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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

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Outcomes of adult-to-adult living donor liver transplantation： a single center experience

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Chinese Medical Journal 2009年第7期122卷 781-786页

作者： FENG Xi YUAN Ding WEI Yong-gang LI Fu-qiang WEN Tian-fu ZENG Yong ZHAO Ji-chun WANG Wen-tao XU Ming-qing YANG Jia-yin MA Yu-kui CHEN Zhe-yu YE Hui YAN Lti-nan LI Bo center of liver transplantation West China Hospital SichuanUniversity Chengdu Sichuan 610041 China

Background Since January 2002, adult-to-adult living donor liver transplantation （AALDLT） has gained increasing popularity in China in response to the shortage of cadaveric donor livers. This study presents a detailed analysis of the outcomes of AALDLT in a single center. Methods A total of 70 patients underwent AALDLT at our center between January 2002 and January 2007. Among these, 67 patients received a right lobe graft without the middle hepatic vein and 3 patients received dual grafts. Three-dimensional volumetric computed tomography, magnetic resonance imaging with angiography and cholangiography were performed preoperatively. Recipient operation time, intraoperative transfusion requirement, length of intensive care unit stay, length of hospital stay, liver function tests, coagulation tests and surgical outcomes were routinely investigated throughout this study. Results All donors survived the procedure with an overall complication rate of 15.3%. Overall recipient 1-year survival and complication rates were 87.1% and 34.2%, respectively. Among the 70 cases, average graft recipient weight ratio was 0.94% （0.72%-1.43%） and average graft volume/standard liver volume ratio was 46.42% （31.74%-71.68%）. All residual liver volumes exceeded 35%. liver function and coagulation recovered rapidly within the first 7 days after transplantation. Conclusions AALDLT is a safe procedure for the donors and an effective therapy for patients with end-stage liver disease. Patient selection and timely decision-making for transplantation are essential in achieving good outcomes. With accumulation of experience in surgery and clinical management, timely feedback and proper modification, we foresee better outcomes in the future.

关键词： adult living donors liver transplantation survival rate postoperative complications

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Early hepatic arterial thrombosis after pediatric living donor liver transplantation:a single-center experience

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Chinese Medical Journal 2021年第5期134卷 602-604页

作者： Zhi-Gui Zeng Liu-Xin Zhou Li-Ying Sun Lin Wei Wei Qu Ying Liu Yu-Le Tan Hai-Ming Zhang Xiao-Jie Chen Zhi-Jun Zhu 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

To the Editor:As one of the most severe vascular complications after liver transplantation(LT),early hepatic arterial thrombosis(eHAT)may lead to ischemic liver necrosis and ischemic biliary tract complications such as biliary leakage and eventually graft or patient *** outcome,however,can be signifcantly improved by early diagnosis and intervention.4 Satisfying intervention is achieved by revascularization,when it fails,life-saving retransplantation must be considered.

关键词： arterial diagnosis liver

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Peri-operative extracorporeal membrane oxygenation in adult and pediatric living donor liver transplantation:a single-center experience

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Hepatobiliary Surgery and Nutrition 2023年第6期12卷 898-908,I0011页

作者： Itsuko Chih-Yi Chen Leona Bettina PDungca Chee-Chien Yong Wei Ho Jiunn-Jye Sheu Chao-Long Chen liver transplantation center Department of SurgeryKaohsiung Chang Gung Memorial HospitalKaohsiung Cardiovascular Surgery Kaohsiung Chang Gung Memorial HospitalKaohsiung

Background:Extracorporeal membrane oxygenation(ECMO)is a potential rescue therapy for patients with acute cardiopulmonary dysfunction refractory to conventional *** this study,we described the clinical profiles and outcomes of adult and pediatric living donor liver transplantation(LDLT)patients who received ECMO support during the peri-operative ***:From June 1994 to December 2020,eleven out of the 1,812 LDLTs performed at Kaohsiung Chang Gung Memorial Hospital required ECMO support:six for respiratory failure,three for cardiogenic shock,and two for refractory septic *** between the survivor and non-survivor groups was ***:The survival rate for liver transplantation(LT)patients on ECMO support is 36.4%-40%in adults and 33.3%in pediatrics,while the survival rate per indication is as follows:acute respiratory distress syndrome(ARDS)(50%),cardiogenic shock(33.3%),and sepsis(0%).Shorter durations of LT-to-ECMO and pre-ECMO mechanical ventilation were observed in the survivor *** the other hand,we observed persistently elevated total bilirubin levels in non-survivors,while none of the survivors had aspartate aminotransferase(AST)/alanine aminotransferase(ALT)levels>1,000 U/L.A higher proportion of non-survivors were on concurrent continuous renal replacement therapy(CRRT).Conclusions:Our experience has proven ECMO’s utility during the peri-operative period for both adult and pediatric LDLT patients,more specifically for indications other than septic *** studies are needed to better understand the factors leading to poor outcomes in order to identify patients who will more likely benefit from ECMO.

关键词： Extracorporeal membrane oxygenation(ECMO) living donor liver transplantation(LDLT) respiratory failure cardiogenic shock septic shock

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Preliminary experience in adult-to-adult living donor liver transplantation in a single center in China

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Frontiers of Medicine 2007年第2期1卷 136-141页

作者： YAN Lunan LI Bo ZENG Yong WEN Tianfu ZHAO Jichun WANG Wentao YANG Jiayin XU Mingqing MA Yukui CHEN Zheyu LIU Jiangwen WU Hong liver transplantation Division Department of SurgeryWest China HospitalSichun University Medical SchoolChengdu 610041China

The aim of this paper is to report the authors’experience in performing adult-to-adult living donor liver transplantation(LDLT)by using a modified technique in using grafts of the right lobe of the *** January 2002 to September 2006,56 adult patients underwent LDLT using right lobe grafts at the West China Hospital,Sichuan University Medical School,*** patients underwent a modified operation designed to improve the reconstruction of the right hepatic vein(RHV)and the tributariers of the middle hepatic vein(MHV)by interposing a vessel graft,and by anastomosing the hepatic arteries and bile *** were no severe complications or deaths in all ***-two(92.8%)recipients survived the *** the 56 recipients,complications were seen in 15 recipients(26.8%),including hepatic vein stricture(one case),small-for-size syndrome(one case),hepatic artery thrombosis(two cases),intestinal bleeding(one case),bile leakage(two cases),left subphrenic abscess(one case),renal failure(two cases)and pulmonary infection(five cases).Within three months after transplantation,four recipients(7.14%)died due to smallfor-size syndrome(one case),renal failure(one case)and multiple organ failure(two cases).All patients underwent direct anastomoses of the RHV and the inferior vena cava(IVC),and in 23 cases,reconstruction of the right inferior hepatic vein was also *** 24 patients,the reconstruction of the tributaries of the MHV was also done by interposing a vessel graft to provide sufficient venous *** of the portal vein was seen in nine ***,veno-plasty or separate anastomoses were *** graft and recipient body weight ratios(GRWR)were between 0.72%and 1.43%,and in three cases it wasliver volume ratios(GV/SLV)were between 31.86%and 71.68%,among which four cases had<40%.No“small-for-size syndrome”*** modification of the surgical technique,especially in the reconstruction of

关键词： living donors liver transplantation

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Up-to-seven criteria for hepatocellular carcinoma liver transplantation:A single center analysis

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World Journal of Gastroenterology 2013年第36期19卷 6077-6083页

作者： Jian-Yong Lei Wen-Tao Wang Lu-Nan Yan liver transplantation center West China Hospital of Sichuan University

AIM:To detect whether the up-to-seven should be used as inclusion criteria for liver transplantation for hepatocellular ***:Between April 2002 and July 2008,220hepatocellular carcinoma(HCC)patients who were diagnosed with HCC and underwent liver transplantation(LT)at our liver transplantation center were *** patients were divided into three groups according to the characteristics of their tumors(tumor diameter,tumor number):the Milan criteria group(Group 1),the in up-to-seven group(Group 2)and the out up-toseven group(Group 3).Then,we compared long-term survival and tumor recurrence of these three ***:The baseline characteristics of transplant recipients were comparable among these three groups,except for the type of liver graft(deceased donor liver transplant or live donor liver transplantation).There were also no significant differences in the pre-operativeα-fetoprotein *** 1-,3-,and 5-year overall survival and tumor-free survival rate for the Milan criteriagroup were 94.8%,91.4%,89.7%and 91.4%,86.2%,and 86.2%respectively;in the up-to-seven criteria group,these rates were 87.8%,77.8%,and 76.6%and 85.6%,75.6%,and 75.6%respectively(P<0.05).However,the advanced HCC patients’(in the group out of up-to-seven criteria)overall and tumor-free survival rates were much lower,at 75%,53.3%,and 50%and65.8%,42.5%,and 41.7%,respectively(P<0.01).CONCLUSION:Considering that patients in the up-toseven criteria group exhibited a considerable but lower survival rate compared with the Milan criteria group,the up-to-seven criteria should be used carefully and selectively.

关键词： Up-to-seven criteria liver transplantation Outcome Hepatocellular carcinoma Recurrence

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Up-to-seven criteria for hepatocellular carcinoma liver transplantation:a single center analysis

Up-to-seven criteria for hepatocellular carcinoma liver tran...

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2013中国器官移植大会

作者： Jianyong Lei Lunan Yan Bo Li Tianfu Wen Wentao Wang Mingqing Xu Jiaying Yang Yonggang Wei liver transplantation center West China Hospital of Sichuan University

Aim The aim of our study was to detect whether the up—to—seven should be used as inclusion criteria for liver transplantation for hepatocelluar carcinoma. Patients and methods Between April 2002 and July 2008,220 HCC patients who were diagnosed with HCC and underwent liver transplantation(LT) at our liver transplantation center were *** patients were divided into three groups according to the characteristics of their tumors tumor diameter,tumor number):the Milan criteria group(Group 1),the in up-to-seven group(Group 2) and the out up-to-seven group(Group 3).Then,we compared long-term survival and tumor recurrence of these three groups. Results The baseline characteristics of transplant recipients were comparable among these three groups,except for the type of

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Impact of EBV infection and immune function assay for lymphoproliferative disorder in pediatric patients after liver transplantation: A single-center experience

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Hepatobiliary & Pancreatic Diseases International 2020年第1期19卷 3-11页

作者： Tian Qin Xiang-Qian Gu Seog-Song Jeong Yan-Yan Song Jin-Chuan Liu Jian-Xin Zheng Feng Xue Qiang Xia Department of liver Surgery Renji HospitalSchool of MedicineShanghai Jiaotong UniversityShanghai 200127China Department of Biostatistics Institute of Medical SciencesShanghai Jiaotong University School of MedicineShanghai 200025China

Background:Post-transplant lymphoproliferative disorder(PTLD)is a lethal complication after pediatric liver transplantation,but information regarding risk factors for the development of PTLD remains *** study was to identify characteristics and risk factors of ***:A total of 705 pediatric patients who underwent liver transplantation between January 2017 and October 2018 were *** of clinical characteristics and Epstein-Barr virus(EBV)infection on the development of PTLD was *** addition,ImmuKnow assay was adopted in partial patients to analyze the immune ***:Twenty-five(3.5%)patients suffered from PLTD with a median time of 6 months(3–14 months)after *** high tacrolimus(TAC)level was found in 2 fatal cases at PTLD *** infection was found in 468(66.4%)patients.A higher peak EBV DNA loads(>9590 copies/mL)within 3 months was a significant indicator for the onset of *** addition,the ImmuKnow assay demonstrated that overall immune response was significantly lower in patients with EBV infection and PTLD(Pliver *** addition,application of the ImmuKnow assay may provide guidance in reducing immunosuppressive agents in treatment of PTLD.

关键词： Post-transplant lymphoproliferative disor Pediatric liver transplantation Epstein-Barr virus

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Criteria-specific long-term survival predicting model for hepatocellular carcinoma recipients after liver transplantation:a single-center experience

Criteria-specific long-term survival predicting model for he...

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2013中国器官移植大会

作者： Fei Teng Guihua Wang Yifeng Tao Wenyuan Guo Zhengxin Wang Guoshan Ding Xiaomin Shi Zhiren Fu Organ transplantation Institute of Changzheng Hospital Second Military Medical University

Objective This study was aimed to establish and deliberate predicting models for long-term survival of hepatocellular carcinoma (HCC)recipients after liver transplantation(LT)based on different criteria(MHCAT). Methods Two hundred and twenty-three consecutive cases of HCC patients,who underwent LT in Jan 2001 to Dec 2006,have been followed until Dec 3 1,2012 to identify independent risk factors for long-term posttransplant survival,including pre—and intraoperative recipient characteristics as well as different criteria for HCC *** indication for HCC LT included TNM staging(7th edition),Milan,University of California San Francisco(UCSF),Hangzhouand Shanghai Fudan *** Cox regression model was used

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The Selection of donors after cardiac death for liver transplantation:A single center's experience from the mainland of China

The Selection of donors after cardiac death for Liver Transp...

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2013中国器官移植大会

作者： Zhenhua Tu Shusen Zheng Division of Hepatobiliary and Pancreatic Surgery Department of Surgery Key Laboratory of Combined Multi-Organ transplantation Ministry of Public Health & Key Laboratory of Organ Transplantation of Zhejiang Province First Affiliated HospitalZhejiang UniversitySchool of Medicine

AIM To explore the selection of donors after cardiac death for liver transplantation(LTx) to the end stage of liver disease recipients in the mainland of China. METHODS There are 54 cases of donation after cardiac death(DCD) during the last 3 years,and 53 cases of LTx are perfromed with the graft from the DCD,in the corresponding time *** donation cases are composed of 50 cases in Maastricht Category HI and 3 cases in Maastricht Category IV. RESULTS It’s showed encouraging results in short time follow-up for survival rate,compared with 2 death cases after the LTx in early-time. CONCLUSION The graft from DCD for liver transplantation could be applied with carefully *** multiple-center programs shoulb be launched in the mainland of China. The guidelines of the Ethics Committee of our hospital,the current regulation of the Chinese Government,and the Declaration of Helsinki were stricdy followed for each organ donation and transplant performed in our *** donor livers were harvested from executed prisoners.

关键词： liver transplantation donation after cardiac death

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