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The influence of brain death on donor liver and the potential mechanisms of protective intervention

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《医学前沿（英文）》 2011年 第5卷 第1期   页码 8-14 doi: 10.1007/s11684-011-0109-y

摘要：

Brain-dead donors have become one of the main sources of organs for transplantation in Western countries. The quality of donor organs is closely related to the outcome of the transplantation. Experimental studies have confirmed the inferior graft survival of livers from brain-dead donors compared with those from living donors. Studies conducted in the past 10 years have shown that brain death is associated with effects on the decreased donor organ quality. However, whether the decrease in the viability of donor organs is caused by brain death or by the events before and after brain death remains uncertain. The purpose of this review is to introduce the advances and controversies regarding the influence of brain death on the viability of donor livers and to summarize the mechanisms of the different protective interventions for donor livers.

关键词： brain death     donor liver    

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Partial liver transplantation

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《医学前沿（英文）》 2011年 第5卷 第1期   页码 1-7 doi: 10.1007/s11684-010-0105-7

摘要：

Partial liver transplantation, including reduced-size liver transplantation, split liver transplantation, and living donor liver transplantation, has been developed with several innovative techniques because of donor shortage. Reduced-size liver transplantation is based on Couinaud’s anatomical classification, benefiting children and small adult recipients but failing to relieve the overall donor shortage. Split liver transplantation provides chances to two or even more recipients when only one liver graft is available. The splitting technique must follow stricter anatomical and physiological criteria either ex situ or in situto ensure long-term quality. The first and most important issue involving living donor liver transplantation is donor safety. Before surgery, a series of donor evaluations—including anatomical, liver volume, and liver function evaluations—is indispensable, followed by ethnic agreement. At different recipient conditions, auxiliary liver transplantation and auxiliary partial orthotopic liver transplantation, which employ piggyback techniques, are good alternatives. Partial liver transplantation enriches the practice and knowledge of the transplant society.

关键词： partial liver transplantation     reduced-size liver transplantation     split liver transplantation     living donor liver transplantation    

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“机械灌注+”应用于扩大标准供肝移植——肝尽其用 Review

王周城, Jack Martin, 余炯杰, 汪恺, Kourosh Saeb-Parsy, 徐骁

《工程（英文）》 2024年 第32卷 第1期   页码 30-41 doi: 10.1016/j.eng.2023.11.003

摘要：

移植是终末期肝病最有效的治疗方法，但由于供体器官的短缺而受到限制。扩大标准供体（ECD）供肝在临床实践中越来越多地用于缓解这一挑战。然而，这些移植物耐受缺血的能力下降，危及冷保存期间器官的活力。机器灌注（MP）旨在改善器官保存并减少移植后并发症。然而，越来越明显的是，单独使用MP无法达到ECD供肝的最佳保存。因此，人们逐渐开始重视改良的 MP 策略，包括使用不同的灌注剂、改良的灌注方式并结合不同的治疗干预策略。本文中，我们提出了“机械灌注+”的新理念，代表这些旨在提升器官功能并可能实现ECD供肝体外再生的机械灌注新策略。为此，我们总结了现有和改良的MP策略，并阐述其在临床场景中修复不同ECD供肝的优势。

关键词： 肝移植     扩大标准供体     机械灌注+     器官短缺    

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

YAN Lunan, ZENG Yong, WEN Tianfu, ZHAO Jichun, WANG Wentao, YANG Jiayin, XU Mingqing, MA Yukui, CHEN Zheyu, LIU Jiangwen, WU Hong

《医学前沿（英文）》 2007年 第1卷 第2期   页码 136-141 doi: 10.1007/s11684-007-0026-2

摘要： 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 liver. From January 2002 to September 2006, 56 adult patients underwent LDLT using right lobe grafts at the West China Hospital, Sichuan University Medical School, China. All 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 ducts. There were no severe complications or deaths in all donors. Fifty-two (92.8%) recipients survived the operations. Among 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 done. In 24 patients, the reconstruction of the tributaries of the MHV was also done by interposing a vessel graft to provide sufficient venous outflow. Trifurcation of the portal vein was seen in nine cases. Thus, veno-plasty or separate anastomoses were performed. The graft and recipient body weight ratios (GRWR) were between 0.72% and 1.43%, and in three cases it was <0.8%. The graft weight to recipient standard liver volume ratios (GV/SLV) were between 31.86% and 71.68%, among which four cases had <40%. No small-for-size syndrome occurred. With modification of the surgical technique, especially in the reconstruction of the hepatic vein to provide sufficient venous outflow, living donor liver grafts in adults using the right lobe of the liver can become a relatively safe procedure and prevent the small-for-size syndrome .
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Reducing biliary complications in adult-to-adult living donor liver transplantation using right lobe

YAN Lunan, WEN Tianfu, WANG Wentao, YANG Jiayin, XU Mingqing, CHEN Zheyu, WU Hong

《医学前沿（英文）》 2008年 第2卷 第2期   页码 130-133 doi: 10.1007/s11684-008-0024-z

摘要： The aim of this paper is to summarize our experience of using right lobe liver grafts to reduce biliary complications in adult-to-adult (A-A) living donor liver transplantation (LDLT). From January 2002 to October 2007, 124 adult patients underwent living donor liver transplantation using right lobe grafts at the West China Hospital, Sichuan University Medical School, China. There was no death in all donors. Biliary reconstruction for 178 hepatic duct orifices from 124 donor grafts was performed which included 106 reconstructions of duct-to-duct anastomoses and 72 cholangiojejunostomy. Nine recipients had biliary complications including six bile leakages (four from the anastomotic site and two from the cut surface of the liver graft) and three biliary strictures. With the improved techniques for biliary reconstruction, we have achieved good results in 124 recipients of A-A LDLT. We ascribe our success to the introduction of microsurgical techniques and the use of fixed operators which help in decreasing the biliary complications of LDLT.

关键词： microsurgical     October     improved     success     transplantation    

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Emergency adult living donor right lobe liver transplantation for fulminant hepatic failure

ZHANG Feng, WANG Xuehao, LI Xiangcheng, KONG Lianbao, SUN Beicheng, LI Guoqiang, QIAN Xiaofen, CHEN Feng, WANG Ke, LU Sheng, PU Liyong, LU Ling

《医学前沿（英文）》 2007年 第1卷 第3期   页码 282-286 doi: 10.1007/s11684-007-0054-y

摘要： Fulminant hepatitis is fatal in most cases and timely liver transplantation is the only effective treatment. This study evaluates the survival outcomes of patients who underwent living-donor liver transplantation (LDLT) using right lobe liver grafts for fulminant liver failure due to hepatitis B infection. Nine cases of adult right lobe LDLT were performed in our department from September 2002 to August 2005 and the clinical and following-up data were reviewed. According to the pre-transplant Child-Pugh-Turcotte classification, the nine patients were classified as grade C. The model for end-stage liver disease (MELD) score of these patients ranged from 16 to 42. The principal complications before transplantation included abnormal renal function, hepatic coma of different degrees and alimentary tract hemorrhage. The main complications after transplantation included pulmonary infection in two cases, acute renal failure in three cases and transplantation-related encephalopathy in one case. No primary failure of vascular or biliary complications occurred. The one-year survival rate was 55.6%. There were no serious complications or deaths in donors. In general, it is extremely difficult to treat fulminant hepatitis by conservative regimen, particularly, in cases with rapid progression. Emergency adult living-donor liver transplantation is an effective treatment for fulminant hepatitis patients and is relatively safe for donors.

关键词： alimentary     abnormal     hemorrhage     principal     different    

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Regulation of radicals by hydrogen-donor solvent in direct coal liquefaction

《化学科学与工程前沿（英文）》 2022年 第16卷 第12期   页码 1689-1699 doi: 10.1007/s11705-022-2186-7

摘要： Radicals are important intermediates in direct coal liquefaction. Certain radicals can cause the cleavage of chemical bonds. At high temperatures, radical fragments can be produced by the splitting of large organic molecules, which can break strong chemical bonds through the induction pyrolysis of radicals. The reaction between the formation and annihilation of coal radical fragments and the effect of hydrogen-donor solvents on the radical fragments are discussed in lignite hydrogenolysis. Using the hydroxyl and ether bonds as indicators, the effects of different radicals on the cleavage of chemical bond were investigated employing density functional theory calculations and lignite hydrogenolysis experiments. Results showed that the adjustment of the coal radical fragments could be made by the addition of hydrogen-donor solvents. Results showed that the transition from coal radical fragment to H radical leads to the variation of product distribution. The synergistic mechanism of hydrogen supply and hydrogenolysis of hydrogen-donor solvent was proposed.

关键词： direct coal liquefaction     hydrogen-donor solvent     induced pyrolysis     radical mechanism     density functional theory calculations    

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γδ T cells in liver diseases

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《医学前沿（英文）》 2018年 第12卷 第3期   页码 262-268 doi: 10.1007/s11684-017-0584-x

摘要：

γδ T cells display unique developmental, distributional, and functional patterns and can rapidly respond to various insults and contribute to diverse diseases. Different subtypes of γδ T cells are produced in the thymus prior to their migration to peripheral tissues. γδ T cells are enriched in the liver and exhibit liver-specific features. Accumulating evidence reveals that γδ T cells play important roles in liver infection, non-alcoholic fatty liver disease, autoimmune hepatitis, liver fibrosis and cirrhosis, and liver cancer and regeneration. In this study, we review the properties of hepatic γδ T cells and summarize the roles of γδ T cells in liver diseases. We believe that determining the properties and functions of γδ T cells in liver diseases enhances our understanding of the pathogenesis of liver diseases and is useful for the design of novel γδ T cell-based therapeutic regimens for liver diseases.

关键词： γδT cells     liver infection     non-alcoholic fatty liver disease     autoimmune hepatitis     liver fibrosis and cirrhosis     liver cancer     liver regeneration    

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Enhanced photoelectrochemical water splitting with a donor-acceptor polyimide

《能源前沿（英文）》 doi: 10.1007/s11708-023-0910-8

摘要： Polyimide (PI) has emerged as a promising organic photocatalyst owing to its distinct advantages of high visible-light response, facile synthesis, molecularly tunable donor-acceptor structure, and excellent physicochemical stability. However, the synthesis of high-quality PI photoelectrode remains a challenge, and photoelectrochemical (PEC) water splitting for PI has been less studied. Herein, the synthesis of uniform PI photoelectrode films via a simple spin-coating method was reported, and their PEC properties were investigated using melamine as donor and various anhydrides as acceptors. The influence of the conjugate size of aromatic unit (phenyl, biphenyl, naphthalene, perylene) of electron acceptor on PEC performance were studied, where naphthalene-based PI photoelectrode exhibited the highest photocurrent response. This is resulted from the unification of wide-range light absorption, efficient charge separation and transport, and strong photooxidation capacity. This paper expands the material library of polymer films for PEC applications and contributes to the rational design of efficient polymer photoelectrodes.

关键词： polyimide (PI) film     photoelectrochemistry     band structure engineering     aromatic unit    

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NKT cells in liver diseases

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《医学前沿（英文）》 2018年 第12卷 第3期   页码 249-261 doi: 10.1007/s11684-018-0622-3

摘要：

Natural killer T cells are innate-like and tissue-resident lymphocytes, which recognize lipid antigens and are enriched in the liver. Natural killer T cells play important roles in infections, tumors, autoimmune diseases, and metabolic diseases. In this study, we summarize recent findings on biology of natural killer T cells and their roles in hepatitis B virus and hepatitis C virus infection, autoimmune liver diseases, alcoholic liver disease, nonalcoholic fatty liver disease, and hepatocellular carcinoma. Controversial results from previous studies are discussed, and indicate the dynamic alteration in the role of natural killer T cells during the progression of liver diseases, which might be caused by changes in natural killer T subsets, factors skewing cytokine responses, and intercellular crosstalk between natural killer T cells and CD1d-expressing cells or bystander cells.

关键词： natural killer T cells     hepatitis B virus and hepatitis C virus infection     autoimmune liver diseases     alcoholic liver disease     nonalcoholic fatty liver disease     hepatocellular carcinoma    

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Natural killer cells in liver diseases

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《医学前沿（英文）》 2018年 第12卷 第3期   页码 269-279 doi: 10.1007/s11684-018-0621-4

摘要：

The liver has been characterized as a frontline lymphoid organ with complex immunological features such as liver immunity and liver tolerance. Liver tolerance plays an important role in liver diseases including acute inflammation, chronic infection, autoimmune disease, and tumors. The liver contains a large proportion of natural killer (NK) cells, which exhibit heterogeneity in phenotypic and functional characteristics. NK cell activation, well known for its role in the immune surveillance against tumor and pathogen-infected cells, depends on the balance between numerous activating and inhibitory signals. In addition to the innate direct “killer” functions, NK cell activity contributes to regulate innate and adaptive immunity (helper or regulator). Under the setting of liver diseases, NK cells are of great importance for stimulating or inhibiting immune responses, leading to either immune activation or immune tolerance. Here, we focus on the relationship between NK cell biology, such as their phenotypic features and functional diversity, and liver diseases.

关键词： natural killer cell     phenotype     immune activation     immune tolerance     liver diseases    

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The “Traditional Chinese medicine regulating liver regeneration” treatment plan for reducing mortalityof patients with hepatitis B-related liver failure based on real-world clinical data

Ling Dai, Xiang Gao, Zhihua Ye, Hanmin Li, Xin Yao, Dingbo Lu, Na Wu

《医学前沿（英文）》 2021年 第15卷 第3期   页码 495-505 doi: 10.1007/s11684-020-0790-9

摘要： On the basis of real-world clinical data, the study aimed to explore the effect and mechanisms of the treatment plan of “traditional Chinese medicine (TCM) regulating liver regeneration.” A total of 457 patients with HBV-related liver failure were retrospectively collected. The patients were divided into three groups: the modern medicine control group (MMC group), patients treated with routine medical treatment; the control group combining traditional Chinese and Western medicine (CTW), patients treated with routine medical treatment plus the common TCM formula; and the treatment group of “TCM regulating liver regeneration” (RLR), patients treated with both routine medical treatment and the special TCM formula of RLR. After 8 weeks of treatment, the mortality of patients in the RLR group (12.31%) was significantly lower than those in the MMC (50%) and CTW (29.11%) groups. Total bilirubin level significantly decreased and albumin increased in the RLR group when compared with the MMC and CTW groups ( <0.05). In addition, there were significant differences in the expression of several cytokines related to liver regeneration in the RLR group compared with the MMC group. RLR treatment can decrease jaundice, improve liver function, and significantly reduce the mortality in patients with HBV-related liver failure. The mechanism may be related to the role of RLR treatment in influencing cytokines related to liver regeneration.

关键词： hepatitis B virus-related liver failure     traditional Chinese medicine     liver regeneration     liver regeneration microenvironment     cytokines    

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Assessment of liver volume variation to evaluate liver function

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《医学前沿（英文）》 2012年 第6卷 第4期   页码 421-427 doi: 10.1007/s11684-012-0223-5

摘要：

In order to assess the value of liver volumetry in cirrhosis and acute liver failure (ALF) patients, we explored the correlation between hepatic volume and severity of the hepatic diseases. The clinical data of 48 cirrhosis patients with 60 normal controls and 39 ALF patients were collected. Computed tomography-derived liver volume (CTLV) and body surface area (BSA) of normal controls were calculated to get a regression formula for standard liver volume (SLV) and BSA. Then CTLV and SLV of all patients were calculated and grouped by Child-Turcotte-Pugh classification for cirrhosis patients and assigned according to prognosis of ALF patients for further comparison. It turned out that the mean liver volume of the control group was 1 058±337 cm3. SLV was correlated with BSA according to the regression formula. The hepatic volume of cirrhosis patients in Child A, B level was not reduced, but in Child C level it was significantly reduced with the lowest liver volume index (CTLV/SLV). Likewise, in the death group of ALF patients, the volume index was significantly lower than that of the survival group. Based on volumetric study, we proposed an ROC (receiver operating characteristic) analysis to predict the prognosis of ALF patients that CTLV/SLV<83.9% indicates a poor prognosis. In conclusion, the CTLV/SLV ratio, which reflects liver volume variations, correlates well with the liver function and progression of cirrhosis and ALF. It is also a very useful marker for predicting the prognosis of ALF.

关键词： liver volume variation     cirrhosis     acute liver failure (ALF)    

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used as a salvage option for patients with relapsed acute leukemia post-chemotherapy plus modified donor

《医学前沿（英文）》 2021年 第15卷 第5期   页码 728-739 doi: 10.1007/s11684-021-0833-x

摘要： Relapse is the main problem after allogeneic hematopoietic stem cell transplantation (allo-HSCT). The outcome of a second allo-HSCT (HSCT2) for relapse post-HSCT has shown promising results in some previous studies. However, little is known about the efficacy of HSCT2 in patients with relapsed/refractory acute leukemia (AL) post-chemotherapy plus modified donor lymphocyte infusion (post-Chemo+m-DLI) after the first allo-HSCT (HSCT1). Therefore, we retrospectively analyzed the efficacy of HSCT2 in 28 patients with relapsed/refractory AL post-Chemo+m-DLI in our center. With a median follow-up of 918 (457–1732) days, 26 patients (92.9%) achieved complete remission, and 2 patients exhibited persistent disease. The probabilities of overall survival (OS) and disease-free survival (DFS) 1 year after HSCT2 were 25.0% and 21.4%, respectively. The cumulative incidences of nonrelapse mortality on day 100 and at 1 year post-HSCT2 were 7.1%±4.9% and 25.0%±8.4%. The cumulative incidences of relapse were 50.0%±9.8% and 53.5%±9.9% at 1 and 2 years post-HSCT2, respectively. Risk stratification prior to HSCT1 and percentage of blasts before HSCT2 were independent risk factors for OS post-HSCT2, and relapse within 6 months post-HSCT1 was an independent risk factor for DFS and relapse post-HSCT2. Our findings suggest that HSCT2 could be a salvage option for patients with relapsed AL post-Chemo+m-DLI.

关键词： second hematopoietic stem cell transplantation     acute leukemia     relapse     chemotherapy     modified donor lymphocyte infusion    

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Gut microbial balance and liver transplantation: alteration, management, and prediction

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《医学前沿（英文）》 2018年 第12卷 第2期   页码 123-129 doi: 10.1007/s11684-017-0563-2

摘要：

Liver transplantation is a conventional treatment for terminal stage liver diseases. However, several complications still hinder the survival rate. Intestinal barrier destruction is widely observed among patients receiving liver transplant and suffering from ischemia–reperfusion or rejection injuries because of the relationship between the intestine and the liver, both in anatomy and function. Importantly, the resulting alteration of gut microbiota aggravates graft dysfunctions during the process. This article reviews the research progress for gut microbial alterations and liver transplantation. Especially, this work also evaluates research on the management of gut microbial alteration and the prediction of possible injuries utilizing microbial alteration during liver transplantation. In addition, we propose possible directions for research on gut microbial alteration during liver transplantation and offer a hypothesis on the utilization of microbial alteration in liver transplantation. The aim is not only to predict perioperative injuries but also to function as a method of treatment or even inhibit the rejection of liver transplantation.

关键词： gut microbial balance     liver transplantation     ischemia–reperfusion     acute rejection    

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标题 作者 时间 类型 操作

The influence of brain death on donor liver and the potential mechanisms of protective intervention

null

期刊论文

Partial liver transplantation

null

期刊论文

“机械灌注+”应用于扩大标准供肝移植——肝尽其用

王周城, Jack Martin, 余炯杰, 汪恺, Kourosh Saeb-Parsy, 徐骁

期刊论文

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

YAN Lunan, ZENG Yong, WEN Tianfu, ZHAO Jichun, WANG Wentao, YANG Jiayin, XU Mingqing, MA Yukui, CHEN Zheyu, LIU Jiangwen, WU Hong

期刊论文

Reducing biliary complications in adult-to-adult living donor liver transplantation using right lobe

YAN Lunan, WEN Tianfu, WANG Wentao, YANG Jiayin, XU Mingqing, CHEN Zheyu, WU Hong

期刊论文

Emergency adult living donor right lobe liver transplantation for fulminant hepatic failure

ZHANG Feng, WANG Xuehao, LI Xiangcheng, KONG Lianbao, SUN Beicheng, LI Guoqiang, QIAN Xiaofen, CHEN Feng, WANG Ke, LU Sheng, PU Liyong, LU Ling

期刊论文

Regulation of radicals by hydrogen-donor solvent in direct coal liquefaction

期刊论文

γδ T cells in liver diseases

null

期刊论文

Enhanced photoelectrochemical water splitting with a donor-acceptor polyimide

期刊论文

NKT cells in liver diseases

null

期刊论文

Natural killer cells in liver diseases

null

期刊论文

The “Traditional Chinese medicine regulating liver regeneration” treatment plan for reducing mortalityof patients with hepatitis B-related liver failure based on real-world clinical data

Ling Dai, Xiang Gao, Zhihua Ye, Hanmin Li, Xin Yao, Dingbo Lu, Na Wu

期刊论文

Assessment of liver volume variation to evaluate liver function

null

期刊论文

used as a salvage option for patients with relapsed acute leukemia post-chemotherapy plus modified donor

期刊论文

Gut microbial balance and liver transplantation: alteration, management, and prediction

null

期刊论文