1.The influence of donor age on the early postoperative recovery of liver function in liver transplant recipients and the analysis of risk factors for postoperative arterial complications
Yong ZHANG ; Lijie QI ; Dong WANG ; Feng WANG ; Qingguo XU ; Yandong SUN ; Xin WANG ; Jinzhen CAI
Chinese Journal of Organ Transplantation 2025;46(3):212-218
Objective:To investigate the impact of donor age on early postoperative liver function recovery in liver transplant recipients, as well as the incidence and risk factors for arterial complications following liver transplantation.Methods:A total of 518 patients who underwent liver transplantation at the Organ Transplantation Center of the Affiliated Hospital of Qingdao University between January 2021 and January 2024 were included in the study. Based on donor age, patients were classified into the elderly donor group (≥70 years, n=28) and the non-elderly donor group (<70 years, n=490). Liver function indicators—including aspartate aminotransferase (AST), alanine aminotransferase (ALT), total bilirubin (TBIL), and direct bilirubin (DBIL)—were measured on postoperative days 1, 3, 7, and 14. The incidence of arterial complications, including hepatic artery thrombosis and hepatic artery stenosis, was recorded. Recipients were further categorized into the arterial complication group (n=26) and the non-arterial complication group (n=492) based on postoperative outcomes, and clinical characteristics of donors and recipients were compared. Binary logistic regression analysis was conducted to identify risk factors for arterial complications.Rusults:No significant differences were observed in baseline characteristics between the elderly and non-elderly donor groups ( P>0.05). However, the elderly donor group exhibited significantly higher AST, ALT, TBIL, and DBIL levels at all postoperative time points compared to the non-elderly donor group (all P<0.05). Specifically, on postoperative day 1, AST and ALT levels were (1,024.57±256.49) U/L and (756.24±145.89) U/L in the elderly donor group, compared to (895.23±225.19) U/L and (614.85±126.51) U/L in the non-elderly donor group. On day 3, AST and ALT levels were (402.46±71.61) U/L and (423.31±87.44) U/L versus (226.37±66.54) U/L and (256.79±70.25) U/L, respectively. On day 7, AST and ALT levels were (91.78±21.84) U/L and (92.36±21.62) U/L versus (68.41±18.38) U/L and (77.47±18.16) U/L. By day 14, AST and ALT levels were (67.52±10.35) U/L and (72.17±16.28) U/L versus (35.32±9.27) U/L and (48.56±14.10) U/L, respectively ( P<0.05 for all comparisons). For bilirubin indicators, TBIL and DBIL levels in the elderly donor group were also consistently higher than in the non-elderly donor group. On day 1, TBIL and DBIL were (95.76±21.93) μmol/L and (64.22±15.07) μmol/L, compared to (77.59±20.48) μmol/L and (51.18±12.96) μmol/L. By day 14, TBIL and DBIL levels had decreased to (41.26±8.30) μmol/L and (32.45±6.21) μmol/L, compared to (28.39±7.15) μmol/L and (20.58±5.04) μmol/L in the non-elderly donor group ( P<0.05 for all comparisons). The incidence of hepatic artery complications was 10.71% (3/28) in the elderly donor group and 4.69% (23/490) in the non-elderly donor group, with no statistically significant difference between the two groups ( P>0.05). Statistical analysis employing independent t-tests and χ2 tests demonstrated significant differences between the arterial complication group and non-arterial complication group in donor quality ratio ( P<0.05) and incidence of hepatic arterial hypoperfusion ( P<0.05). Multivariate binary logistic regression analysis, after adjusting for confounding factors (e.g., recipient gender, age, body mass index [BMI], primary disease, and donor-recipient blood type compatibility), identified recipient-to-donor mass ratio ( OR=1.352, P<0.05) and insufficient hepatic arterial blood flow ( OR=1.497, P<0.05) as independent risk factors for arterial complications following liver transplantation. Conclusion:Elderly liver donors can have a certain impact on early postoperative liver function recovery in liver transplant recipients, but have no significant impact on the occurrence of arterial complications after liver transplantation. The mass ratio of recipients to donors and insufficient hepatic arterial blood flow are independent risk factors for arterial complications after liver transplantation.
2.Pulmonary function outcomes and influencing factors after congenital diaphragmatic hernia surgery
Zhong FENG ; Yi ZHANG ; Qin LIU ; Ying WANG ; Yandong WEI ; Chao LIU ; Yanxia ZHANG ; Lishuang MA
Chinese Journal of Perinatal Medicine 2025;28(4):265-272
Objective:To investigate the short-term pulmonary function outcomes in children with congenital diaphragmatic hernia (CDH) following surgery and analyze the influencing factors of poor outcomes.Methods:This study retrospectively enrolled 81 children who had undergone surgery for CDH and were discharged after recovery at the Department of Neonatal Surgery, Children's Hospital of Capital Institute of Pediatrics from January 2020 to June 2023. All children had pulmonary function tests before discharge, 6 months to 2 year after discharge. Changes in the pulmonary function parameters at different time points were compared. Based on the results of the final pulmonary function test after discharge, these patients were categorized into a favorable outcome group (32 cases) with normal pulmonary function and an unfavorable outcome group (49 cases) with pulmonary dysfunction. Clinical data of the two groups were compared using two independent samples t-test, rank-sum test, Chi-square test, or Fisher's exact test. Logistic regression analysis was used to explore the factors influencing pulmonary function outcomes. Results:A total of 81 cured and discharged CDH children were included in this study, comprising 34 males (42.0%) and 47 females (58.0%). The first two pulmonary function tests were performed at a mean postnatal age of (30.1±14.1) d (14-75 d) and (8.3±1.3) months (4 months and 14 d to 12 months), respectively. Pre-discharge pulmonary function tests revealed that 13 cases (16.0%) had nearly normal pulmonary function, while 68 cases (84.0%) showed pulmonary function abnormalities with seven cases of restrictive ventilatory dysfunction, 56 cases of obstructive ventilatory dysfunction, and five cases of mixed ventilatory dysfunction. In the children with abnormal pulmonary function before discharge, their second pulmonary function tests showed that some parameters including tidal volume [(7.49±1.35) ml/kg vs. (8.02±2.21) ml/kg], the ratio of time to peak tidal expiratory flow and expiratory time [(23.21±4.95)% vs. (26.50±5.48)%], the ratio of volume to peak expiratory flow and expiratory volume [(26.41±5.79)% vs. (27.55±5.20)%], respiratory system compliance per kg body weight during single occlusion [(0.93±0.22) ml/(cmH 2O·kg) vs. (0.96±0.25) ml/(cmH 2O·kg), 1 cmH 2O=0.098 kPa], functional residual capacity [(52.18±17.83) ml vs. (126.39±26.73) ml], and respiratory system resistance in single occlusion condition [(0.06±0.02) cmH 2O/(ml·s) vs. (0.05±0.01) cmH 2O/(ml·s)] improved after discharge ( t values were-2.41,-6.14,-7.68,-2.26,-18.94, and 4.87, all P<0.05). Eight children with obstructive ventilatory dysfunction were followed up for two years after surgery, of which three had normal lung function and five still showed mild to moderate obstructive ventilatory dysfunction. Logistic regression analysis indicated that liver herniation, severe pulmonary hypertension (PH), low observed-to-expected lung-to-head ratio (o/e LHR), grade C/D diaphragmatic defect, and prolonged invasive ventilation were risk factors for poor pulmonary outcomes [ OR(95% CI) were 5.655(1.410-22.676), 5.610 (1.589-19.804),4.183 (1.234-14.180) and 1.195(1.074- 1.329), all P<0.05]. Conclusions:Although lung function parameters of CDH patients show certain improvement after surgery, many children still have mild to moderate obstructive ventilatory dysfunction, requiring long-term follow-up. Prenatal and postnatal indicators such as liver herniation, severe PH, and low o/e LHR can predict the pulmonary outcomes of children with CDH.
3.Prediction of suitable habitats of Phlebotomus chinensis in Gansu Province based on the Biomod2 ensemble model
Dawei YU ; Yandong HOU ; Aiwei HE ; Yu FENG ; Guobing YANG ; Chengming YANG ; Hong LIANG ; Hailiang ZHANG ; Fan LI
Chinese Journal of Schistosomiasis Control 2025;37(3):276-283
Objective To investigate the suitable habitats of Phlebotomus chinensis in Gansu Province, so as provide insights into effective management of mountain-type zoonotic visceral leishmaniasis (MT-ZVL). Methods The geographical coordinates of locations where MT-ZVL cases were reported were retrieved in Gansu Province from 2015 to 2023, and data pertaining to 26 environmental variables were captured, including 19 climatic variables (annual mean temperature, mean diurnal range, isothermality, temperature seasonality, maximum temperature of the warmest month, minimum temperature of the coldest month, temperature annual range, mean temperature of the wettest quarter, mean temperature of the driest quarter, mean temperature of the warmest quarter, mean temperature of the coldest quarter, annual precipitation, precipitation of the wettest month, precipitation of the driest month, precipitation seasonality, precipitation of the wettest quarter, precipitation of the driest quarter, precipitation of the warmest quarter, and precipitation of the coldest quarter), five geographical variables (elevation, annual normalized difference vegetation index, vegetation type, landform type and land use type), and two population and economic variables (population distribution and gross domestic product). Twelve species distribution models were built using the biomod2 package in R project, including surface range envelope (SRE) model, generalized linear model (GLM), generalized additive model (GAM), multivariate adaptive regression splines (MARS) model, generalized boosted model (GBM), classification tree analysis (CTA) model, flexible discriminant analysis (FDA) model, maximum entropy (MaxEnt) model, optimized maximum entropy (MAXNET) model, artificial neural network (ANN) model, random forest (RF) model, and extreme gradient boosting (XGBOOST) model. The performance of 12 models was evaluated using the area under the receiver operating characteristic curve (AUC), true skill statistics (TSS), and Kappa coefficient, and single models with high performance was selected to build the optimal ensemble models. Factors affecting the survival of Ph. chinensis were identified based on climatic, geographical, population and economic variables. In addition, the suitable distribution areas of Ph. chinensis were predicted in Gansu Province under shared socioeconomic pathway 126 (SSP126), SSP370 and SSP585 scenarios based on climatic data during the period from 1991 to 2020, from 2041 to 2060 (2050s), and from 2081 to 2100 (2090s) . Results A total of 11 species distribution models were successfully built for prediction of potential distribution areas of Ph. chinensis in Gansu Province, and the RF model had the highest predictive accuracy (AUC = 0.998). The ensemble model built based on the RF model, XGBOOST model, GLM, and MARS model had an increased predictive accuracy (AUC = 0.999) relative to single models. Among the 26 environmental factors, precipitation of the wettest quarter (12.00%), maximum temperature of the warmest month (11.58%), and annual normalized difference vegetation index (11.29%) had the greatest contributions to suitable habitats distribution of Ph. sinensis. Under the climatic conditions from 1991 to 2020, the potential suitable habitat area for Ph. chinensis in Gansu Province was approximately 5.80 × 104 km2, of which the highly suitable area was 1.42 × 104 km2, and primarily concentrated in the southernmost region of Gansu Province. By the 2050s, the unsuitable and lowly suitable areas for Ph. chinensis in Gansu Province had decreased by varying degrees compared to that of 1991 to 2020 period, while the moderately and highly suitable areas exhibited expansion and migration. By the 2090s, under the SSP126 scenario, the suitable habitat area for Ph. chinensis increased significantly, and under the SSP585 scenario, the highly suitable areas transformed into extremely suitable areas, also showing substantial growth. Future global warming is conducive to the survival and reproduction of Ph. chinensis. From the 2050s to the 2090s, the highly suitable areas for Ph. chinensis in Gansu Province will be projected to expand northward. Under the SSP126 scenario, the suitable habitat area for Ph. chinensis in Gansu Province is expected to increase by 194.75% and 204.79% in the 2050s and 2090s, respectively, compared to that of the 1991 to 2020 period. Under the SSP370 scenario, the moderately and highly suitable areas will be projected to increase by 164.40% and 209.03% in the 2050s and 2090s, respectively, while under the SSP585 scenario, they are expected to increase by 195.98% and 211.66%, respectively. Conclusions The distribution of potential suitable habitats of Ph. sinensis gradually shifts with climatic changes. Intensified surveillance and management of Ph. sinensis is recommended in central and eastern parts of Gansu Province to support early warning of MT-ZVL.
4.Report of 6 cases of lymphoproliferative disorders after liver transplantation
Hui ZHANG ; Yandong SUN ; Feng WANG ; Dan LIU ; Bin ZHUANG ; Jianhong WANG ; Dahong TENG ; Jinzhen CAI
Chinese Journal of Organ Transplantation 2025;46(2):161-165
This study reports the diagnosis and treatment of six cases of post-transplant lymphoproliferative disorder (PTLD) in liver transplant recipients, confirmed at the Affiliated Hospital of Qingdao University between August 2017 and May 2023. The report includes details on anti-rejection therapy, Epstein-Barr virus (EBV) and cytomegalovirus (CMV) infections, imaging findings, histopathological results, treatment courses, and prognoses. By summarizing the clinical experience in the diagnosis and management of PTLD following liver transplantation, this study aims to provide valuable insights and references for the clinical diagnosis and treatment of this condition.
5.The influence of donor age on the early postoperative recovery of liver function in liver transplant recipients and the analysis of risk factors for postoperative arterial complications
Yong ZHANG ; Lijie QI ; Dong WANG ; Feng WANG ; Qingguo XU ; Yandong SUN ; Xin WANG ; Jinzhen CAI
Chinese Journal of Organ Transplantation 2025;46(3):212-218
Objective:To investigate the impact of donor age on early postoperative liver function recovery in liver transplant recipients, as well as the incidence and risk factors for arterial complications following liver transplantation.Methods:A total of 518 patients who underwent liver transplantation at the Organ Transplantation Center of the Affiliated Hospital of Qingdao University between January 2021 and January 2024 were included in the study. Based on donor age, patients were classified into the elderly donor group (≥70 years, n=28) and the non-elderly donor group (<70 years, n=490). Liver function indicators—including aspartate aminotransferase (AST), alanine aminotransferase (ALT), total bilirubin (TBIL), and direct bilirubin (DBIL)—were measured on postoperative days 1, 3, 7, and 14. The incidence of arterial complications, including hepatic artery thrombosis and hepatic artery stenosis, was recorded. Recipients were further categorized into the arterial complication group (n=26) and the non-arterial complication group (n=492) based on postoperative outcomes, and clinical characteristics of donors and recipients were compared. Binary logistic regression analysis was conducted to identify risk factors for arterial complications.Rusults:No significant differences were observed in baseline characteristics between the elderly and non-elderly donor groups ( P>0.05). However, the elderly donor group exhibited significantly higher AST, ALT, TBIL, and DBIL levels at all postoperative time points compared to the non-elderly donor group (all P<0.05). Specifically, on postoperative day 1, AST and ALT levels were (1,024.57±256.49) U/L and (756.24±145.89) U/L in the elderly donor group, compared to (895.23±225.19) U/L and (614.85±126.51) U/L in the non-elderly donor group. On day 3, AST and ALT levels were (402.46±71.61) U/L and (423.31±87.44) U/L versus (226.37±66.54) U/L and (256.79±70.25) U/L, respectively. On day 7, AST and ALT levels were (91.78±21.84) U/L and (92.36±21.62) U/L versus (68.41±18.38) U/L and (77.47±18.16) U/L. By day 14, AST and ALT levels were (67.52±10.35) U/L and (72.17±16.28) U/L versus (35.32±9.27) U/L and (48.56±14.10) U/L, respectively ( P<0.05 for all comparisons). For bilirubin indicators, TBIL and DBIL levels in the elderly donor group were also consistently higher than in the non-elderly donor group. On day 1, TBIL and DBIL were (95.76±21.93) μmol/L and (64.22±15.07) μmol/L, compared to (77.59±20.48) μmol/L and (51.18±12.96) μmol/L. By day 14, TBIL and DBIL levels had decreased to (41.26±8.30) μmol/L and (32.45±6.21) μmol/L, compared to (28.39±7.15) μmol/L and (20.58±5.04) μmol/L in the non-elderly donor group ( P<0.05 for all comparisons). The incidence of hepatic artery complications was 10.71% (3/28) in the elderly donor group and 4.69% (23/490) in the non-elderly donor group, with no statistically significant difference between the two groups ( P>0.05). Statistical analysis employing independent t-tests and χ2 tests demonstrated significant differences between the arterial complication group and non-arterial complication group in donor quality ratio ( P<0.05) and incidence of hepatic arterial hypoperfusion ( P<0.05). Multivariate binary logistic regression analysis, after adjusting for confounding factors (e.g., recipient gender, age, body mass index [BMI], primary disease, and donor-recipient blood type compatibility), identified recipient-to-donor mass ratio ( OR=1.352, P<0.05) and insufficient hepatic arterial blood flow ( OR=1.497, P<0.05) as independent risk factors for arterial complications following liver transplantation. Conclusion:Elderly liver donors can have a certain impact on early postoperative liver function recovery in liver transplant recipients, but have no significant impact on the occurrence of arterial complications after liver transplantation. The mass ratio of recipients to donors and insufficient hepatic arterial blood flow are independent risk factors for arterial complications after liver transplantation.
6.Pulmonary function outcomes and influencing factors after congenital diaphragmatic hernia surgery
Zhong FENG ; Yi ZHANG ; Qin LIU ; Ying WANG ; Yandong WEI ; Chao LIU ; Yanxia ZHANG ; Lishuang MA
Chinese Journal of Perinatal Medicine 2025;28(4):265-272
Objective:To investigate the short-term pulmonary function outcomes in children with congenital diaphragmatic hernia (CDH) following surgery and analyze the influencing factors of poor outcomes.Methods:This study retrospectively enrolled 81 children who had undergone surgery for CDH and were discharged after recovery at the Department of Neonatal Surgery, Children's Hospital of Capital Institute of Pediatrics from January 2020 to June 2023. All children had pulmonary function tests before discharge, 6 months to 2 year after discharge. Changes in the pulmonary function parameters at different time points were compared. Based on the results of the final pulmonary function test after discharge, these patients were categorized into a favorable outcome group (32 cases) with normal pulmonary function and an unfavorable outcome group (49 cases) with pulmonary dysfunction. Clinical data of the two groups were compared using two independent samples t-test, rank-sum test, Chi-square test, or Fisher's exact test. Logistic regression analysis was used to explore the factors influencing pulmonary function outcomes. Results:A total of 81 cured and discharged CDH children were included in this study, comprising 34 males (42.0%) and 47 females (58.0%). The first two pulmonary function tests were performed at a mean postnatal age of (30.1±14.1) d (14-75 d) and (8.3±1.3) months (4 months and 14 d to 12 months), respectively. Pre-discharge pulmonary function tests revealed that 13 cases (16.0%) had nearly normal pulmonary function, while 68 cases (84.0%) showed pulmonary function abnormalities with seven cases of restrictive ventilatory dysfunction, 56 cases of obstructive ventilatory dysfunction, and five cases of mixed ventilatory dysfunction. In the children with abnormal pulmonary function before discharge, their second pulmonary function tests showed that some parameters including tidal volume [(7.49±1.35) ml/kg vs. (8.02±2.21) ml/kg], the ratio of time to peak tidal expiratory flow and expiratory time [(23.21±4.95)% vs. (26.50±5.48)%], the ratio of volume to peak expiratory flow and expiratory volume [(26.41±5.79)% vs. (27.55±5.20)%], respiratory system compliance per kg body weight during single occlusion [(0.93±0.22) ml/(cmH 2O·kg) vs. (0.96±0.25) ml/(cmH 2O·kg), 1 cmH 2O=0.098 kPa], functional residual capacity [(52.18±17.83) ml vs. (126.39±26.73) ml], and respiratory system resistance in single occlusion condition [(0.06±0.02) cmH 2O/(ml·s) vs. (0.05±0.01) cmH 2O/(ml·s)] improved after discharge ( t values were-2.41,-6.14,-7.68,-2.26,-18.94, and 4.87, all P<0.05). Eight children with obstructive ventilatory dysfunction were followed up for two years after surgery, of which three had normal lung function and five still showed mild to moderate obstructive ventilatory dysfunction. Logistic regression analysis indicated that liver herniation, severe pulmonary hypertension (PH), low observed-to-expected lung-to-head ratio (o/e LHR), grade C/D diaphragmatic defect, and prolonged invasive ventilation were risk factors for poor pulmonary outcomes [ OR(95% CI) were 5.655(1.410-22.676), 5.610 (1.589-19.804),4.183 (1.234-14.180) and 1.195(1.074- 1.329), all P<0.05]. Conclusions:Although lung function parameters of CDH patients show certain improvement after surgery, many children still have mild to moderate obstructive ventilatory dysfunction, requiring long-term follow-up. Prenatal and postnatal indicators such as liver herniation, severe PH, and low o/e LHR can predict the pulmonary outcomes of children with CDH.
7.Report of 6 cases of lymphoproliferative disorders after liver transplantation
Hui ZHANG ; Yandong SUN ; Feng WANG ; Dan LIU ; Bin ZHUANG ; Jianhong WANG ; Dahong TENG ; Jinzhen CAI
Chinese Journal of Organ Transplantation 2025;46(2):161-165
This study reports the diagnosis and treatment of six cases of post-transplant lymphoproliferative disorder (PTLD) in liver transplant recipients, confirmed at the Affiliated Hospital of Qingdao University between August 2017 and May 2023. The report includes details on anti-rejection therapy, Epstein-Barr virus (EBV) and cytomegalovirus (CMV) infections, imaging findings, histopathological results, treatment courses, and prognoses. By summarizing the clinical experience in the diagnosis and management of PTLD following liver transplantation, this study aims to provide valuable insights and references for the clinical diagnosis and treatment of this condition.
8.Study of related factors to vascular complications after pediatric liver transplantation
Bin ZHUANG ; Qi GAO ; Yandong SUN ; Feng WANG ; Nan ZHENG ; Jinzhen CAI
Chinese Journal of Surgery 2024;62(11):1038-1044
Objective:To explore the related factors of vascular complications after liver transplantation in children.Methods:This is a retrospective case series research. The clinical data of 89 pediatric liver transplant patients admitted to the Organ Transplantation Center, the Affiliated Hospital of Qingdao University from January 2016 to March 2024 were collected retrospectively. This study included 44 males and 45 females,aged from 4 months to 17 years. The ratio of graft to recipient weight was 0.6% to 7.7%. The primary diseases included 48 cases of biliary atresia and 41 cases of non-biliary atresia. The Wilcoxon rank sum test, χ2 test, and Fisher′s exact probability method were used for data analysis. Multivariate Logistic regression was used to analyze the related factors of vascular complications. Results:All 89 children with liver transplantation completed surgery successfully. There were 8 cases of arterial complications after surgery, including 6 cases of hepatic artery thrombosis and 2 cases of hepatic artery stenosis. There were 16 cases of portal vein complications after surgery, including 9 cases of portal vein stenosis and 7 cases of portal vein thrombosis. The results of univariate analysis showed that the age of the recipient ≤1 year was the relevant factor for hepatic arterial complications( χ 2=4.772, P=0.029). The age of the recipient ≤1 year, the age of the donor, the hepatic phase, and the time of cold ischemia were the relevant factors for the occurrence of portal vein complications( χ 2=7.270, Z=388.500, Z=838.000, Z=894.500;all P<0.05). The results of multivariate analysis showed that age(≤1 year vs. >1 year) and duration of cold ischemia(every additional 1 hour) were independent related factors for portal vein complications after liver transplantation in children(both P<0.05). Conclusion:Children aged ≤1 year and with prolonged cold ischemia are more likely to develop portal vein complications after liver transplantation.
9.Study of related factors to vascular complications after pediatric liver transplantation
Bin ZHUANG ; Qi GAO ; Yandong SUN ; Feng WANG ; Nan ZHENG ; Jinzhen CAI
Chinese Journal of Surgery 2024;62(11):1038-1044
Objective:To explore the related factors of vascular complications after liver transplantation in children.Methods:This is a retrospective case series research. The clinical data of 89 pediatric liver transplant patients admitted to the Organ Transplantation Center, the Affiliated Hospital of Qingdao University from January 2016 to March 2024 were collected retrospectively. This study included 44 males and 45 females,aged from 4 months to 17 years. The ratio of graft to recipient weight was 0.6% to 7.7%. The primary diseases included 48 cases of biliary atresia and 41 cases of non-biliary atresia. The Wilcoxon rank sum test, χ2 test, and Fisher′s exact probability method were used for data analysis. Multivariate Logistic regression was used to analyze the related factors of vascular complications. Results:All 89 children with liver transplantation completed surgery successfully. There were 8 cases of arterial complications after surgery, including 6 cases of hepatic artery thrombosis and 2 cases of hepatic artery stenosis. There were 16 cases of portal vein complications after surgery, including 9 cases of portal vein stenosis and 7 cases of portal vein thrombosis. The results of univariate analysis showed that the age of the recipient ≤1 year was the relevant factor for hepatic arterial complications( χ 2=4.772, P=0.029). The age of the recipient ≤1 year, the age of the donor, the hepatic phase, and the time of cold ischemia were the relevant factors for the occurrence of portal vein complications( χ 2=7.270, Z=388.500, Z=838.000, Z=894.500;all P<0.05). The results of multivariate analysis showed that age(≤1 year vs. >1 year) and duration of cold ischemia(every additional 1 hour) were independent related factors for portal vein complications after liver transplantation in children(both P<0.05). Conclusion:Children aged ≤1 year and with prolonged cold ischemia are more likely to develop portal vein complications after liver transplantation.
10.Long term efficacy of absorbable sutures coated with silver nanoparticles on the suture track of skin incisions in mice
Feng HE ; Juan DU ; Yanbiao SONG ; Mao YE ; Yandong WEI ; Xuelai LIU
Chinese Journal of Burns 2024;40(12):1184-1192
Objective:To explore the long term efficacy of absorbable sutures coated with silver nanoparticles on the suture track of skin incisions in mice.Methods:This study was an experimental research. Eighteen half male and half female BALB/c mice aged 10-12 weeks were divided into normal Vicryl suture group, antibiotic Vicryl suture group, and silver nanoparticle Vicryl suture group according to the random number table, with 6 mice in each group, half male and half female. After the skin incisions were created on the back of all mice, the skin incisions of mice in normal Vicryl suture group, antibiotic Vicryl suture group, and silver nanoparticle Vicryl suture group were performed with continuous intradermal suture by absorbable Vicryl sutures, absorbable Vicryl sutures coated with triclosan antimicrobial, and absorbable Vicryl sutures coated with silver nanoparticles, respectively. On the 25 th day after surgery, the skin tissue in the suture track of incisions was collected, immunohistochemical staining was used to detect the percentages of F4/80, interleukin-6 (IL-6), and tumor necrosis factor α (TNF-α) positive areas in the suture track of incisions of mice, the TdT-mediated dUTP nick-end labeling (TUNEL) staining was used to detect the percentage of TUNEL staining positive area in the suture track of incisions of mice, Masson staining was used to observe the collagen fiber formation in the suture track of incisions of mice, and immunohistochemical staining was used to detect the percentage of tissue cathepsin K positive area in the suture track of incisions of mice. The number of the above experimental samples was 6. Results:On the 25 th day after surgery, the percentages of F4/80, IL-6, and TNF-α positive areas in the suture track of incisions of mice in silver nanoparticle Vicryl suture group ((19.2±1.6)%, (20.2±1.7)%, and (16.0±1.6)%) were significantly lower than those in normal Vicryl suture group ((100±6.4)%, (100±7.6)%, and (100±9.6)%) and antibiotic Vicryl suture group ((47.2±3.2)%, (53.8±5.0)%, and 43.2%, P<0.05). The percentages of F4/80, IL-6, and TNF-α positive areas in the suture track of incisions of mice in antibiotic Vicryl suture group were significantly lower than those in normal Vicryl suture group ( P<0.05). On the 25 th day after surgery, the percentage of TUNEL staining positive area in the suture track of incisions of mice in silver nanoparticle Vicryl suture group was significantly lower than those in normal Vicryl suture group and antibiotic Vicryl suture group (with both P values <0.05). The percentage of TUNEL staining positive area in the suture track of incisions of mice in antibiotic Vicryl suture group was significantly higher than that in normal Vicryl suture group ( P<0.05). On the 25 th day after surgery, the collagen fiber deposition was not obvious in the suture track of incisions of mice in normal Vicryl suture group, no obvious collagen fiber formation was observed in the suture track of incisions of mice in antibiotic Vicryl suture group, while the collagen fibers were mostly densely arranged and well-ordered in the suture track of incisions of mice in silver nanoparticle Vicryl suture group. On the 25 th day after surgery, the percentage of tissue cathepsin K positive area in the suture track of incisions of mice in silver nanoparticle Vicryl suture group was significantly lower than those in normal Vicryl suture group and antibiotic Vicryl suture group (with P values both <0.05), the percentage of tissue cathepsin K positive area in the suture track of incisions of mice in antibiotic Vicryl suture group was significantly lower than that in normal Vicryl suture group ( P<0.05). Conclusions:In the suture track of incisions of mice, silver nanoparticle Vicryl sutures exhibit superior long-term anti-inflammatory effects compared with absorbable Vicryl sutures coated with triclosan antimicrobial and normal absorbable Vicryl sutures. Additionally, cell apoptosis is reduced, collagen fiber deposition is obvious, and delayed-type hypersensitivity reactions is the weakest in the suture track of incisions of mice sutured by silver nanoparticle Vicryl sutures. The silver nanoparticle Vicryl sutures have potential value for clinical application.

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