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Safety of hepatitis B virus core antibody-positive grafts in liver transplantation: A single-center experience in China

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World Journal of Gastroenterology 2018年第48期24卷 5525-5536页

作者： Ming Lei Lu-Nan Yan Jia-Yin Yang Tian-Fu Wen Bo Li Wen-Tao Wang Hong Wu Ming-Qing Xu Zhe-Yu Chen Yong-Gang Wei Department of liver Surgery Liver Transplantation CenterWest China Hospital of Sichuan University

BACKGROUND Given the shortage of suitable liver grafts for liver transplantation, proper use of hepatitis B core antibody-positive livers might be a possible way to enlarge the donor pool and to save patients with end-stage liver diseases. However, the safety of hepatitis B virus core antibody positive(HBcAb+) donors has been controversial. Initial studies were mainly conducted overseas with relatively small numbers of HBcAb+ liver recipients, and there are few relevant reports in the population of China's Mainland. We hypothesized that the safety of HBcAb+ liver grafts is not *** To evaluate the safety of using hepatitis B virus(HBV) core antibody-positive donors for liver transplantation in Chinese *** We conducted a retrospective study enrolling 1071 patients who underwent liver transplantation consecutively from 2005 to 2016 at West China Hospital liver transplantation Center. Given the imbalance in several baseline variables, propensity score matching was used, and the outcomes of all recipients were reviewed in this *** In the whole population, 230 patients received HBcAb+ and 841 patients received HBcAb negative(HBcAb-) liver grafts. The 1-, 3-and 5-year survival rates in patients and grafts between the two groups were similar(patient survival: 85.8% vs 87.2%, 77.4% vs 81.1%, 72.4% vs 76.7%, log-rank test, P = 0.16; graft survival: 83.2% vs 83.6%, 73.8% vs 75.9%, 70.8% vs 74.4%, log-rank test, P = 0.19). After propensity score matching, 210 pairs of patients were generated. The corresponding 1-, 3-and 5-year patient and graft survival rates showed no significant differences. Further studies illustrated that the post-transplant major complication rates and liver function recovery after surgery were also similar. In addition, multivariate regression analysis in the original cohort and propensity score-matched Cox analysis demonstrated that receiving HBcA b+ liver grafts was not a significant risk factor for long-term survival.

关键词： liver transplantation Long-term outcome Hepatitis B core antibody Hepatitis B virus infection

Comparison of hepatitis B prophylactic outcomes in living donor liver transplantation recipients who meet the Milan or UCSF criteria

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Hepatobiliary & Pancreatic diseases International 2013年第5期12卷 494-499页

作者： Li Jiang Lu-Nan Yan Tian-Fu Wen Bo Li Jia-Yin Yang liver transplantation Center Department of Liver SurgeryWest China HospitalSichuan University

BACKGROUND:The tumor burden before liver transplantation indicates that hepatitis B virus(HBV) may hide in the extrahepatic and micrometastatic sites which serve as a source of HBV ***,many liver transplant centers,especially in Western countries,use the Milan or UCSF criteria to select patients with hepatocellular carcinoma for liver *** study was undertaken to compare the HBV prophylactic outcomes in two groups of living donor liver transplantation(LDLT) *** in group A met the Milan criteria and those in group B exceeded the Milan criteria but were within the UCSF ***:A database of adult-to-adult right-lobe LDLT performed at our institution for HBV-related hepatocellular carcinoma within the Milan or UCSF criteria between June 2002 and May 2012 was used to compare the HBV prophylactic outcomes between patients within the Milan criteria(group A,41 patients) and those exceeding the Milan criteria but within the UCSF criteria(group B,19 patients).RESULTS:The 1-,3-,and 5-year survival rates were similar between groups A and B(87.8%,85.1% and 74.0% vs 73.3%,61.1% and 61.1%,respectively,P=0.067).HBV recurred in 1 patient in 3.1 months after LDLT in group A and in 2 patients in group B(1 in 11.9 months and 1 in 24.1 months after LDLT).The 1-,3-,and 5-year HBV recurrence rates were 2.6%,2.6% and 2.6% in group A,and 7.3%,17.9% and 17.9% in group B,respectively(P=0.118).CONCLUSION:LDLT recipients who exceed the Milan criteria but remain within the UCSF criteria may have post-transplant HBV prophylactic outcomes similar to those who meet the Milan criteria.

关键词： living donor liver transplantation hepatitis B virus hepatocellular carcinoma antiviral therapy

Dermatomyositis associated with gallbladder carcinoma:A case report

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World Journal of Hepatology 2013年第4期5卷 230-233页

作者： Qing-Feng Ni Guo-Qing Liu Li-Yong Pu Liang-Liang Kong Lian-Bao Kong Department of liver transplantation Center The First Affiliated Hospital of Nanjing Medical UniversityThe National Institute of Living Donor Liver Transplantation

Patients with gallbladder carcinoma can present with a variety of paraneoplastic syndromes,including Cushing's syndrome,hypercalcemia,acanthosis nigricans,bullous pemphigoid,dermatomyositis and the sign of Leser-Tré*** resection of the primary tumor results in resolution of these paraneoplastic *** present a 67-year old female with facial and cervical erythema who was initially diagnosed with ***,an abdominal computed tomography(CT)and positron emission tomographyCT scan was suspicious for gallbladder carcinoma with lymph node *** surgical resection,her dermatomyositis was *** case demonstrates that dermatomyositis may be a manifestation of preexisting gallbladder carcinoma.

关键词： Dermatomyositis Paraneoplastic syndromes Gallbladder carcinoma

PTPROt maintains T cell immunity in the microenvironment of hepatocellular carcinoma

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Journal of Molecular Cell Biology 2015年第4期7卷 338-350页

作者： Jiajie Hou Lei Deng Han Zhuo Zhe Lin Yun Chen Runqiu Jiang Dianyu Chen Xudong Zhang Xingxu Huang Beicheng Sun liver transplantation Center of the First Affiliated Hospital Nanjing Medical UniversityNanjingChina MOE Key Laboratory of Model Animal for disease Study Model Animal Research Center of Nanjing UniversityNanjingChina liver transplantation Center Renji HospitalSchool of MedicineShanghai Jiaotong UniversityShanghaiChina

Intratumoral T cells play a central role in anti-tumor immunity,and the balance between T effector cells(Teff)and regulatory T cells(Treg)affects the prognosis of cancer ***,educated by tumor microenvironment,T cells frequently fail in their *** this study,we aimed to investigate the role of truncated isoform of protein tyrosine phosphatase receptor-typeO(PTPROt)in T cell-mediated anti-tumor *** recruited 70 hepatocellular carcinoma(HCC)patients and 30 healthy volunteers for clinical investigation,and analyzed cellular tumor immunity by using ptpro^(-/-) C57BL/6 mice and NOD/SCID *** expression was significantly downregulated in human HCC-infiltrating T cells due to the hypoxia microenvironment;PTPROt expression highly correlated with the intratumoral Teff/Treg ratio and clinicopathologic ***,PTPROt deficiency attenuated T cell-mediated anti-tumor immunity and remarkably promoted mouse HCC ***,deletion of PTPROt decreased Teff quantity and quality through phosphorylation of lymphocyte-specific tyrosine kinase,but increased Treg differentiation through phosphorylation of signal transducer and activator of transcription *** support of the Teff/Treg homeostasis,PTPROt serves as an important tumor suppressor in HCC microenvironment.

关键词： PTPROt Teff Treg hepatocellular carcinoma

Long-term results of liver transplantation for over 60 years old patients with hepatitis B virus-related end-stage liver disease

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Hepatobiliary & Pancreatic diseases International 2014年第5期13卷 501-507页

作者： Shu-Hong Yi Hui-Min Yi Bin-Sheng Fu Chi Xu Min-Ru Li Qi Zhang Yang Yang Gui-Hua Chen liver Transplant Center Third Affiliated Hospitaland Transplantation Research Institute Sun Yat-Sen University

BACKGROUND： Hepatitis B virus（HBV）-related end-stage liver disease is the leading indication for liver transplantation in China, but long-term results of liver transplantation in patients aged over 60 years are not clear. The present study was to reveal the natural history of liver recipients with hepatitis B older than60 ***： The recipients who had received liver transplantation between December 2003 and December 2005 were divided into two groups： those equal or older than 60 years（older group,n60） and those younger than 60 years（younger group, n305）.Risk factors for poor long-term outcome in patients aged over 60 years were also ***： Except for age and preexisting chronic disease（P0.05）,no significant differences were observed in perioperative characteristics between the two groups. There was also no significant difference in HBV and hepatocellular carcinoma recurrence（P0.05）. The actuarial 1-, 3-, 5- and 8-year survival rates were 81.6%, 71.6%, 66.7% and 63.3% respectively for the older group vs 84.9%, 77.7%, 70.8% and 65.6% for the younger group（P0.05）. Multivariate analyses showed that pre-liver transplant renal insufficiency was a risk factor for poor outcome in the older group（odds ratio=3.615, P0.014）.CONCLUSIONS： liver transplantation is safe and feasible for patients with HBV-related end-stage liver disease aged over 60years. Older patients with renal insufficiency should undergo transplantation earlier than younger patients.

关键词： ge hepatitis B virus liver transplantation renal insufficiency long-term

Bile leakage test in liver resection:A systematic review and meta-analysis

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World Journal of Gastroenterology 2013年第45期19卷 8420-8426页

作者： Hai-Qing Wang Jian Yang Jia-Yin Yang Lu-Nan Yan Department of liver and Vascular Surgery Liver Transplantation Center West China Hospital of Sichuan University

AIM:To assess systematically the safety and efficacy of bile leakage test in liver ***:Randomized controlled trials and controlled clinical trials involving the bile leakage test were included in a systematic literature *** authors independently assessed the studies for inclusion and extracted the data.A meta-analysis was conducted to estimate postoperative bile leakage,intraoperative positive bile leakage,and *** used either the fixed-effects or random-effects ***:Eight studies involving a total of 1253 patients were included and they all involved the bile leakage test in liver *** bile leakage test group was associated with a significant reduction in bile leakage compared with the non-bile leakage test group(RR=0.39,95%CI:0.23-0.67;I2=3%).The white test had superiority for detection of intraoperative bile leakage compared with the saline solution test(RR=2.38,95%CI:1.24-4.56,P=0.009).No significant intergroup differences were observed in total number of complications,ileus,liver failure,intraperitoneal hemorrhage,pulmonary disorder,abdominal infection,and wound ***:The bile leakage test reduced postoperative bile leakage and did not increase incidence of *** emulsion is the best choice of solution for the test.

关键词： Bile leakage test Bile leakage liver resection Postoperative complications Meta-analysis

Risk factors associated with early and late recurrence after curative resection of hepatocellular carcinoma: a single institution's experience with 398 consecutive patients

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Hepatobiliary & Pancreatic diseases International 2014年第2期13卷 153-161页

作者： Zheng-Gui Du Yong-Gang Wei Ke-Fei Chen Bo Li Department of liver and Vascular Surgery Liver Transplantation CenterWest China HospitalSichuan University

BACKGROUND: Surgical resection is an important curative treatment for hepatocellular carcinoma (HCC); however, some patients experience an unexpected recurrence even after hepatectomy. The present study aimed to investigate risk factors and predictive criteria for early and late recurrence of HCC after ***: A retrospective analysis of 398 Chinese patients who received curative resection for HCC was conducted. Patients were divided into three groups: without recurrence, early recurrence and late recurrence. Prognostic factors and predictive criteria for early and late recurrence were statistically analyzed. RESULTS: The cumulative recurrence-free survival rates at1, 2, 3, 4, and 5 years were 75.5%, 58.2%, 54.1%, 40.5%, and28.7%, respectively. The distribution of the time to recurrence suggested that recurrence could be divided into early phase(before 2 years; n=164) and late phase (after 2 years; n=83)Cox’s multivariate proportional hazard model analysis revealed that multiplicity of tumors (P=0.004) and venous infiltration(P=0.002) were independent risk factors associated with early recurrence. In contrast, indocyanine green retention rate at 15minutes (P=0.007), serum albumin level (P=0.045), and HBeAg status ( =0.028) proved to be significant independent adverse prognostic factors for late recurrence. Patients with at least 1of the 2 early recurrence risk factors (multiplicity of tumors ≥2and venous infiltration) or with 2 or more late recurrence risk factors are often susceptible to recurrence (P=1.36e-4 and 1.0e-6respectively).CONCLUSIONS: Early and late recurrences correlate with different risk factors and predictive criteria. Early recurrence primarily results from intrahepatic metastases, while late recurrence may be multicentric in origin.

关键词： hepatocellular carcinoma intrahepatic recurrence hepatectomy risk factors prognosis

Pigmented well-differentiated hepatocellular neoplasm with β-catenin mutation

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Hepatobiliary & Pancreatic diseases International 2015年第6期14卷 660-664页

作者： Lara Neves Souza Rodrigo Bronze de Martino Richard Thompson Sandra Strautnieks Nigel D Heaton Alberto Quaglia institute of liver Studies King's College Hospital Department of Gastroenterology Discipline of Liver and Gastrointestinal TransplantationHospital das ClínicasUniversity of S?o Paulo

ABSTRACT： According to the most recent WHO classification of hepatocellular adenomas, a small percentage of inflammatory hepatocellular adenomas presents with mutation in the β-catenin gene and are at higher risk of malignant transformation. It has been recognized that adenoma-like hepatocellular neoplasms with focal atypia, or in unusual clinical context present with similar cytogenetic and immunohistochemistry characteristics to well-differentiated hepatocellular carcino- mas.

关键词： hepatocellular adenoma hepatocellular carcinoma β-catenin glutamine synthetase diethylstilbestrol

Gallstone ileus: Case report and literature review

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World Journal of Gastroenterology 2013年第33期19卷 5586-5589页

作者： Xin-Zheng Dai Guo-Qiang Li Feng Zhang Xue-Hao Wang Chuan-Yong Zhang liver transplantation Center First Affiliated Hospital of Nanjing Medical UniversityKey Laboratory of Living Donor Liver TransplantationMinistry of Public Health

Gallstone ileus(GI)is characterized by occlusion of the intestinal lumen as a result of one or more *** is a rare complication of gallstones that occurs in1%-4%of all cases of bowel *** mortality associated with GI ranges between 12%and 27%.Classical findings on plain abdominal radiography include:(1)pneumobilia;(2)intestinal obstruction;(3)an aberrantly located gallstone;and(4)change of location of a previously observed *** optimal management of acute GI is controversial and can be:(1)enterotomy with stone extraction alone;(2)enterotomy,stone extraction,cholecystectomy and fistula closure;(3)bowel resection alone;and(4)bowel resection with fistula *** describe a case to highlight some of the pertinent issues involved in GI management,and propose a scheme to minimize recurrent disease and postoperative *** conclude that GI is a rare condition affecting mainly the older population with a female *** advent of computed tomography and magnetic resonance imaging has made it easier to diagnose *** with stone extraction alone remains the most common surgical method because of its low incidence of complications.

关键词： Gallstone ileus Fistula closure Intestinal obstruction Bowel obstruction Enterolithotomy