1.Storage effect and transplant outcomes of University of Wisconsin preservation solution and histidine-tryptophan-ketoglutarate preservation solution on liver allografts: a Meta-analysis
Apaer SHADIKE ; Tuxun TUERHONGJIANG ; Yupeng LI ; Aierken AMINA ; Tao LI ; Jinming ZHAO ; Hao WEN
Chinese Journal of Digestive Surgery 2016;15(5):482-489
Objective To systematically evaluate the storage effect and transplant outcomes of University of Wisconsin (UW) preservation solution and histidine-tryptophan-ketoglutarate (HTK) preservation solution on liver allografts.Methods Literatures were researched using PubMed,Embase (1980-),Ovid Medline (1948-),The Cochrane Library,Wanfang database,VIP database from the database establishement to October 2015 with the key words including organ preservation,storage solutions,Histidine-tryptophan-ketoglutarate or HTK,custodial,bretschneider,University of Wisconsin,UW solution,viaspan,cardiosol,belzer solution,hepatic transplantation,liver transplantation,viscera transplantation,liver grafts,hepatic grafts,liver allografts,hepatic allografts,器官移植,器官保存液,UW,HTK,肝移植and比较.Two reviewers independently screened literatures,extracted data and assessed the risk of bias.All the patients using UW and HTK preservation solutions were respectively allocated into the UW group and HTK group.Count data were represented as the odds ratio (OR) and measurement data were represented as the standardized mean difference (SMD) and 95% confidence interval (CI).The heterogeneity of the studies was analyzed using the I2 test.Results Eleven literatures were retrieved,and the total sample size were 34 475 patients including 25 248 in the UW group and 9 227 in the HTK group.The results of Meta analysis showed that there were no statistically significant differences in the primary transplants nonfunction,retransplant rate and 1-year grafts overall survival rate between the 2 groups (OR =1.18,0.84,0.97,1.02,95% CI:0.55-2.57,0.47-1.50,0.66-1.42,0.66-1.58,P >0.05).There were also no statistically significant differences in the levels of alanine transaminase (ALT),aspartate transaminase (AST),total bilirubin (TBil) at postoperative day 1 between the 2 groups (SMD =-0.19,-O.30,0.30,95% CI:-0.62-0.23,-0.70-0.10,-0.01-0.61,P >0.05).There were no statistically significant differences in the postoperative prothrombin time(PT) and alkaline phosphatase(ALP) between the 2 groups (P >0.05) and in the incidence of postoperative biliary complications between the 2 groups (OR =1.49,95% CI:0.97-2.30,P > 0.05).Conclusion There is similar storage effect between UW and HTK preservation solutions on liver allografts,and no difference in the transplant outcomes.
2.Clinical value of thrombospondin-1 and transforming growth actor-β in predicting post hepatectomy liver failure
Hasimu HAXIAOBIEKE ; Jing WU ; Gang YAO ; Apaer SHADIKE ; Fulati XIAPUKAITI ; Yun-Fei ZHANG ; Tuersunmaimaiti ABUDUSHALAMUU ; Tuxun TUERHONGJIANG
Chinese Journal of Current Advances in General Surgery 2024;27(6):442-446
Objective:To explore the dynamic changes of thrombosbondin-1(TSP-1)and transforming growth factor beta(TGF-β)in patients who underwent hepatectomy and their clinical value in predicting post-hepatectomy liver failure(PHLF).Methods:Clinical data of 113 patients who received hepatectomy in the First Affiliated Hospital of Xinjiang Medical University from Janu-ary 2016 to March 2019 were retrospectively analyzed.The cohort comprised 59 males and 54 fe-males,with an average age of(41.00±13.98)years.According to the standard of the International Study Group of Liver Surgery(ISGLS),TSP-1 was divided into the PHLF group(n=40)and the non-PHLF group(n=73).The dynamic changes of plasma TSP-1 and TGF-β plasma levels during peri-operative period were observed.The definition and diagnostic criteria suggested by ISGLS was used to evaluate PHLF.The value of plasma TSP-1 and TGF-β level in predicting PHLF were ana-lyzed by calculating areas under the receiver operating characteristic curves(AUCs).Patients were divided into TSP-1 high group and TSP-1 low groups based upon the ROC cutoff values and their correlation with PHLF was analyzed.T test and Mann-Whitney rank sum test were performed to compare the TSP-1 and TGF-β levels between the two groups.The rate comparison was carried out by Chi-square test or Fisher's exact test.Results:In this study,40 patients experienced vary-ing degrees of PHLF.The plasma levels of TSP-1 on postoperative day I(POD1)and day 7(POD 7)in the PHLF group were significantly higher than those in the non-PHLF group(P<0.05,P<0.01,re-spectively).The area under the ROC curve of plasma TSP-1 level on postoperative 1 d in the diag-nosis of PHLF was 0.725,with sensitivity of 0.864 and specificity of 0.647.The area under the ROC curve of plasma TSP-1 level on postoperative 7 d in the diagnosis of PHLF was 0.81,with sensitiv-ity of 0.818 and specificity of 0.765.Conclusion:The incidence of PHLF is related to the extent of liver resection,Child-Pugh grade and TSP-1 levels on postoperative day 1.The concentration level of TSP-1 on POD land 7 might be utilized as an effective marker for predicting PHLF.
3.Meso-Rex bypass using iliac arterial for primary cavernous transformation of portal vein
Apaer SHADIKE ; Tuxun TUERHONGJIANG ; Gang YAO ; Payiziwula JIANGDUOSI ; Hao ZHANG ; Jinming ZHAO ; Tao LI
Chinese Journal of Hepatic Surgery(Electronic Edition) 2018;7(2):133-137
Objective To explore the feasibility of superior mesenteric vein-left portal vein bypass (Meso-Rex) using iliac arterial in the treatment of primary cavernous transformation of portal vein (CTPV). Methods The patient, female, 40 years old, was hospitalized due to dull pain in the upper abdomen for 4 weeks. Abdominal CT angiography showed CTPV, varicosity in the lower esophagus and fundus of stomach, and splenauxe. The admitting diagnosis was primary CTPV. Meso-Rex was performed using iliac artery from donation after cardiac death bridging between superior mesenteric vein and left intrahepatic portal vein. The patient was given heparin for anticoagulation therapy and was followed up by ultrasound after the operation. The informed consent of this patient were obtained and the local ethical committee approval was received. Results The operation was performed successfully. The blood flow of bypass vessel was good after operation, and no complication was observed. During 3 months follow-up, no thrombosis in the bypass blood vessel was observed. Conclusion Meso-Rex is a curative operation for CTPV, and has definite clinical effect. Iliac artery is safe and feasible when used as a shunt vessel. Giving active anticoagulant therapy to prevent thrombosis after operation is the key to success.