Nicoletti Unit of Plastic and Reconstructive Surgery Department of Clinical SurgicalDiagnostic and Pediatric SciencesUniversity of PaviaPavia 27100Italy Department of Surgery Istituti Clinici Scientifici MaugeriPavia 27100Italy Department of Clinical Surgical Diagnostic and Pediatric Sciences and Department of Public Health and Experimental and Forensic MedicineAdvanced Technologies for Regenerative Medicine and Inductive Surgery Research CenterUniversity of PaviaPavia 27100Italy Plastic Surgery Unit Azienda Socio-Sanitaria Territoriale di PaviaPavia 27100Italy

Several studies demonstrated the favorable effects of platelet rich plasma(PRP)on the skin and promoted its wide use in clinical *** growth factors stored in platelet alfa-granules allow for the tissue regeneration and the main fields of application of PRP in current clinical practice are the cartilage and musculoskeletal defects,osteoarthritis and other bone disorders,chronic and difficult to heal wounds,and aesthetic *** relevant number of different PRP preparation protocols may explain the inconsistency of the different clinical outcomes reported in the *** the technological advances in PRP preparation,the objective assessment of the clinical efficacy of PRP from the literature reports still is difficult due to the low homogeneity of the samples in terms of both inclusion criteria and ***,it might be useful to establish standardized and reproducible experimental models to confirm and objectively measure the effectiveness of the available clinical *** experimental investigations have been carried out to objectively assess the effectiveness of PRP and platelet gel on several *** far as the skin is concerned,the studies carried out to date are limited to fibroblasts in in-vitro culture models or to collagen,vascular supply,epithelium,and hair follicle in in-vivo *** skin,however,is a very complex organ,where different cell lines coexist and feature complex mutual interaction.A model that combines the advantages of both in-vitro and in-vivo cultures is the ex-vivo *** demonstration of the platelet derived growth factors effects through the ex-vivo human full-thickness skin culture model is a keystone to support the evidence of the PRP effectiveness,as it represents an objective,fast,reproducible,and ethical investigational method.

关键词： Platelet rich plasma PRP ex-vivo regeneration culture techniques skin

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Liver transplantation with grafts obtained after cardiac death-current advances in mastering the challenge

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World Journal of Translational Medicine 2014年第2期3卷 58-68页

作者： Fateh Bazerbachi Nazia Selzner John B Seal Markus Selzner Department of Medicine University of Minnesota Department of Medicine University of TorontoMultiorgan Transplant Program Toronto General Hospital Department of Surgery University of Toronto Multiorgan Transplant Program Toronto General Hospital

The scarcity of donor livers has increased the interest in donation after cardiac death(DCD) as an additional pool to expand the availability of organs. However, the initial results of liver transplantation with DCD grafts have been suboptimal due to an increased rate of complications, as well as decreased graft survival. These challenges have led to many developments in DCD donation outcome, as well as basic and translational research. In this article we review the unique characteristics of DCD donors, nuances of DCD organ procurement, the effect of prolonged warm and cold ischemia times, and discuss major studies that compared DCD to donation after brain death liver transplantation, in terms of outcomes and complications. We also review the different methods of donor treatment that has been applied to ameliorate DCD organ outcome, and we discuss the role of machine perfusion techniques in organ reconditioning. We discuss the two major perfusionmodels, namely, hypothermic machine perfusion and normothermic machine perfusion; we compare both methods, and delineate their major differences.

关键词： Transplant hepatology Liver transplantation Organ donation extended criteria donors Donation after cardiac death ex-vivo liver perfusion Normothermic machine perfusion Hypothermic machine perfusion

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