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“Metroticket” predictor for assessing liver transplantation to treat hepatocellular carcinoma:A single-center analysis in China's Mainland

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World Journal of Gastroenterology 2013年第44期19卷 8093-8098页

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

AIM:To validate the"Metroticket"predictor using a large cohort of liver transplantation(LT)patients with hepatocellular carcinoma(HCC)in ***:In total,230 cases of LT for HCC treatment at our center,from July 2000 to August 2008,were included in the present *** predicted 1-,3-and 5-year post-LT survival rates were calculated using the Metroticket model(http://89.***.76.14/metroticket/calculator/).The predicted and observed long-term survival rates were then compared and ***:The predicted survival rates for all 230cases,as calculated by the Metroticket model,were64.7%and 56.2%at 3 and 5 years,respectively,and the observed survival rates for these patients were71.3%and 57.8%,*** the 23 cases with macrovascular invasion,the predicted 5-year survival rate was 43.5%,whereas the observed 5-year survival rate was only 8.7%.For the 42 cases with microvascular invasion but an absence of macrovascular invasion,the predicted 5-year survival rate was 44.9%,and the observed 5-year survival rate was 50%.For the remaining 165 patients without any vascular invasion,the predicted 5-year survival rate was 65.8%,and the observed 5-year survival rate was 66.7%.CONCLUSION:The Metroticket model can be used to accurately predict survival in HCC-related LT cases with an absence of macrovascular invasion.

关键词： Metroticket Model Survival Hepatocellular carcinoma Liver transplantation

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

Liver transplantation in Wilson's disease: Single center experience from Saudi Arabia

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World Journal of Hepatology 2013年第3期5卷 127-132页

作者： Musthafa Chalikandy Peedikayil Hamad Ibrahim Al Ashgar Abdullah Al Mousa Mohammed Al Sebayel Khalid Al Kahtani Faisal Aba Alkhail Department of Medicine King Faisal Specialist Hospital and Research Center Liver transplantation and Hepatobiliary Surgery King Faisal Specialist Hospital and Research Center

AIM: To determine liver transplantation outcomes in Wilson's disease (WD) patients, focusing on neurological manifestations. METHODS: This retrospective study assessed data from 16 WD patients (nine males, 56%) who had liver transplants between 1991 and 2007. Survival, graft function, and neurological complications were assessed during a follow-up period of up to 15 years. In addition, each patient's medical record was reviewed in detail to find the type of Wilson's disease (hepatic or hepatic plus neurological WD), indication for liver transplantation, use of chelating agents prior to transplantation, immediate and long term complications following transplantation, the donor details, and the pathology of explanted liver. RESULTS: End-stage liver disease was the indication for transplantation in all 16 WD patients. Four patients displayed WD-related neurological symptoms in addition to liver disease. Living-related liver transplantation was done in three cases. One patient died on postoperative day 6 due to primary graft non-function. Oneyear post liver transplant survival was 94%. Neurological manifestations of all four patients disappeared during their follow-up. Four patients developed acute cellular rejection, but all responded to treatment. One patient developed chronic ductopenic rejection after 15 years post-transplantation and their graft failed; this patient is currently waiting for re-transplantation. Fourteen patients (88%) are still living. The long-term average survival is currently 10.5 years, with a current median survival of 8 years. Long-term graft survival is currently 81%. CONCLUSION: Shortand long-term survival in WD patient liver transplantation was excellent, and neurological and psychological WD manifestations disappeared during long-term follow-up.

关键词： Wilson’s disease Liver transplantation Neurological Psychiatric Penicillamine Saudi Arabia transplantation

Mesenchymal stem cell therapy in patients with small bowel transplantation:Single center experience

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World Journal of Gastroenterology 2014年第25期20卷 8215-8220页

作者： Sait Murat Do?an Sel?uk K?l?n? Eyüp Kebap?? Cem Tu?men Mustafa ?lmez Cezmi Karaca Alp Gürkan Ma?allah Baran Yusuf Kurtulmu? Organ transplantation center SB Tepecik Teaching and Research Hospital35121 Izmir Turkey Organ transplantation center Caml?ca University Hospital34360 IstanbulTurkey Department of Gastroenterology SB Tepecik Teaching and Research Hospital35121 IzmirTurkey Tissue Typing Laboratory SB Tepecik Teaching and Research Hospital 35121 Izmir Turkey

AIM: To study the effects of mesenchymal stem cell (MSC) therapy on the prevention of acute rejection and graft vs host disease following small bowel transplantation.

关键词： Short gut syndrome Small bowel transplantation Mesenchymal stem cells Acute rejection Stem cell therapy

Optimizing biliary outcomes in living donor liver transplantation:Evolution towards standardization in a high-volume center

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Hepatobiliary & Pancreatic Diseases International 2020年第4期19卷 324-327页

作者： Tsan-Shiun Lin Jeffrey Samuel Co Chao-Long Chen Aldwin D.Ong Liver transplantation center Department of SurgeryKaohsiung Chang Gung Memorial Hospital123 Ta-Pei RoadNiao SungKaohsiung 833TaiwanChina

Biliary complications have always been a dreaded cause of morbidity after living donor liver *** intrinsic variations in both graft and recipient biliary anatomy remain a significant factor to the difficulty of biliary reconstruction,our institution has taken advantage of its high volume of cases to critically review and evaluate modifiable operative risk factors,in particular,our surgical *** present herein,the evolution of our reconstructive biliary technique from conventional methods to our current standard of microsurgical biliary reconstruction for both graft and recipient *** this period of transition,our center has created a classification system for biliary reconstruction that decreased the biliary complication rates from 40.0%to 10.2%.

关键词： Living donor liver transplantation Biliary reconstruction Microsurgical biliary reconstruction Biliary classification Biliary complications

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

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

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

Safety evaluation of donors for living-donor liver transplantation in Chinese mainland:A single-center report

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World Journal of Gastroenterology 2007年第32期13卷 4379-4384页

作者： Guo-Qiang Li Feng Zhang Xiang-Cheng Li Bei-Cheng Sun Feng Cheng Wen-Gang Ge Xue-Hao Wang Liver transplantation center First Affiliated Hospital of Nanjing Medical University Nanjing 210029 Jiangsu Province China

AIM： To discuss the safety of donors during living donor liver transplantation （LDLT） and the authors＇ experience with 50 cases. METHODS： Between January 1995 and March 2006, 50 patients with end-stage liver disease received LDLT in our department. Donors （at the age of 27-58 years） were healthy and antibody （ABO）-compatible. The protocol of evaluation and selection of donors, choice of surgical methods and strategy applied in the safety evaluation of donors were analyzed. RESULTS： A total of 115 candidate donors were evaluated for LDLT at our center. Of these, 50 underwent successful hepatectomy for living donation. The elimination rate for donors was 43.5%. Positive hepatitis serology and ABO incompatibility were the main factors for excluding candidates. All donors recovered uneventfully. The follow-up time ranged from 3 to 135 too. The incidence of major and minor medical complications was 12.0% and 28.0%, respectively. CONCLUSION： LDLT provides an excellent approach to the problem of donor shortage in China. With a thorough and complete preoperative workup and meticulous intra-and postoperative management, LDLT can be performed with minimal donor morbidity.

关键词： Liver transplantation Living donor Safety Evaluation