Objective To explore the treatment of ABO-incompatible orthotopic liver transplantation. Methods Nine cases of ABO-incompatible liver transplantation performed in our hospital were analyzed retrospectively. Plasma exchange was done before the operation in 1 case. Hepatic artery and biliary duct anastomosis were performed by the microvascular technique. Splenectomy was done during operation in 5 cases. The immunosuppressive protocol included a quadruple drug therapy. Blood oxygen saturation was maintained above 95% and anticoagulant therapy was performed after operation.Results Four patients recovered smoothly without complications. Postoperative complications included acute rejection in 3 patients and biliary nonanastomotic stricture in 4. Three patients died. Conclusion ABO-incompatible orthotopic liver transplantation can be used when the graft is scarce, and should manage to decrease the complications.

Objective To probe into the value of micro-perfusion examination at the early stage after right lobe living donor liver transplantation by contrast-enhanced ultrasound(CEUS). Methods Twenty-six recipients of right lobe living donor liver transplantation received CEUS examination at 1,7,15 and 30 days respectively after operation using contrast medium SonoVue. Perfusion patterns were observed and analyzed considering operation method. Results Of 26 recipients, 15 cases showed normal perfusion patterns with normal hemodynamics; 11 cases showed abnormal perfusion patterns with abnormal hemodynamics:8 had conduit venous obstruction,4 high portal vein blood flow. The abnormal patterns was in the early arterial phase of enhancement process at the first day examination, showing hyper- and hypo- enhancement area compared with normal liver parenchyma. And the difference gradually disappeared in the subsequent examination. Conclusions Abnormal micro-perfusion patterns are highly related to abnormal inflow and outflow in the early post operation stage. The main reasons are conduit venous obstruction and excessive perfusion of portal vein. CEUS can be used as an effective method in evaluating the graft micro-perfusion.

Objective: To analyze the epidemiological characteristics of latent syphilis in Yancheng City from 2016 to 2020, so as to provide insights into syphilis control. Methods: All reported cases with latent syphilis in Yancheng City from 2016 to 2020 was collected from the Communicable Disease Report System of China Disease Prevention and Control Information System, and the prevalence of latent syphilis was estimated and standardized by the seventh population census data in Yancheng City. The trends in the incidence of latent syphilis were evaluated using annual percent change (APC), and the temporal, regional and human distributions of latent syphilis patients were descriptively analyzed. In addition, the spatial clusters of latent syphilis incidence were identified using spatial autocorrelation analysis. Results: A total of 7 790 cases with latent syphilis were reported in Yancheng City from 2016 to 2020, and the standardized incidence of latent syphilis increased from 15.35/105 in 2016 to 28.70/105 in 2020 (APC=17.54%, t=5.357, P=0.013). Latent syphilis cases were reported in each month, and no obvious seasonable characteristics were seen. During the period from 2017 to 2020, the highest incidence of latent syphilis was seen in residents at ages of 70 to 79 years, with incidence rates of 41.71/105, 43.04/105, 75.79/105 and 72.94/105, respectively, and most cases were farmers (4 711 cases, 60.47%). The three highest incidence of latent syphilis was reported in Funing County (191.40/105), Tinghu District (137.13/105) and Yandu District (126.23/105). There was a positive spatial correlation of latent syphilis incidence in Yancheng City from 2016 to 2020 (Moran's I=0.23, Z=4.457, P=0.001), and two high-high clusters were identified in 14 townships (streets) of Funing County, Binhai County, Tinghu District, Sheyang County and Yandu District and 3 low-low clusters in 7 townships (streets) in Jianhu County, Tinghu District, Dongtai City and Sheyang County. Conclusions The incidence of latent syphilis appeared a tendency towards a rise, and there were remarkable spatial clusters identified in latent syphilis incidence in Yancheng City from 2016 to 2020. The elderly people and farmers are at high risk of latent syphilis.

Objective To investigate the clinical effect of donor kidneys in rhabdomyolysis(RM) combined with acute kidney injury(AKI).Methods A retrospective analysis was made on the clinical data of 10 donors with RM and 14 cases of renal transplantation from March 2017 to May 2018.Results AKI was caused by RM in 10 donors.Before harvesting the donor kidneys,blood creatine kinase (CK) level was (14 005.19 ± 11 894.27) U/L in 10 donors,plasma myoglobin level was ＞3 000 μg/L in 7 cases,and that was (2 288 ± 680) μg/L in 3 cases.LDH level was 883 ± 453 IU/L and serum creatinine (Cr) value was (216.55 ± 125) μmol/L.6 donors received continuous renal replacement therapy.Six patients with delayed renal function recovery (DGF) were treated with CRRT.The duration of GDF was 3-20 days,with an average of 10 ± 6.6 days.All the patients were followed up for 3-15 months.The glomerular filtration rate was (40.19 ± 19.55) ml·min· 1.73 m-2 and (55.01 ± 15.94) ml · min· 1.73 m-2 at 1st and 3rd month after operation,respectively.Conclusion The incidence of DGF in donor kidneys with RM and AKI is high,and the short-term effect is satisfactory.The long-term effect needs to be further observed.

Objective To investigate the safety and efficacy of splitting liver transplantation (SLT). Methods Clinical data of 10 donors and 19 recipients undergoing SLT in Institute of Organ Transplantation, General Hospital of Chinese People's Armed Police Forces from January 2008 to August 2013 were analyzed retrospectively. Of these 19 recipients, 9 were male, 10 were female and 9 were children,10 were adults. The age ranged from 7 months to 62 years with a median age of 31 years. The graft recipient weigh ratio (GRWR) was 1.0%to 4.3%. The informed consents of all patients were obtained and the ethical committee approval was received. The 10 cadaveric donor livers were split in vitro, in which 9 pair grafts were transplanted in 9 children and 8 adults respectively. The left lateral lobes (segmentⅡ,Ⅲ) were transplanted in children and the extended right lobes (segmentⅠ,Ⅳ-Ⅷ) in adults. The other donor liver was split in left and right half lobes and were transplanted in 2 adults. Piggyback liver transplantation was performed in the 9 children receiving left lateral lobes and 1 adult receiving right half lobe. Classic orthotopic liver transplantation was performed in the 8 adults receiving extended right lobes and 1 adult receiving left half lobe. Peri-operative death and complications of the patients were observed. The patients were followed up regularly for observing the survival situation. Results All the operations of 19 recipients were completed successfully. Seventeen cases were cured and discharged from hospital and 2 cases died during the peri-operative period. The 2 dead cases were both children. One died of septic shock 2 weeks after operation and the other died of primary liver graft nonfunction 2 d after liver retransplantation. Biliary leak of liver section occurred in 2 pediatric recipients and was cured by puncture drainage. One adult recipient with intrahepatic cholangiocarcinoma died of lung and bone multiple metastases 15 months after operation. Conclusions SLT is a safe and feasible transplant operation and it can help to alleviate the shortage of donor livers to some extent.