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Exosome is involved in liver graft protection after remote ischemia reperfusion conditioning

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国际肝胆胰疾病杂志:英文版 2023年第5期22卷 498-503页

作者： Jian-Hui Li Jun-Jun Jia Ning He Xue-Lian Zhou Yin-Biao Qiao Hai-Yang Xie Lin Zhou Shu-Sen Zheng department of hepatobiliary and pancreatic surgery Department of Liver TransplantationShulan(Hangzhou)HospitalZhejiang Shuren University School of MedicineHangzhou 310022China NHC Key Laboratory of Combined Multi-organ transplantation Hangzhou 310022China Division of hepatobiliary pancreatic surgery First Affiliated HospitalZhejiang University School of MedicineHangzhou 310003China department of Endocrinology Children’s HospitalZhejiang University School of MedicineHangzhou 310052China

Background:Remote ischemic perconditioning(RIPerC)has been demonstrated to protect grafts from hepatic ischemia-reperfusion injury(IRI).This study investigated the role of exosomes in RIPerC of liver grafts in ***:Twenty-five rats(including 10 donors)were randomly divided into five groups(n=5 each group):five rats were used as sham-operated controls(Sham),ten rats were for orthotopic liver transplantation(OLT,5 donors and 5 recipients)and ten rats were for OLT+RIPerC(5 donors and 5 recipients).liver architecture and function were ***:Compared to the OLT group,the OLT+RIPerC group exhibited significantly improved liver graft histopathology and liver function(P<0.05).Furthermore,the number of exosomes and the level of P-Akt were increased in the OLT+RIPerC ***:RIPerC effectively improves graft architecture and function,and this protective effect may be related to the increased number of *** upregulation of P-Akt may be involved in underlying mechanisms.

关键词： Exosome P-Akt Ischemia-reperfusion injury Remote ischemic perconditioning

Surgical vs percutaneous radiofrequency ablation for hepatocellular carcinoma in dangerous locations

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World Journal of Gastroenterology 2011年第1期17卷 123-129页

作者： Ji-Wei Huang Roberto Hernandez-Alejandro Kristopher P Croome Lu-Nan Yan Hong Wu Zhe-Yu Chen Pankaj Prasoon Yong Zeng department of Hepato-Biliary-pancreatic surgery Division of Liver Transplantation West China Hospital Sichuan University Chengdu 610041 Sichuan Province China department of surgery University of Western Ontario Hepatobiliary and Liver Transplant Surgery London Health Sciences Centre London Ontario N6A 4S2 Canada

AIM:To compare the long-term outcome of percutaneous vs surgical radiofrequency ablation(RFA) for hepatocellular carcinoma(HCC) in dangerous ***:One hundred and sixty-two patients with HCC in dangerous locations treated with percutaneous or surgical RFA were enrolled in this *** patients were divided into percutaneous RFA group and surgical RFA *** the patients were regularly followed up for a long time,their curative rate,hospital stay time,postoperative complications and 5-year local tumor progression were compared and ***:No significant difference was observed in curative rate between the two groups(91.3% vs 96.8%,P = 0.841).The hospital stay time was longer and more analgesics were required while the incidence of bile duct injury and RFA-related hemorrhage was lower in surgical RFA group than in percutaneous RFA group(P < 0.05).The local progression rate of HCC in dangerous locations was significantly lower in surgical RFA group than in percutaneous RFA group(P = 0.05).The relative risk of local tumor progression was 14.315 in percutaneous RFA ***:The incidence of severe postoperative complications and local tumor progression is lower after surgical RFA than after percutaneous RFA.

关键词： Hepatocellular carcinoma Radiofrequency ablation liver cirrhosis Recurrence Local therapy

liver protection strategies in liver transplantation

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hepatobiliary & pancreatic Diseases International 2015年第1期14卷 34-42页

作者： Jun-Jun Jia Jian-Hui Li Li Jiang Bin-Yi Lin Li Wang Rong Su Lin Zhou Shu-Sen Zheng Key Laboratory of Combined Multi-organ transplantation Ministry of Health department of hepatobiliary and pancreatic surgery First Affiliated Hospital Zhejiang University School of Medicine

BACKGROUND： liver transplantation is the therapy of choice for patients with end-stage liver diseases. However, the gap between the low availability of organs and high demand is continuously increasing. Innovative strategies for organ protection are necessary to expand donor pool and to achieve better outcomes for liver transplantation. The present review analyzed and compared various strategies of liver *** SOURCES： Databases such as PubM ed, Embase and Ovid were searched for the literature related to donor liver protection strategies using following key words：＂ischemia reperfusion injury＂, ＂graft preservation＂, ＂liver transplantation＂, ＂machine perfusion＂ and ＂conditioning＂. Of the 146 studies identified,only those with cutting edge strategies were ***： A variety of therapeutic approaches were proposed to alleviate graft ischemia/reperfusion injury, which included static cold storage, machine perfusion （hypothermic, normothermic and subnormothermic）, manual conditioning （pre,post and remote）, and pharmacological conditioning. Evidences from animal experiments and clinical trials suggested that all these strategies could potentially protect liver graft; however, their clinical applications are limited partially due to their own ***： There are a plenty of methods suggested to decrease the degree of donor liver transplantation-related injury. However, none of these approaches is perfect in clinical practice. More translational researches （molecular and clinical studies） are needed to improve the techniques in liver graft protection.

关键词： ischemia reperfusion injury liver transplantation organ protection conditioning

Mitofusin-2 mediated mitochondrial Ca2+ uptake 1/2 induced liver injury in rat remote ischemic perconditioning liver transplantation and alpha mouse liver-12 hypoxia cell line models

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World Journal of Gastroenterology 2017年第38期23卷 6995-7008页

作者： Ruo-Peng Liang Jun-Jun Jia Jian-Hui Li Ning He Yan-Fei Zhou Li Jiang Tao Bai Hai-Yang Xie Lin Zhou Yu-Ling Sun department of hepatobiliary and pancreatic surgery The First Affiliated Hospital of Zhengzhou University Institute of hepatobiliary and pancreatic Diseases Zhengzhou University Key Lab of Combined Multi-Organ transplantation Ministry of Public Health Division of hepatobiliary and pancreatic surgery Department of Surgery First Affiliated Hospital Zhejiang University School of Medicine Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases

AIM To investigate the protective mechanism of mitofusin-2 (Mfn2) in rat remote ischemic perconditioning (RIC) models and revalidate it in alpha mouse liver-12 (AML-12) hypoxia cell lines. METHODS Sprague-Dawley rats were divided into three groups (n = 6 each): sham, orthotopic liver transplantation and RIC. After operation, blood samples were collected to test alanine aminotransferase and aspartate aminotransferase. The liver lobes were harvested for histopathological examination, western blotting (WB) and quantitative real-time (qRT)-PCR. AML-12 cell lines were then subjected to normal culture, anoxic incubator tank culture (hypoxia) and anoxic incubator tank culture with Mfn2 knockdown (hypoxia + Si), and data of qRT-PCR, WB, mitochondrial membrane potential (Delta psi m), apoptosis, endoplasmic reticulum Ca2+ concentrations and mitochondrial Ca2+ concentrations were collected. RESULTS Both sham and normal culture groups showed no injury during the experiment. The RIC group showed amelioration of liver function compared with the orthotopic liver transplantation group (P liver injury in rat RIC models and AML-12 hypoxia cell lines by regulating the MICUs pathway.

关键词： Remote ischemic per-conditioning Ischemia-reperfusion injury Ca2+ Mitofusin-2 Mitochondrial Ca2+ uniporter

Derivation and validation of a preoperative prognostic model for resectable pancreatic ductal adenocarcinoma

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hepatobiliary & pancreatic Diseases International 2023年第2期22卷 160-168页

作者： Shuai Xu Xiu-Ping Zhang Guo-Dong Zhao Wen-Bo Zou Zhi-Ming Zhao Qu Liu Ming-Gen Hu Rong Liu Faculty of Hepato-Biliary-pancreatic surgery The First Medical CenterChinese PLA General HospitalBeijing 100853China department of liver transplantation and hepatobiliary surgery Shandong Provincial Hospital Affiliated to Shandong First Medical UniversityJinan 250021China

Background: The prognosis of patients with pancreatic ductal adenocarcinoma(PDAC) remains poor even after radical pancreaticoduodenectomy(PD). The study aimed to develop and validate a novel preoperative prognostic model to accurately predict the long-term survival of patients with ***: Patients with PDAC of pancreatic head from Chinese PLA General Hospital were included. The preoperative PDAC model with contour plots was developed using a non-linear model in the training cohort and then tested in the validation ***: Of 421 patients who met the inclusion criteria, 280 were in the training cohort and 141 in the validation cohort. Contour plots for preoperative PDAC model were established to visually predict the survival probabilities of these patients, based on preoperative carbohydrate antigen 19-9, preoperative fibrinogen to albumin ratio and pain symptoms. This model stratified patients into low-and high-risk groups with distinctly different long-term survival in the training cohort [median overall survival(OS)32.1 vs. 17.5 months;median recurrence-free survival(RFS) 19.3 vs. 10.0 months, both P pancreatic head. Besides, the model can screen high-risk patients with poor prognosis, which may provide references for personal treatment strategies in the future.

关键词： pancreatic ductal adenocarcinoma pancreaticoduodenectomy Contour plot Overall survival Recurrence-free survival

Robotic pancreaticoduodenectomy for pancreatic ductal adenocarcinoma: Analysis of surgical outcomes and long-term prognosis in a high-volume center

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hepatobiliary & pancreatic Diseases International 2023年第2期22卷 140-146页

作者： Xiu-Ping Zhang Shuai Xu Zhi-Ming Zhao Qu Liu Guo-Dong Zhao Ming-Gen Hu Xiang-Long Tan Rong Liu Faculty of Hepato-Biliary-pancreatic surgery The First Medical CenterChinese PLA General HospitalBeijing 100853China department of liver transplantation and hepatobiliary surgery Shandong Provincial Hospital Affiliated to Shandong First Medical UniversityJinan 250021China

Background: Robotic pancreaticoduodenectomy(RPD) has been reported to be safe and feasible for patients with pancreatic ductal adenocarcinoma(PDAC) of the pancreatic head. This study aimed to analyze the surgical outcomes and risk factors for poor long-term prognosis of these patients. Methods: Data from patients who underwent RPD for PDAC of pancreatic head were retrospectively analyzed. Multivariate Cox regression analysis was used to seek the independent prognostic factors for overall survival(OS), and an online nomogram calculator was developed based on the independent prognostic factors. Results: Of the 273 patients who met the inclusion criteria, the median operative time was 280.0 minutes, the estimated blood loss was 100.0 m L, the median OS was 23.6 months, and the median recurrence-free survival(RFS) was 14.4 months. Multivariate analysis showed that preoperative carbohydrate antigen 19-9(CA19-9) [hazard ratio(HR) = 2.607, 95% confidence interval(CI): 1.560-4.354, P pancreatic head. Preoperative CA19-9, lymph node metastasis, tumor poorly differentiated, and Clavien-Dindo grade ≥ Ⅲ were independent prognostic factors for OS. The online nomogram calculator could predict the OS of these patients in a simple and convenient manner.

关键词： Robotic pancreaticoduodenectomy Nomogram Long-term prognosis pancreatic ductal adenocarcinoma

Day-of-surgery rejection of donors in living donor liver transplantation

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World Journal of Hepatology 2012年第11期4卷 299-304页

作者： Bassem Hegab Mohamed Rabei Abdelfattah Ayman Azzam Hazem Mohamed Waleed Al Hamoudi Faisal Aba Alkhail Hamad Al Bahili Hatem Khalaf Mohammed Al Sofayan Mohammed Al Sebayel department of liver Trans-plantation and hepatobiliary-pancreatic surgery King Faisal Specialist Hospital and Research Center Riyadh 11211 Saudi Arabia department of Hepato-Biliary-pancreatic surgery and liver transplantation National Liver Institute University of Menoufiya Menoufiya 32714 Egypt department of Hepato-Biliary and pancreatic surgery University of Alexan-dria Alexandria 21131 Egypt

AIM: To study diagnostic laparoscopy as a tool for excluding donors on the day of surgery in living donor liver transplantation (LDLT).METHODS: This study analyzed prospectively collected data from all potential donors for LDLT. All of the donors were subjected to a three-step donor evaluation protocol at our institution. Step one consisted of a clinical and social evaluation, including a liver profile, hepatitis markers, a renal profile, a complete blood count, and an abdominal ultrasound with Doppler. Step two involved tests to exclude liver diseases and to evaluate the donor’s serological status. This step also included a radiological evaluation of the biliary anatomy and liver vascular anatomy using magnetic resonance cholan-giopanc reatography and a computed tomography (CT) angiogram, respectively. A CT volumetric study was used to calculate the volume of the liver parenchyma. Step three included an ultrasound-guided liver biopsy. Between November 2002 and May 2009, sixty-nine potential living donors were assessed by open exploration prior to harvesting the planned part of the liver. Between the end of May 2009 and October 2010, 30 potential living donors were assessed laparoscopically to determine whether to proceed with the abdominal incision to harvest part of the liver for donation. RESULTS: Ninety-nine living donor liver transplants were attempted at our center between November 2002 and October 2010. Twelve of these procedures were aborted on the day of surgery (12.1%) due to donor findings, and eighty-seven were completed (87.9%). These 87 liver transplants were divided into the following groups: Group A, which included 65 transplants that were performed between November 2002 and May 2009, and Group B, which included 22 transplants that were performed between the end of May 2009 and October 2010. The demographic data for the two groups of donors were found to match; moreover, no significant difference was observed between the two groups of donors with res

关键词： Live donor Laparoscopic assessment Re-jected donors Day of surgery Fatty liver

liver transplantation for intrahepatic and perihilar cholangiocarcinoma: Current and future

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hepatobiliary & pancreatic Diseases International 2020年第2期19卷 101-102页

作者： Shu-Sen Zheng Zhe Yang Yi-Chao Wu department of hepatobiliary and pancreatic surgery Department of Liver TransplantationShulan(Hangzhou)HospitalZhejiang Shuren University School of MedicineHangzhou 310022China National Clinical Research Center of Infectious Diseases Hangzhou 310003China Division of hepatobiliary pancreatic surgery First Affiliated HospitalZhejiang University School of MedicineHangzhou 310003China

Cholangiocarcinomas are categorized as intrahepatic cholangio- carcinoma (iCCA), perihilar cholangiocarcinoma (pCCA), and dis- tal cholangiocarcinoma (dCCA) [1] . iCCA and pCCA are the second most common primary hepatobiliary malignant neoplasms [ 1 , 2 ]. Most patients with iCCA and pCCA have asymptomatic clinical course, highly aggressive nature and dismal prognosis [3] . Com- plete surgical resection offers the best possibility of long-term sur- vival but only a minority of patients are amenable to R0 resec- tion [4] . Tumor involvement of segmental bilateral intrahepatic bile duct, inadequate remnant liver volume or hepatic functional reserve due to underlying chronic liver disease, are key factors limiting the resectability of iCCA and pCCA. liver transplantation (LT) provides an option for patients with unresectable iCCA and pCCA [4] .

关键词： intrahepatic neoplasms liver

Three-dimensional modeling in complex liver surgery and liver transplantation

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hepatobiliary & pancreatic Diseases International 2022年第4期21卷 318-324页

作者： Jian-Peng Liu Jan Lerut Zhe Yang Ze-Kuan Li Shu-Sen Zheng department of hepatobiliary and pancreatic surgery Department of Liver TransplantationShulan(Hangzhou)HospitalZhejiang Shuren University School of MedicineHangzhou 310000China Starzl Unit of Abdominal transplantation University Hospitals Saint LucUniversitécatholique LouvainBrusselsBelgium Division of hepatobiliary pancreatic surgery the First Affiliated HospitalZhejiang University School of MedicineHangzhou 310003China National Clinical Research Center of Infectious Diseases Hangzhou 310003China

liver resection and transplantation are the most effective therapies for many hepatobiliary tumors and ***,these surgical procedures are challenging due to the anatomic complexity and many anatomical variations of the vascular and biliary ***-dimensional(3D)printing models can clearly locate and describe blood vessels,bile ducts and tumors,calculate both liver and residual liver volumes,and finally predict the functional status of the liver after resection *** 3D printing models may be particularly helpful in the preoperative evaluation and surgical planning of especially complex liver resection and transplantation,allowing to possibly increase resectability rates and reduce postoperative *** the continuous developments of imaging techniques,such models are expected to become widely applied in clinical practice.

关键词： 3D printing models liver surgery liver transplantation