Objective To evaluate the predictive value of raised eosinophil count in peripheral blood in the diagnosis of acute rejection (AR) after liver transplantation (LT).Methods The peripheral blood eosinophil count the day before or on the day of biopsy in 125 biopsies from 101 liver transplant patients was retrospectively analyzed.Patients were divided into AR group and non-acute rejection (NAR) group according to histopathologic findings.Absolute and relative eosinophil counts were compared between two groups.The optimal cut-off value for both parameters was determined by using a receiver operating characteristic curve analysis.Sensitivity and specificity of the parameters was calculated.Results Absolute and relative eosinophil counts were significantly higher in the AR group (n =56) than in the NAR group and positively correlated with the episode of AR (r=0.218,P =0.015,and r =0.182,P =0.042,respectively),ROC curve analysis showed that absolute eosinophil counts of 0.145 × 109/L and relative eosinophil counts of 2.35％ had the highest Youden index (0.17 and 0.185,respectively).The cut-off value of 0.145 × 109/L for absolute eosinophil counts and 2.35％ for relative eosinophil counts was used,respectively.The sensitivity of both absolute and relative eosinophil counts to predict AR was 28.6％,and the specificity was 88.4％ and 89.9％,respectively.Conclusion A raised eosinophil population in peripheral blood is associated with AR.Raised eosinophil count has a predictive value in diagnosis of AR after LT with a high specificity but low sensitivity.

ObjectiveTo explore an effective method for the isolation and purification of rats bone marrow mesenchymal stem cells (BMSCs) and to study the basic biological characteristics of BMSCs. MethodsOne healthy Sprague-Dawley (SD) rat of specific pathogen free (SPF) grade aged 4 weeks was selected, and the BMSCs were isolated using the modiifed whole bone marrow adherent method. The morphologic variation and proliferation features of BMSCs were observed under inverted phase contrast microscope, and the surface markers of BMSCs of P3 generation were detected by flow cytometry. Cell growth curves were drawn using the cell counting kit (CCK)-8 assay.ResultsTypical adherent growth was observed in the primary BMSCs with the forms of fusiform or polygon and appearance of circinate cell colony. The cell colonies fused with each other up to 80% in about 8 d. The puriifed passage cells still kept a homogeneous morphology and a high potential of proliferation. The growth curve of BMSCs indicated an S shape. The surface markers of BMSCs of P3 generation cluster of differentiation (CD) 29 and CD90 were observed positive, but CD11b and CD45 negative. ConclusionsBMSCs with high-purity, active proliferation and stable biological characteristics can be cultured using modiifed whole bone marrow adherent method. The growth curve of BMSCs presents in an S shape.

Objective To investigate the causes, prevention and treatment of seizures following liver transplantation (LT). Methods In the 772 patients undergoing LT in Organ Transplantation Center, the third Affiliated Hospital of Sun Yat-sen University from October 2003 to June 2009, clinical data of 8 patients who developed seizures during the follow-up after operation were analyzed retrospectively. The informed consents of all patients were obtained and the ethical committee approval was received. There were 5 males and 3 females with age ranging from 46 to 58 years old and median age of 54 years old. The patients received regular reexaminations of blood routine, liver function, renal function, electrolytes, blood concentration of immunosuppressant, infection related etiological examinations, etc. The examinations of electroencephalogram (EEG), computed tomography (CT), or magnetic resonance imaging (MRI) were completed for the suspicious patients of seizures. The causes of disease, diagnosis, treatments and outcome of the patients were analyzed, including the incidence, onset time, seizures types, etiological analysis, treatments and outcome. Results The incidence of seizures following LT was 1.0% (8/772), in which 1 case occurred in 1 week after operation, 2 cases within 5 to 6 weeks, 5 cases over 16 weeks and the longest case over 7 years after operation. Generalized tonic-clonic seizure was observed in 7 cases, including 2 cases developed to status epilepticus and 1 case of complex partial seizure. The etiological analysis revealed that 1 case had a history of seizures and 2 cases had hepatic encephalopathy before operation. Water-electrolyte imbalance occurred in 6 cases after operation including 2 cases complicated with hypoglycemia. And cerebral apoplexy occurred in 4 cases after operation including 1 case complicated with abnormally elevating blood concentration of tacrolimus (FK506), 1 case complicated with intracranial fungus and cytomegalovirus infections. Sedative and antiepileptic were given to all of 8 patients and various inducements were treated. Two cases recovered well and were discharged from hospital, and 6 cases died of multiple organ dysfunction syndrome or cerebral hemorrhage. Conclusions Seizures following LT may be related with many factors such as preoperative history of seizures and hepatic encephalopathy, immunosuppressant toxicity, water-electrolyte imbalance, cerebral apoplexy and intracranial infections after operation, etc. Once seizures are confirmed, sedative and antiepileptic should be given to the patients and various inducements should be treated. The prognosis of the patients is poor.