The Publisher regrets that this article is an accidental duplication of an article that has already been published, http://dx.doi.org/10.1016/j.livres.2017.07.001. The duplicate article has therefore been withdrawn. The full Elsevier Policy on Article Withdrawal can be found at https://www.elsevier.com/about/our-business/policies/article-withdrawal
Background: Individualized prediction of survival after liver transplantation (LT) for patients with hepatitis B virus-related acute-on-chronic liver failure (HBV-ACLF) has not been well investigated. This study aimed to develop a prognostic nomogram for patients with HBV-ACLF undergoing LT.Methods: The nomogram was derived from a retrospective study of 290 patients who underwent LT for HBV-ACLF at the Third Affiliated Hospital of Sun Yat-sen University between January 2012 and December 2017. Concordance index and determiner calibration curve was used to ascertain the predictive accuracy and discriminative ability of the nomogram. The predictive performance of the nomogram was compared with that of Child-Pugh score, model for end-stage liver disease (MELD), MELD-Na, chronic liver failure Consortium Organ Failure score (CLIF-C OFs), and CLIF-C ACLF.Results: The 1-year mortality rate was 23.1% (67/290). The Cox multivariate analysis showed that risk factors for 1-year survival rate included white blood cell count, alanine aminotransferase/aspartate aminotransferase ratio, and the organ failure numbers. The determiner calibration curve showed good agreement between prediction of the nomogram and actual observation. The concordance index of the nomogram for predicting 1-year survival was 0.707, which was significantly higher than that of other prognostic models: Child-Pugh score (0.626), MELD (0.627), MELD-Na (0.583), CLIF-C OF (0.674), and comparable to that of CLIF-C ACLF (0.684).Conclusions: Our study developed a novel nomogram that could accurately predict individualized post-transplantation survival in patients with HBV-ACLF. The nomogram might be a useful tool for identifying HBV-ACLF patients who would benefit from LT.
To explore the treatment and appropriate management of invasive aspergillosis infection following orthotopic liver transplantation.The clinical data of 576 cases who underwent orthotopic liver transplantation consecutively between January 2000 and January 2005 were analyzed retrospectively.The prevalence of invasive aspergillosis infection was 1.74 (9/576), included 8 cases with pulmonary aspergillosis and 1 case with cerebral aspergillosis. The interval between transplantation and diagnosis were from 10 days to 2 months. Persistent or discontinuous low fever maybe the main clinical presentation after operation. Liposomal amphotericin B (AmBisome) is the mainly treatment for invasive aspergillosis infections, 5 patients were cured and 2 patients developed multi-organ aspergillosis infection died.The clinical features of invasive aspergillosis infection following orthotopic liver transplantation were un-typical presentations in the early stage and easy to disseminate. Appropriate modification of immunosuppression therapy and early, high dose and long-term application of antifungal treatment is effective and safe to cure the disease.
To evaluate the prophylactic efficacy of adefovir dipivoxil (ADV) for post-transplant recurrence of hepatitis B virus (HBV) with lamivudine-resistant YMDD mutation in liver recipients.From March 2004 to May 2006, 20 patients with chronic hepatitis B associated with YMDD mutant HBV prior to liver transplantation received treatment with ADV and additional intramuscular hepatitis B immunoglobulin (HBIG) for prevention of post-transplant graft reinfection. The liver function, serum HBsAg, anti-HBs (HBIG), HBeAg, anti-HBc, anti-HBe, HBV DNA and creatinine were examined in all the patients before and after the transplantation.The median follow-up duration of these patients after the transplantation was 33.5 months. Nineteen patients survived and one patient died of recurrent hepatocellular carcinoma. There was significant difference in YMDD mutation rate between the patients with HBV-DNA over 10(6) copies/ml and those with HBV-DNA less than 10(6) copies/ml (12.4% vs 2.5%, P < 0.05). HBV-DNA was undetectable at 4 weeks after the transplantation in 95.0% of the patients (19/20) and at 6 months in one case. No recurrence of hepatitis B was detected by long-term regular testing of HBsAg, HBeAg and HBV-DNA. Serum creatinine increased in 1 case 1 year after the use of ADV.ADV offers protection against recurrence of HBV with YMDD mutation after liver transplantation with only mild nephrotoxicity, but renal function monitoring during the use of ADV is still necessary.
[Objective] Compare with the effects and mechanism of Panax Notoginseng Saponins (PNGS) and Verapamil (Ver) on the rat liver during cold preservation. [Methods] Using isolated perfusion of rat liver model(IPRL),Fura-2 method was used to measured the intracellar calcium of the 2 hours cold preservation; the liver function,free radical,enery substance and bile production,morphological analysis were measured after 24 hours cold preservation and 30 minutes reperfusion,DMEM solution and Lactate Ringer′s (LR) solution containing PNGS with different dose and Ver 20 mg. [Results] The contents of intracellur calcium of the rat hepatocytes,MDA,SOD,AST,ALT,LDH,ATP,AEC,TNA and bile production were significantly better than in the control group (P 0.01). During 200~600 mg,the protective effects of the PNGS were correlated with the dosage and manifest dosage-dependence(P 0.01),800~1000 mg were not significant (P 0.05). the protective effects of the Ver 20 mg is only correspondent with PNGS 200~400 mg (P 0.01). [Conclusions] The protective effects of the PNGS were better than the Ver 20 mg,it might be correlated with different mechanism of inhibition calcium overload and against free radical injure.
Objective
To investigate pre-treatment condition, mean survival time, survival rate, tumor progression condition, complications and treatment cost of transcatheter arterial chemoembolization(TACE), radiofrequency ablation(RFA) and orthotopic liver retransplantation(re-OLT).
Methods
Retrospective analysis of 53 cases reported for intrahepatic recurrence after liver transplantation of our hospital, from Jan. 2004 to Jun. 2009. There were 3 patients received surgical resection, 22 for TACE, 18 for RFA and 10 for re-OLT. The pre-treatment condition, survival time, tumor progression condition, complications and treatment cost of the patients of surgical resection are investigated. Treatment effect of the patients received TACE, RFA and re-OLT were compared and analyzed.
Results
Three patients received surgical resection. After 4-12 months follow-up, they had not been found complications and tumor progression, and they were still alive. The difference of mean survival time, survival rates and the tumor progression condition among TACE, RFA and re-OLT are considered no significant; But RFA was lower in severe degree of complication, especially the biliary complications, and the cost of treatment: RFA
Objective To compare the efficacy of percutaneous and endoscopic treatment for the biliary stricture(BS) after liver transplantation (LT).Methods The result of percutaneous transhepatic cholangiography (PTC) and drainage ( PTC group) and endoscopic retrograde cholangiopancreatography (ERCP group) for the BS in 132 post-LT patients were analyzed retrospectively.Ninety-nine patients received PTC treatment,and 59 patients received ERCP treatment,26 patients converted to PTC treatment because of the poor efficacy or failure of the ERCP treatment.The operation success rate,complication rate,cure rate and remission rate of the two groups were compared with X2 test.Results The BS types of PTC and ERCP group were different significantly( P ＜ 0.01 ),with more non-anostomotic stricture in PTC group and more anostomotic stricture in ERCP group.The operation success rate of PTC group was higher than of ERCP group( 100％ vs 97％ ) (P ＜0.01 ),and the complication rate of PTC group was lower than of ERCP group.The overall cure and remission rate of PTC and ERCP group were not different significantly(32.3％ vs 45.8％,94.9％ vs 88.1％ ) (P ＞0.05).The cure and remission rate of PTC and ERCP treatment for each subtype of BS were not different significantly ( P ＞ 0.05 ).Conclusions The efficacy of PTC treatment for the post-LT BS is equivalent to that of ERCP treatment.PTC can be considered the first-line option for the post-LT BS.
Key words:
Liver transplantation; Biliary duct diseases; Cholangiography; Cholangiopancreatography,endoscopic retrograde
The potential function of long non-coding RNAs (lncRNAs) in human hepatic ischemia-reperfusion injury (HIRI) remains to be clarified.Clinical samples of transplanted liver tissues from 26 patients undergoing liver transplantation (LT) and normal liver tissues from seven patients undergoing hepatic hemangiomactomy (Con) were collected. Typical samples were subjected to whole transcriptome sequencing (RNA-seq). Differentially expressed genes between groups were identified by DEGseq and were analyzed by enrichment analysis including Gene Ontology, Kyoto Encyclopedia of Genes and Genomes, and gene set enrichment analysis. Transcription of five lncRNAs including NONHSAG039942, NONHSAG071405, NONHSAG027516, LXLOC_058190, and LXLOC_024376 that presented significant difference in RNA-sequencing were validated by a quantitative real-time PCR (qRT-PCR), for which the subcellular localization and the binding ability to known human RNA-binding proteins (RBPs) were respectively predicted by LncLocator and catRAPID genomics v2.1.We identified 2917 lncRNAs and 2811 mRNAs that were differentially expressed (p < 0.05 and log2 fold change > 1 or < -1) between groups (LT vs. Con). NONHSAG039942, NONHSAG071405, LXLOC_058190, and LXLOC_024376 were validated by qRT-PCR to be significantly increased in the LT group, and were all predicted to be localized in cytoplasm or cytosol. NONHSAG039942, NONHSAG071405, and LXLOC_058190 held an RBP interaction propensity score of 98.07%, 76.95%, and 152.99%, respectively, with heterogeneous-nuclear ribonucleoprotein U (HNRNPU). Pathways significantly activated in transplant livers that involved HNRNPU as a core enrichment gene included hypoxia, ACE2 expression, apoptosis, spliceosome formation, etc. CONCLUSIONS: NONHSAG039942, NONHSAG071405, and LXLOC_058190 were significantly increased in transplant livers after reperfusion and their role in HIRI may be associated with HNRNPU, a core protein that participates in hypoxia and chromatin accessibility.
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