Objective To assess the outcome of liver transplantation in patients over sixty years of age,in order to attempt to expand the indications of liver transplantation. Methods From August,2000 to January,2002, the clinical data of 36 patients who underwent liver transplantation in our department were analysed retrospectively. Of the 36 cases, the data (operating time, the length of hospitalization, rejection rate and ICU stay days after operation) of 5 patients whose age were ≥60 years (elderly group) and the data of 31 patients whose age were under 60 years (

Objective To study how to decrease the hospital cost of liver transplants. Methods Fifty-four(patients) who underwent liver transplantation at our hospital within 2 years were analyzed retrospectively. The hospital costs of the patients with different liver function before operation, the costs of the(ICU-dependent), as well as the costs of the non-survival group with the survival group were analyzed and compared. Results The average hospital cost of all the patients was about 340 000 yuan. The cost of(pharmacy), anesthesia,(disposable)(materials), transfusion and laboratory tests accounted for 86.9 percent. The(average) cost of Child grade C(patients) was about 410 000 yuan, was 130 000 yuan higher than that of grade A or B patients. The cost of the ICU-dependent was 240 000 yuan greater than that of the(ICU-independent). The(non-survival) group incurred an average cost of 130 000 yuan higher than the(survival) group. Conclusions For decreasing the hospital cost of liver transplants significantly,it is best to encouraging the patients to receive(liver)(transplants) under good conditions.

Objective:To investigate the common reasons,clinical features and the strategy of management with postoperative bleeding in thorax and abdominal cavity in orthotopic liver transplantation(OLT).Methods:Data based on the 12 cases undergoing OLT in our hospital from August 2000 to January 2002 were collected and analyzed.Results:The most common reason for bleeding post OLT was staxis in abdominal cavity(n=5),then was as followed:the abdominal bleeding caused by hepatic artery thrombolytic therapy(n=3),liver biopsy(n=2),Tipps(n=1),surgical technical reason(n=1).In all 12 cases,re operation of laparotomy was needed in 6 because of the massive bleeding.Acute renal failure happened in 5,and 3 needed hemodialysis.Four patients died postoperatively from massive abdominal bleeding,and 3 caused directly by the acute renal failure.Conclusion:Bleeding in the thorax and abdominal cavity happens frequently after OLT,and staxis in abdominal is the most common reason.The correct management for bleeding is the key thing to prevent complications.It is important to pay close attention to perioperative improvement of coagulative capacity,control of massive bleeding and prevention of renal failure.

Objective:To investigate the risk and prognosis of orthotopic liver transplantation (OLT)for patients with advanced hepatocellular carcinoma(HCC)and those without liver tumor.Methods:The risk and prognosis of 21 cases of orthotopic liver transplantation for patients with HCC were retrospectively reviewed and the comparison was made between such patients and 19 others with non tumor caused end stage failures whose OLT procedures have been done at the same period.Results:Compared with the non tumor OLT recipients,the HCC patients have a better preoperative coagulation function.In accordance with this,the blood lose,the required transfusion and the total infusion during the operation were also less than those of non tumor OLT patients.The duration of hypotension induced by bleeding in HCC patients were also shorter than that in non tumor patients.There were more patients in HCC group with uneventful postoperative course than that in non tumor group.The perioperative mortality was also lower in HCC group.Although the recurrence of malignance affected the long term survival of HCC patients,the whole survival rate was similar to that of non tumor OLT patients.Conclusion:OLT remains an effective alternative for the advanced HCC patients for whom there was no other better choice.It is possible that some patients can get a long term survival and are free of the recurrence of the HCC after OLT treatment.

Objective:To investigate the clinical effect of arthroscopic debridement combined with high lateral tibial osteotomy and Giebel plate internal fixation in the treatment of varus knee osteoarthritis.Methods:From January 2016 to June 2018, 78 patients (96 knees) with varus knee osteoarthritis in Beijing Delcony Orthopedic hospital were treated by arthroscopic debridement combined with closed lateral tibial osteotomy and Giebel plate internal fixation. The femoral tibial angle (FTA) and hospital for special surgery knee score (HSS) score of knee joint were compared before and after operation.Results:70 patients (86 knees) were followed up for 12 to 28 months, with an average of 22.4 months. Bone healing was achieved at the osteotomy site 8 to 14 weeks after operation. Pain symptoms were relieved or disappeared significantly. The force line of X-ray examination was maintained at the postoperative level. The average knee femoral tibial angle was 187.6°preoperatively and 172.5° postoperatively, which showed significant statistical difference ( P<0.05). HSS knee score criteria: excellent: 70 knees; good: 10 knees; medium: 4 knees; poor: 2 knees. The excellent and good rate was 93.0%. The HSS score increased from (69.0±3.6) before operation to (87.2±8.1) after operation, with significant difference ( P<0.05). Conclusions:Arthroscopic debridement combined with high lateral tibial osteotomy and Giebel plate internal fixation is a very good method for the treatment of varus knee osteoarthritis, which is worthy of further clinical application.