With the changes of the disease spectrum of liver transplantation and organ allocation system, more and more patients complicated with cardiovascular complications have entered the waiting list for liver transplantation. However, surgical stress, severe infection and adverse reactions of immunosuppressive drugs will significantly increase the risk of postoperative cardiac complications and affect the short-and long-term survival of the recipients. Therefore, comprehensive evaluation of cardiac structure and function of the recipients before liver transplantation is of significance for improving clinical prognosis of the recipients. In this article, the main causes for the increased risk of heart disease during the perioperative period of liver transplantation, the time and methods of heart disease risk assessment for liver transplant recipients were reviewed, and existing assessment approaches for common heart diseases before liver transplantation were illustrated, aiming to provide reference for further reducing the incidence of heart complications after liver transplantation, improving the survival rates of grafts and recipients and enhancing clinical prognosis.

Antigens, Neoplasm ; analysis ; Carcinoma, Hepatocellular ; chemistry ; Humans ; Liver Neoplasms ; chemistry

Objective To investigate the long-term safety and effectiveness of withdrawal of hepatitis B immuneglobulin (HBIG) and/or nucleos(t)ide analogues (NAs) to prevent hepatitis B virus (HBV) reinfection in liver transplant recipients with hepatitis B-related diseases after successful vaccination. Methods Baseline data of 76 liver transplant recipients undergoing hepatitis B immune reconstitution after receiving hepatitis B vaccines were retrospectively analyzed. The vaccination and response, the follow-up results of respondents with HBIG and/or NAs withdrawal, and the reinfection of HBV after withdrawal of HBIG and/or NAs were analyzed. Results The time interval from liver transplantation to hepatitis B vaccination was 26 (20, 40) months. The time interval from vaccination to response was 15 (8,27) months. Initially, 76 recipients withdrew HBIG, and 36 recipients withdrew HBIG and NAs. During the follow-up, 12 of 76 recipients who withdrew HBIG resumed use of HBIG, and 16 of 36 recipients who withdrew HBIG and NAs resumed use of NAs. The withdrawal time of HBIG and NAs was 135 (98,150) and 133 (34,149) months, respectively. Sixteen respondents did not receive booster, and 36 respondents received boosters on a regular basis. The time interval between the first booster and HBIG withdrawal was 44 (11,87) months. No significant differences were observed in baseline data between the respondents with and without boosters (all P>0.05). During the follow-up, 9 recipients were lost to follow-up, 5 were re-infected with HBV, 3 died, and 1 recipient developed graft loss and underwent secondary liver transplantation. Among 5 recipients re-infected with HBV, 4 cases had virus mutation. Significant differences were found between re-infected and uninfected patients regarding withdrawal of NAs and hepatitis B e antigen (HBeAg) positive before transplantation (both P<0.05). Conclusions Long-term withdrawal of HBIG is feasible and safe for recipients with successful hepatitis B immune reconstitution after liver transplantation for hepatitis B-related diseases. Nevertheless, whether antiviral drugs can be simultaneously withdrawn remains to be validated.

Humans ; Liver Failure ; mortality ; Portasystemic Shunt, Transjugular Intrahepatic ; mortality ; Survival Rate

OBJECTIVETo study the quantities of myeloid and plasmacytoid dendritic cell (mDC, pDC) subsets associated with different blood virus loads (HBV DNA) in patients in different periods of HBV infection (immune tolerance, immune activities and non-replicating periods).

METHODSThirty HBV infected patients in different stages of infection were enrolled. They were divided into three groups: an immune tolerance group (10 cases), an immunization activities group (10 cases), and a non-replication group (10 cases). Ten healthy people were enrolled and served as controls. Blood (10 ml) from the patients and the controls were collected and the numbers of dendritic cells (DC) in percentage were counted using flow cytometry. The numbers of mDC and pDC were counted and the relevance of them with their blood virus loads (HBV DNA) was analyzed using statistical methods.

RESULTS(1) Absolute values of mDC, pDC percentage and pDC absolute value of the HBV infected patients were lower than those of the healthy control group (P less than 0.05). mDC percentage of the HBV infected patients was a little lower than that of the healthy controls but of no statistical significance (P more than 0.05). (2) The percentage of mDC in the healthy controls was higher than that in the tolerance group (P less than 0.05) and its absolute value in the healthy control group was higher than those in the immune tolerance group and the immune activities group (P less than 0.05). pDC percentage of the healthy control group was higher than those of the immune activities and non-reproduction groups (P less than 0.05). pDC absolute value of the healthy control group was higher than those of the immune tolerance, immune activities and non-reproduction groups (P less than 0.05). (3) The pDC counts in the tolerance group were negatively correlated with HBV DNA levels (r = -0.686, P less than 0.05).

CONCLUSIONS(1) DC frequency and counts of HBV infected patients in different periods decreased. The immune active group decreased significantly more than the healthy control group (P less than 0.05). (2) pDC counts show a negative correlation with HBV DNA levels in only the tolerance group.

Adult ; Case-Control Studies ; Cell Count ; DNA, Viral ; blood ; Dendritic Cells ; Female ; Flow Cytometry ; Hepatitis B ; blood ; immunology ; Humans ; Male ; Viral Load ; Young Adult

OBJECTIVETo observe the dynamic characteristics of symptoms and tongue figure in SARS patients, and the relationship between them and laboratory indexes.

METHODSThe dynamic changes of 63 patients, who were hospitalized in authors' hospital from March 11 to April 30, 2003, were observed.

RESULTSThe symptoms mostly often revealed in patients of early stage were fever in 56 patients, cough in 41 and weakness or heaviness of limbs in 40, which in patients of middle or crisis stage were cough in 53 and weakness or heaviness of limbs in 43. The clinical symptoms in patients of recovery stage were atypical, they occasionally manifested as limb weakness or heaviness in 17, chest stuffiness or pain in 13, low fever in 11, cough in 12 and expectoration in 11. In the early stage, patients' tongue was pink or red in tongue tip, with thin-white, white-greasy or yellow-greasy coating; in middle stage, tongue in most patients were red, with white-greasy or yellow-thick-greasy coating; in recovery stage, tongues of patients were mostly pink or red in tongue tip, few were dark purple, with thin-white or white-greasy, occasionally yellow-greasy coating.

CONCLUSIONTCM syndrome of SARS patients has its characteristics and regularity of changes, which was in accordance with the laboratory findings.

Adolescent ; Adult ; Aged ; Diagnosis, Differential ; Drug Therapy, Combination ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Humans ; Male ; Medicine, Chinese Traditional ; Middle Aged ; Phytotherapy ; Severe Acute Respiratory Syndrome ; diagnosis ; therapy

In order to optimize the fabrication of SiO2 tubes immobilized with antibody for hepatitis C virus antigen (HCAg) detection, we formed the activated amino on the surface of SiO2 tubes by using the activation of aminosilane. Then we immobilized the hepatitis C virus (HCV) monoclonal antibody on the surface of SiO2 tubes by using glutaraldehyde as a chemical cross-linker, followed by detecting HCAg. Sequence tests showed that when the SiO2 tubes were treated in 10% (V/V) aminosilane solution and 3% (V/V) glutaraldehyde solution for 3 hours and 2 hours, respectively, the HCV monoclonal antibody had high immobilization efficiency and low nonspecificity, and the HCAg was detected to 1 ng/mL. This experiment can provide principle and experimental data for establishment of HCAg magnetic immunoassay system.
Antibodies, Immobilized ; immunology ; Antibodies, Monoclonal ; chemistry ; immunology ; Hepatitis C Antibodies ; chemistry ; immunology ; Hepatitis C Antigens ; analysis ; immunology ; Humans ; Silicon Dioxide ; chemistry

Objective To evaluate the safety of programmed cell death protein 1 (PD-1) inhibitor in the treatment of primary liver cancer (liver cancer) before liver transplantation. Methods Clinical data of 7 recipients given with PD-1 inhibitor before liver transplantation for liver cancer were retrospectively analyzed. The incidence of immune-related adverse event (irAE) and clinical prognosis of the recipients were summarized. The safety of PD-1 inhibitor in recipients prior to liver transplantation for liver cancer was evaluated. Results Seven recipients were treated with PD-1 inhibitor with 1-20 courses before liver transplantation for liver cancer. The time interval from drug withdrawal to liver transplantation was 6-120 d. Five recipients suffered from irAE of different degrees, including fatigue in 3 cases, fever in 2 cases, alopecia in 2 cases, rash in 1 case, nausea in 1 case and myocarditis in 1 case, respectively. A majority of these irAE were classified as grade Ⅰ-Ⅱ. One recipient died from grade Ⅴ irAE (fatal myocarditis). One recipient developed rejection at postoperative 7 d, which were mitigated after glucocorticoid pulse therapy combined with increased dosage of tacrolimus. Conclusions PD-1 inhibitor can be applied in preoperative treatment before liver transplantation for liver cancer. Nevertheless, the incidence of irAE and postoperative rejection should be intimately monitored.

Liver transplantation is one of the standard treatments for end-stage liver disease. With the development of surgical techniques and the optimization of perioperative management, the incidence of complications after liver transplantation has decreased, but perioperative neurological complications are still relatively common. The incidence of stroke varies greatly, with complex causes, as well as insidious onset, rapid progression and high fatality. Early identification and diagnosis of perioperative stroke after liver transplantation and timely effective treatment are of great significance for improving the prognosis of patients. Therefore, this article reviews the concept, occurrence, risk factors, diagnosis, treatment and prevention of perioperative stroke after liver transplantation, and explores the research progress of perioperative stroke after liver transplantation, in order to provide a reference for the diagnosis and treatment of perioperative stroke after liver transplantation.

In recent years, the number of autoimmune hepatitis cases in the world has shown a significant upward trend, but its etiology and pathogenesis is still unclear. At present, it is generally considered to be caused by abnormal immune regulation mechanism of the body, especially the lymphocytes and their cytokines, which has attracted widespread concern and thus is reviewed here.
Cytokines ; Hepatitis, Autoimmune ; Humans ; Lymphocytes