Adolescent ; Adult ; Child ; Child, Preschool ; Female ; Humans ; Liver Cirrhosis ; surgery ; Liver Neoplasms ; surgery ; Liver Transplantation ; methods ; Male ; Middle Aged

The indications, effectiveness, and other relevant problems of the orthotopic liver transplantation (OLT) for hepatocellular carcinoma (HCC) are still under controversy in our country. This article collects and analyzes resent published literatures as well as the clinical data of 112 patients who underwent OLT for HCC in our hospital, and tries to investigate the staging system of HCC, liver allocation policy for OLT, expanded criteria for OLT in HCC, tumor management when awaiting transplantation, prognostic factors of recurrence, and principles to make a choice between resection and transplantation in patients with HCC. It is most important to establish a staging system and transplantation indications for liver transplantation of HCC in China.
Carcinoma, Hepatocellular ; surgery ; Humans ; Liver Neoplasms ; surgery ; Liver Transplantation ; Prognosis ; Tissue Donors ; supply & distribution

Adult ; Humans ; Liver Transplantation ; Living Donors

OBJECTIVETo analyze the complication rate and survival rate of the patients whose graft-recipient weight ratio (GRWR) less than 0.8% following living donor liver transplantation (LDLT).

METHODSThere were 92 consecutive LDLT patients from January 2001 to December 2007 in West China Hospital, Sichuan University. There were 85 males and 7 females aged from 18 to 65 years old (averaged, 42 years old) and among which 89 patients were involved in the study. There were 15 patients whose GRWR less than 0.8% (group 1), while other 74 recipients were in group 2. Comparing the two groups' complication rates and survival rates and finding out the potential influencing factor of small-size-graft recipients' survival rate.

RESULTSThe survival rates of group 1 and group 2 were 73.3% (11/15) and 71.6% (53/74), respectively. The grade II-V complication rates of group 1 and group 2 were 46.7% (7/15) and 48.6% (36/74), respectively. There were no difference in survival rates (chi(2) = 0.058, P = 0.811) and complication rates (chi(2) = 0.000, P = 1.000) between the two groups. Ascites volume of group 1 and group 2 were (1532 +/- 322) ml and (1466 +/- 110) ml, respectively (t = 0.234, P = 0.815). The condition of the graft's middle hepatic vein had significant influence on small-size-liver recipients' survival rates (chi(2) = 6.821, P = 0.009).

CONCLUSIONSGRWR < 0.8% is not the limitation of the living donor liver transplantation but the outflow tract of the graft must be unobstructed.

Adolescent ; Adult ; Aged ; Female ; Follow-Up Studies ; Graft Survival ; Humans ; Liver Transplantation ; Living Donors ; Male ; Middle Aged ; Postoperative Complications ; Retrospective Studies ; Survival Analysis ; Young Adult

OBJECTIVETo discuss the safety line to avoid the post-hepatectomy hepatic insufficiency by combining indocyanine green test by pulse dye-densitometry (PDD-ICG) and standard remnant liver volume (SRLV).

METHODSSeventy-five hepatic cancer patients undergone hepatectomy from March 2007 to February 2008 were included. According to the liver function decompensatory grades after operation, the relationship between ICG retention rate at 15 min (ICGR15) and standard remnant liver volume by linear regression were analyzed.

RESULTSThere were 60 cases with slight hepatic insufficiency, 12 cases with moderate hepatic insufficiency, and 3 cases with severe hepatic insufficiency. There were no difference in age [(50 +/- 13) years old and (53 +/- 9) years old], prothrombin time [(13.6 +/- 1.0) s and (13.5 +/- 1.0) s], international normalized ratio (1.09 +/- 0.10 and 1.06 +/- 0.10) between slight hepatic insufficiency group and moderate and severe hepatic insufficiency group (P > 0.05). And there were difference in K value (0.20 +/- 0.04 and 0.17 +/- 0.03), ICGR15 (6 +/- 4 and 9 +/- 4), SRLV [(545 +/- 93) ml and (398 +/- 82) ml] between two groups (P < 0.05). Compared ICG test and standard remnant liver volume of the patients with moderate hepatic insufficiency after operation, the liner relationship was found (R = 0.640, P = 0.025), and the regression equation was: standard remnant liver volume (ml/m(2)) = 1594.6 x ICGR15 + 265.

CONCLUSIONSPDD-ICG test and standard remnant liver volume are effective to estimate hepatic function reserve of patient undergone hepatectomy.

Adult ; Female ; Hepatectomy ; methods ; Hepatic Insufficiency ; etiology ; Humans ; Indocyanine Green ; pharmacokinetics ; Liver ; pathology ; Liver Neoplasms ; pathology ; surgery ; Male ; Middle Aged ; Postoperative Complications ; etiology

Adult ; Female ; Follow-Up Studies ; Hepatitis B Surface Antigens ; blood ; Humans ; Liver Transplantation ; Male ; Middle Aged ; Tissue Donors

Pancreatic neuroendocrine tumors (NETs) are one subgroup of gastroenteropancreatic NETs. Its main characteristics are slow growth, frequent metastasis to the liver, and limited to the liver for long periods. In patients with irresectable liver metastatic NET, liver transplantation is the only radical treatment. About 160 cases of liver transplantation for liver metastatic NET have been reported worldwide. However, there is no such report of liver transplantation for hepatic metastatic NET in China by now. We herein report a case of liver transplantation for hepatic metastatic pancreatic insulinoma with a survival of over 5 years.
Humans ; Insulinoma ; secondary ; therapy ; Liver Neoplasms ; complications ; Liver Transplantation ; Male ; Middle Aged ; Pancreatic Neoplasms ; secondary ; therapy

Adult ; Female ; Follow-Up Studies ; Humans ; Liver Diseases, Alcoholic ; surgery ; Liver Transplantation ; Male ; Middle Aged

OBJECTIVETo evaluate the effect of a community-based intervention project among men who have sex with men (MSM) after two-year implementation.

METHODSComprehensive interventions among MSM in 18 cities of seven provinces were conducted. The pre-intervention questionnaire was conducted in September 2006 and 5178 subjects were investigated through snowball method. In May 2007, post-questionnaire was conducted and 5460 subjects were investigated through snowball or accompanied recommendation method. For each subject, a questionnaire was completed, including basic information, HIV/AIDS knowledge, behaviours and intervention status. At the same time, 5 ml intravenous blood sample was collected to detect HIV infection and evaluated the intervention effect.

RESULTSAfter two-year implementation, the awareness rate of HIV/AIDS knowledge increased from 76.0% (3933/5178) in 2006 to 90.5% (4943/5460) in 2008 (chi(2) = 451.786, P < 0.001); the rate of condom use in the last anal sex with males increased from 58.0% (2382/4105) to 76.7% (3643/4750) (chi(2) = 215.491, P < 0.01); the rate of consistent condom use in the last six months increased from 28.2% (1163/4118) to 44.5% (2114/4753) (chi(2) = 264.606, P < 0.01); the proportion of MSM receiving HIV antibody test increased from 18.8% (973/5170) to 39.1% (2136/5454) (chi(2) = 530.181, P < 0.01); and the HIV infection rate increased from 2.3% (118/5178) to 5.0% (271/5427) (chi(2) = 47.613, P < 0.01).

CONCLUSIONThe MSM community-based intervention project achieved some good results after two-year implementation and contributed to an increase in HIV/AIDS knowledge and safe sex.

Adolescent ; Adult ; China ; Community Health Services ; HIV Infections ; prevention & control ; Homosexuality, Male ; Humans ; Male ; Risk-Taking ; Young Adult

OBJECTIVETo explore the effects of overexpression of human tissue inhibitors of metalloproteinase-1 (hTIMP-1) on proliferation, invasion, metastasis, angiogenesis, and apoptosis in human hepatocellular carcinoma (HCC) cells in vitro and in vivo.

METHODSRecombinant adenoviral vector containing hTIMP-1 (AdhTIMP-1) was constructed previously. HepG2 cells were infected by AdhTIMP-1 and the changes of cell proliferation and invasion were detected in vitro. The anticancer activity of AdhTIMP-1 was evaluated in BAL B/c mice bearing HCC. Tumor volume and pulmonary metastases were observed. The mechanisms underlying the antitumor effect in vivo were investigated based on detection of microvessel density and apoptosis in tumor tissues.

RESULTSThe resultant AdhTIMP-1 was successfully constructed and the expression of hTIMP-1 was detected by Western blot and RT-PCR. AdTIMP-1 could effectively infect HepG2 cells and significantly inhibit the proliferative activity and invasive ability of the tumor cells. Compared with the controls, pre-infection of HepG2 cells by AdhTIMP-1 resulted in a significant inhibition of tumor formation by 75. 8%. A single local injection of AdhTIMP-1 into pre-established tumors significantly reduced the tumor growth rate by 45.4%, tumor-associated angiogenesis index by 47.8%, lung metastases by 70.4%, and showed a 3-fold increase of apoptotic tumor cells.

CONCLUSIONOur data indicated that AdhTIMP-1 can significantly attenuate tumor proliferation and invasion, reduce metastasis, inhibit angiogenesis, and induce apoptosis in HCC-bearing mice and may pave the way for further liver cancer gene therapy.

Adenoviridae ; genetics ; Animals ; Apoptosis ; Cell Line, Tumor ; Cell Proliferation ; Female ; Genetic Vectors ; Humans ; Liver Neoplasms ; metabolism ; pathology ; Lung Neoplasms ; prevention & control ; secondary ; Male ; Mice ; Mice, Inbred BALB C ; Mice, Nude ; Neoplasm Transplantation ; Neovascularization, Pathologic ; prevention & control ; Plasmids ; Random Allocation ; Recombinant Proteins ; genetics ; metabolism ; Tissue Inhibitor of Metalloproteinase-1 ; genetics ; metabolism ; Transfection ; Tumor Burden