The past few years have witnessed a rapid development in liver transplantation in China and great achievement has been made.This review introduces the recent focuses on liver transplantation in China,including scoring for end-stage hepatic disease and liver transplantation,liver transplantation for hepatocellular carcinomas,liver re-transplantation,expanding of the donor pool,and post-operative long-term follow-ups.

Hepatitis B recurrence is one of the most frequent complications that will probably result the treat failure of liver transplantation. As many as 80% of patients with HBV are reinfected by this virus after liver transplantation. This has been the most deadly case that threatens patient survival amongst all problems emerging from liver transplantation executed for Hepatitis B ralated hepatocirrhosis. In recent years a great deal of prophylaxis practices have been adopted, which has greatly reduced the possibility of Hepatitis B recurrence. The present paper reviews the causes and treatment of Hepatitis B recurrence after liver transplantation.

Objective To comprehensively summarize the recent development of organ transplantation specialty,and raise a suggestion for the future progress of the subject.Methods The info investigation method was employed to retrieve the literature concerning solid organ transplantation published in recent five years domestically and abroad,and the new progresses were analyzed on organ transplantation in both military and civil fields,and also fundamental and clinical researches.Results Researches on organ transplantation had progressed rapidly on foundation and clinical application in recent 5years in armed forces.The major achievements were in immune recognition and adjustment,transplant immune tolerance,the regulating effect of CTLA4Ig on NK cell function,preparation of the preservation fluid,and pathological diagnosis.Conclusions The professional level of organ transplantation in the armed forces had teken the foremost position in advance in the country.During the period of "12th Five-Year Plan" ,researches should be carried out on procurement,preservation and transplantation of the donated organs after cardiac death(DCD)organ.Meanwhile the foundational and clinical researches should be enhanced of immune tolerance,regulatory T lymphocyte,formulation of preservation fluid,and of animal experiment for closely bonding the foundational and clinical researches,and striving for greater research outcome.

Objective To investigate the related factors of encephalopathy following orthotopic liver transplantation (OLT).Methods The clinical data of 128 patients who underwent liver transplantation consecutively between October 2001 and October 2003 were analyzed retrospectively by SPSS 10.0 . All clinical factors were analyzed by Crosstabs or independent-samples t test. A mutivariative analysis of these significant factors was done by using the Binary Logistic Regression.Results Encephalopathy occurred in 21 cases within the first week after operation, including 19 cases of Child-pugh C and 2 cases of Child-pugh B. There was a higher occurrence in the patients with chronic severe hepatitis or undergoing re-transplantation ( P 0.05 ). In the encephalopathy group the incidence of renal failure after transplantation and infection pre- or postoperation was higher than in control group ( P

Objective To summarize the experience of liver retransplantation, as well as the factors i nfluencing the surgical effects. Methods The clinical data of 8 patients who received liver retransplantation in our cent er were analyzed retrospectively. Results Among 8 cases, complications of biliary tract occurred in 5 cases, chronic rejec tions in 2 cases, embolism in hepatic artery in one case. Infections occurred in 7 cases before engraftment. Case 1 had develope d renal function failure before the surgery, and he died of severe infections an d multi-organ failure after transplantation. Case 4 had massive hemorrhage duri ng the operation and also died of multi-organ failure after transplantation. Case 7 developed in tracanial hemorrhage and abdominal infection and died early after transplantatio n. Other 5 cases has recovered and left hospital. Conclusions Liver retransplantation is the only measure that can be taken to save the lives of patients whose liver allograft fails to function. It's very important that the indications and time of retransplantation should be carefully selected. Factors that may lead to harmful effects on liver retranspl antation include bad preoperative condition of the recipient, tough and long ope ration, massive hemorrhage during the operation, and severe complications after the surgery.

Objective To study the effect of fragile histidine triad (FHIT) gene on pancreatic adenocarcinoma cells growth and tumorigenicity and explore the mechanism of FHIT gene in suppressing the deve lopment of pancreatic adenocarcinoma. Methods By the method of liposome transfection, pRC/CMV FHIT plasmid was transfected into 1990 cell lines which lose all of FHIT gene. Integration and expression of exogenous FHIT gene were confirmed by RT PCR and Western blot technique. 1990 pFHIT cell growth was observed in regular culture medium and tumorigenicity in nude mice. Its DNA was analyzed by electrophoresis. Results The growth of the cells transfected with FHIT gene (named as 1990 pFHIT cells) was suppressed significantly, and the tumorigenicity of the 1990 pFHIT cells was dramatically inhibited in nude mice as compared with that of the parental 1990 cells. Significantly increased apoptosis in 1990 pFHIT was found. Conclusions The growth and tumorigenicity of pancreatic adenocarcinoma cell can be inhibited by transduced exogenous FHIT gene. It's spectulated that FHIT suppress the development of pancreatic adenocarcinoma by the path of apoptosis.

Objective To compare F-Z solution with UW solution in preserving efficacy at cell level. Methods The LDH content in supernatant of endothelial cells after preservation-rewarming to determine the injury after preservation-rewarming. MTT was used to determine the activity of endo-thelial cells after preservation-rewarming. Results After being preserved for 24 h, the LDH content in supernatant of endothelial cells in UW group was not significantly different from that in F-Z group.After preservation for 48 h, there was no marked difference in the activity of endothelial cells between the 2 groups. Conclusion F-Z solution and UW solution have the same effect in reducing injury and maintaining activity of endothelial cells after preservation-rewarming at cell level.

Ischemia-reperfusion injury is a common pathophysiological process in organ transplantation,ischemic stroke and organ resection surgery,and also an important factor causing organ dysfunction and severe postoperative complications.How to avoid or mitigate organ ischemia-reperfusion injury has always been a research hotspot.NLRP3 Inflammasome has been considered to be an important link in inflammatory response.It has an indispensable role in maturation process of IL-lβ and IL-18.We reviewed the research in recent yeas about the role of NLRP3 Inflammasome in organ ischemia-reperfusion injury in this paper.

Objective To investigate the protective effects of Th2 cytokine (hIL-4, hIL-10, hIL-13) on the bovine aortic endothelial cells(BAECs) stimulated by tumor necrosis factor alpher(TNF-?). Methods BAECs were activated by TNF-?(4ng/ml), and a varied dose of Th2 cytokine(2, 5, 10, 20 and 40ng/ml) was used to incubate BAECs for 2h before stimulation with TNF-?, and then co-incubate for 6h or 18h. The expression of cellular adhesive molecules on BAECs was examined by the cellular enzyme-linked immunoabsorbent assay (Cell-ELISA), and BAECs viability was determined by MTT method. Results BAECs pre-treated with Th2 cytokine could down-regulate the expression of E-selectin and ICAM-1 induced by TNF-? in a dose-dependent manner(P

Objective To analyze related perioperative risk factors of acute respiratory distress syndrome (ARDS) early after orthotopic liver transplantation (OLT).Methods The cases from the recipients having undergoing OLT,aged from 15 to 65 years and having no chronic respiratory diseases and hyoxemia were collected.The exclusive criteria were as follows:(1) the patients dead or automatic discharging at the day after the OLT or during the OLT; (2) the patients suffered from severe surgical technic complications; (3) initial poor graft function occurred; (4) marginal donor; (5) pulmonary wedge pressure (PAWP)＞ 2.394kPa.251 patients were enrolled in this analysis,who were grouped according to whether they developed ARDS (group B) or not (group A) in the first postoperative day.The analyzed factors were as follows:(1) the sex,age and weight of the recipients; (2) preoperative variables of recipients:Child-Pugh and Model for end-stage liver disease (MELD) score,left vent ricular ejection fractions,oxygenation index,the serum levels of creatinine,BUN,TB,albumin,prealbumin,fibrinogen and hemoglobin,white blood cells (WBC),platelet count and international normalized ratio (INR) ; (3) the variables of donator:age,the time of warm and cold ischemia; (4) the intraoperative variables:operative time,anhepatic phase,the volumes of hemorrhage and blood-transfusion (red cell suspension and plasma),transfusion volume; (5) postoperative variables of recipients:the serum levels of creatinine,blood urea nitrogen (BUN),total bilirubin (TB),albumin,alanine aminotransferase (ALT),sodium and potassium,fibrinogen and hemoglobin,WBC,platelet count and INR.Results The mild ARDS incidence early after OLT was 25.5 ％ (65/251) and the moderate or severe was 4.8％ (12/265).Single factor analysis showed that the factors having significant difference between group A and group B were as follows:the age of the recipients,preoperative variables (Child-Pugh and MELD score,the preoperative serum levels of BUN,TB,prealbumin,fibrinogen and hemoglobin,WBC,platelet count and INR),the intraoperative variables (the volumes of hemorrhage and blood-transfusion including red cell suspension and plasma) and the postoperative variables (the serum levels of BUN,TB,sodium,fibrinogen and hemoglobin,WBC,platelet count and INR).The significant factors were put to the analysis of LOGISTIC regression,and the results showed that the age of recipients,preoperative Child-Pugh score,BUN and INR,intraoperative hemorrhage volume,postoperative serum level of sodium were the independent risks contributing to ARDS.Conclusion The mild ARDS incidence early after OLT was high but the the moderate or severe incidence was low.The age of recipients,preoperative Child-Pugh score,BUN and INR,intraoperative hemorrhage volume and postoperative serum level of sodium may be the main risk factors to lung injury after OLT.