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

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

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

Animals ; Graft Rejection ; immunology ; Liver Transplantation ; Male ; Rats ; Rats, Sprague-Dawley ; Rats, Wistar ; Sertoli Cells

ObjectiveTo describe the modified (narrowed) gastric tube and two methods on the establishmentof enteral feeding pathway in esophagectomy.MethodsFrom July 2003 to April 2006,we made traditional gastric tube for patients underwent esophagectomy to substitute the dissected esophagus while from May 2006 to November 2009,we made modified gastric tube for the same purpose.From July 2003 to November 2009,enteral nutrition tubes for all these patients are placed intraoperatively by two different ways,which made early post-operative nutrition support possible for these patients.ResultsNo perioperative death occurred among the patients.The length of the modified gastric tube ensured the anastomosis by circular stapler at the apex thorax or in the bases of cervical region.No statistical differences were found between the two group in terms of survival rate.The intraoperative establishment of enteral nutrition pathway ensured the early enteral nutrition support after the operation.ConclusionThe utility of the modified gastric tube extends the length of gastric tube to make mechanical anastomose easier and safer; meanwhile,the intraoperative establishment of enteral nutrition pathway ensures the early enteral nutrition support after the operation.

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

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 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