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肠道菌群 5

肝移植 3

益生菌 2

肝纤维化 2

自体移植 2

造血干细胞移植 2

非酒精性脂肪性肝病 2

骨髓干细胞 2

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三维适形放疗 1

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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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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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A better way to do small-for-size liver transplantation in rats

null

《医学前沿（英文）》 2011年 第5卷 第1期   页码 106-110 doi: 10.1007/s11684-011-0113-2

摘要：

Establishing a model for small-for-size liver transplantation is the basis for this study of partial and living donor graft liver transplantation. This study aims to explore a simpler and more effective way of establishing a 30% small-for-size liver transplantation in rats. Sprague-Dawley rats were selected as the donors and recipients. Small-for-size orthotopic liver transplantation was performed using Kamada’s two-cuff method. The donor’s liver was flushed via the abdominal aorta and hepatectomy was performed in situ. The animals were divided into three groups depending on the graft selected, with 40 pairs of rats in each group. In group I, the median lobe of the liver was used as graft; in group II, the right half of the median lobe and the right lobe were used as graft; and in group III, the median and right lobes were used as graft. In groups I and II, the bodyweights of donors were the same as those of recipients; however, in group III the bodyweights of donors were 100–120 g less than those of the recipients. The duration needed for transplantation, the 7-day survival rates, and the technical complication rates were compared among these three groups. The time required for hepatectomy was shorter in group III compared with groups I and II (8.8?±?0.7 min vs. 11.5?±?1.1 min and 10.1?±?1.0 min, P = 0.001). The cold ischemia time for the grafts, the anhepatic times, and the transplantation times for the recipients were not significantly different among the three groups. Compared with groups I and II, the incidence of bleeding, bile leakage, and inferior vena caval strictures were significantly decreased in group III (P<0.05). No significant differences between the three groups were found based on other complications after the operation (P>0.05). Group III had better 7-day survival rates and longer median survival times but the differences were not statistically significant. The method of small for donor bodyweight using the median and right lobes for grafting may be a more effective and simpler way of establishing a 30% small-for-size liver transplantation in rats, as shown by the shorter hepatectomy time and the occurrence of fewer complications after the operation.

关键词： liver transplantation     small-for-size     rats    

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To restrict indication for stenting of the inferior vena cava and liver transplantation in patients with

WANG Zhonggao

《医学前沿（英文）》 2007年 第1卷 第2期   页码 130-135 doi: 10.1007/s11684-007-0025-3

摘要： The Budd-Chiari syndrome (BCS) used to be a very rare disorder and lacked a means of relieving. However, various shuntings and radical procedures have emerged in the last three decades with quite encouraging outcomes. Recent minimally invasive therapies, such as stenting of the inferior vena cava (IVC), are simple and easy to handle. However, it has been realized that the IVC stent may compromise the hepatic veins and cause catastrophic consequences, thus the indication for IVC stenting should be reevaluated and especially not to be overused. Instead, it should be applied by percutaneous transangiography (PTA) only, which may be repeated when necessary. The BCS in China predominantly belongs to the IVC type rather than the intrahepatic type in Western; the outcome from its conventional therapy, at least for the moment, is better than that of liver transplantation. It is thus suggested that, before liver transplantation is decided, the conventional means for managing BCS be considered. The final suggestion is to restrict the indication both for stenting of the IVC and liver transplantation. In this paper, ten examples are given with figures.

关键词： Budd-Chiari syndrome     conventional     intrahepatic     percutaneous transangiography     necessary    

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肝移植术后营养支持

费佳,冷希圣,彭吉润

《中国工程科学》 2003年 第5卷 第12期   页码 24-29

摘要：

对肝移植受体营养状况的评估、术前营养状态的测定和纠正、移植肝脏功能的评价、肝移植术后营养支持的原则、营养支持的具体实施以及小儿肝移植的营养支持等问题进行了讨论。

关键词： 肝脏移植     术后     营养支持    

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Graft versus host disease after liver transplantation: A case report

Peng-Ji GAO, Xi-Sheng LENG, Dong WANG, Guang-Ming LI, Lei HUANG, Jie GAO, JI-Ye ZHU,

《医学前沿（英文）》 2010年 第4卷 第4期   页码 469-472 doi: 10.1007/s11684-010-0120-8

摘要： In documenting clinical experience in the diagnosis and treatment of graft host disease (GVHD), we retrospectively analyzed data of one case that has developed GVHD after liver transplantation. This patient exhibited fever, skin rash, and diarrhea on day 9 after liver transplantation. His liver function was normal. Skin biopsy showed scattered keratinocytes accompanied by satellite-like lymphocyte infiltration and basal cell liquefaction degeneration. After carefully analyzing the complications, we took the strategy of decreasing the dose of tacrolimus. Thereafter, the patient’s temperature decreased to normal, his skin rashes subsided, and his diarrhea was relieved. This case suggests that reducing the dosage of immunosuppressive agents can be an effective strategy for GVHD after liver transplantation.

关键词： liver transplantation     graft versus host disease    

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Liver surgery and transplantation in China: Progress and Challenges

LAU W Y, LAI E C H

《医学前沿（英文）》 2007年 第1卷 第1期   页码 1-5 doi: 10.1007/s11684-007-0001-y

摘要： From the limited but available information, we traced the history of developments of liver surgery and transplantation in China. Liver surgery first started in the late 1950s in China, and it soon flourished mainly because of the great demand in liver surgery and the emergence of a number of giants in liver surgery. We recognized and honoured the important contributions of these Chinese pioneers in portal hypertension, recurrent pyogenic cholangitis, hepatocellular carcinoma and liver transplantation.

关键词： transplantation     pyogenic cholangitis     available information     important     hypertension    

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Autoimmune hepatitis

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《医学前沿（英文）》 2015年 第9卷 第2期   页码 187-219 doi: 10.1007/s11684-015-0386-y

摘要：

Autoimmune hepatitis is a chronic liver disease putatively caused by loss of tolerance to hepatocyte-specific autoantigens. It is characterized by female predilection, elevated aminotransferase levels, autoantibodies, increased γ-globulin or IgG levels and biopsy evidence of interface hepatitis. It is currently divided into types 1 and 2, based on expression of autoantibodies. Autoantigenic epitopes have been identified only for the less frequent type 2. Although autoimmune hepatitis occurs in childhood, this review focuses on disease in adults. In the absence of pathognomonic biomarkers, diagnosis requires consideration of clinical, biochemical, serological and histological features, which have been codified into validated diagnostic scoring systems. Since many features also occur in other chronic liver diseases, these scoring systems aid evaluation of the differential diagnosis. New practice guidelines have redefined criteria for remission to include complete biochemical and histological normalization on immunosuppressive therapy. Immunosuppression is most often successful using prednisone or prednisolone and azathioprine; however, the combination of budesonide and azathioprine for non-cirrhotic patients offers distinct advantages. Patients failing standard immunosuppression are candidates for alternative immunosuppressive regimens, yet none of the options has been studied in a randomized, controlled trial. Overlap syndromes with either primary sclerosing cholangitis or primary biliary cirrhosis occur in a minority. Liver transplantation represents a life-saving option for patients presenting with acute liver failure, severely decompensated cirrhosis or hepatocellular carcinoma. Transplant recipients are at risk for recurrent autoimmune hepatitis in the allograft, and de novo disease may occur in patients transplanted for other indications. Patients transplanted for AIH are also at risk for recurrent or de novo inflammatory bowel disease. Progress in our understanding of the immunopathogenesis should lead to identification of specific diagnostic and prognostic biomarkers and new therapeutic strategies.

关键词： autoimmune hepatitis     autoantibodies     diagnosis     immunological diseases     drug-induced liver injury     therapy     immunosuppression     outcomes     hepatocellular carcinoma     liver transplantation    

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Liver cell therapies: cellular sources and grafting strategies

《医学前沿（英文）》 2023年 第17卷 第3期   页码 432-457 doi: 10.1007/s11684-023-1002-1

摘要： The liver has a complex cellular composition and a remarkable regenerative capacity. The primary cell types in the liver are two parenchymal cell populations, hepatocytes and cholangiocytes, that perform most of the functions of the liver and that are helped through interactions with non-parenchymal cell types comprising stellate cells, endothelia and various hemopoietic cell populations. The regulation of the cells in the liver is mediated by an insoluble complex of proteins and carbohydrates, the extracellular matrix, working synergistically with soluble paracrine and systemic signals. In recent years, with the rapid development of genetic sequencing technologies, research on the liver’s cellular composition and its regulatory mechanisms during various conditions has been extensively explored. Meanwhile breakthroughs in strategies for cell transplantation are enabling a future in which there can be a rescue of patients with end-stage liver diseases, offering potential solutions to the chronic shortage of livers and alternatives to liver transplantation. This review will focus on the cellular mechanisms of liver homeostasis and how to select ideal sources of cells to be transplanted to achieve liver regeneration and repair. Recent advances are summarized for promoting the treatment of end-stage liver diseases by forms of cell transplantation that now include grafting strategies.

关键词： liver regeneration     hepatocytes     cholangiocytes     stem cells     organoids     regulatory mechanisms     transplantation/grafting strategies    

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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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免疫抑制和肝移植 Review

Jan Lerut, Samuele Iesari

《工程（英文）》 2023年 第21卷 第2期   页码 175-187 doi: 10.1016/j.eng.2022.07.007

摘要：

完美的手术技术和充分的免疫抑制是确保最佳移植物和患者存活的关键。不同药物的可用性导致了一些通常由行业驱动的不同类型的临床试验，以寻找理想的免疫抑制方案。然而，大量概念不同的研究设计未能明确定义最佳免疫抑制方案。基于钙调神经磷酸酶抑制剂他克莫司、抗代谢药物霉酚酸酯或硫唑嘌呤和短期类固醇（除了可能的诱导外）的三联免疫抑制方案仍然是目前公认的肝移植标准免疫抑制方案。然而，鉴于排斥定义的变化、免疫抑制负荷的定制以及由于慢性免疫抑制引起的长期副作用，未来的试验最好包括一个以上的终点，而不是急性T细胞介导的急性排斥（a-TCMR）或肾衰竭。相反，需要一个涵盖患者和移植物存活率以及急性和慢性排斥反应发生率的综合终点。这些免疫现象应根据一系列长期的生物学和组织学随访进行检查。临床相关α-TCMR的诊断和治疗应基于综合生物学、免疫学和组织病理学的发现。这两个要素对于朝着更谨慎的免疫抑制处理和有利于临床操作耐受性的方向发展至关重要。

关键词： 肝移植     免疫抑制     排斥     耐受性     临床试验    

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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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Comprehensive treatment of acute-on-chronic liver failure in a patient with hepatitis B: a case report

null

《医学前沿（英文）》 2014年 第8卷 第2期   页码 250-253 doi: 10.1007/s11684-014-0333-3

摘要：

The clinical data of a patient with acute-on-chronic liver failure were analyzed retrospectively. The patient has suffered from hepatitis B for 30 years. His liver function deteriorated, yielding Child-Pugh grade C and reaching a model for end-stage liver disease score of 33 points within a short period; this condition was complicated with highly active variceal bleeding and coagulation system failure (PT > 100 s). The patient also presented hepatocellular carcinoma. Comprehensive treatments included effective inhibition of hepatitis B virus replication and intensive care support. Piggyback orthotopic liver transplantation was performed as the final treatment. The patient recovered uneventfully and was discharged after surgery.

关键词： acute-on-chronic liver failure     submassive necrosis     viral hepatitis B     esophageal variceal bleeding     liver transplantation    

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自体骨髓干细胞移植与归元方联用治疗急慢性肝损伤实验研究

吴理茂,李连达,刘红,宁可永,李贻奎

《中国工程科学》 2004年 第6卷 第7期   页码 34-42

摘要：

研究中药归元方与自体骨髓干细胞移植对急慢性肝损伤的治疗作用。研究方法：用肝脏局部注射乙醇的方法复制急性局限性肝损伤模型，复合因素（CCl4、乙醇、高脂、低蛋白）刺激复制大鼠肝纤维化模型，通过定量组织学、肝功能检查、免疫组化、肝组织羟脯氨酸含量、损伤或纤维区骨髓干细胞观察等综合评价中药、自体骨髓干细胞移植及两者合用的疗效。结果：归元方与自体骨髓干细胞移植可减小肝损伤区域，改善肝功能，使纤维肝组织表达μPA增强，降低血清ALT，AST，PCⅢ，HA和肝组织羟脯氨酸的含量，改善肝组织肝纤维化评分，骨髓干细胞能在肝损伤、肝纤维化形成环境中存活、增殖，并向肝细胞分化，表达肝脏特异的角蛋白CK18。结论：归元方与自体骨髓干细胞移植对急慢性肝损伤有明确的治疗作用，两者合用可优势互补，协同增效。临床上有良好的应用前景。

关键词： 归元方     骨髓干细胞     自体移植     肝损伤     肝纤维化    

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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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标题 作者 时间 类型 操作

Partial liver transplantation

null

期刊论文

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

null

期刊论文

A better way to do small-for-size liver transplantation in rats

null

期刊论文

To restrict indication for stenting of the inferior vena cava and liver transplantation in patients with

WANG Zhonggao

期刊论文

肝移植术后营养支持

费佳,冷希圣,彭吉润

期刊论文

Graft versus host disease after liver transplantation: A case report

Peng-Ji GAO, Xi-Sheng LENG, Dong WANG, Guang-Ming LI, Lei HUANG, Jie GAO, JI-Ye ZHU,

期刊论文

Liver surgery and transplantation in China: Progress and Challenges

LAU W Y, LAI E C H

期刊论文

Autoimmune hepatitis

null

期刊论文

Liver cell therapies: cellular sources and grafting strategies

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

免疫抑制和肝移植

Jan Lerut, Samuele Iesari

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

Comprehensive treatment of acute-on-chronic liver failure in a patient with hepatitis B: a case report

null

期刊论文

自体骨髓干细胞移植与归元方联用治疗急慢性肝损伤实验研究

吴理茂,李连达,刘红,宁可永,李贻奎

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