2015, (3): 134-138.
Objective To evaluate the early safety of HBcAb positive donor used on pediatric living donor liver transplant recipients. Methods We collected and registered the data of 86 pediatric living donor liver transplant recipients from July 2010 to December 2013 in Tianjin First Center Hospital. The patients were divided into HBcAb+ group and HBcAb- group according to donors' serumtest of HBcAb. The preoperative state,operation time,ICU stay time and postoperative liver function of both group were compared. Results 5 cases died among 86 pediatric living donor liver transplant recipients,and total mortality was 5.81% with 9.37% and 3.70% for HBcAb+ groupand HBcAb- group respectively without statistical difference.All pediatric recipients had no hepatitis B occurred perioperatively and there were no statistical differences of twogroups in average age and weight of recipients,preoperative PELD scores,average age and weight of donors,weight of liver graft,operation time(547.44±71.93 min vs. 546.76±95.67 min),ICU stay(119.27±50.61 hr vs. 126.61±70.78 hr), serum value of total bilirubin,direct bilirubin,glutamic-pyruvic transaminase,glutamic-oxalacetic transaminase and international normalized ratio of 1 and 2 days before operation and post-operative day 1,3,7,14,28. (P > 0.05). Conclusion HBcAb positive liver grafts,on the basis of accurate assessment and appropriatemeasurement applied to preventhepatitisB recurrence,were safe for pediatric patients perioperativelyat least.
2015, (3): 139-141.
Objective To determine the independent risk factors for infection in 30 days after adult living donor liver transplantation of our organ transplant center. Methods A retrospective survey was held in 143 liver transplant recipients in April 2008 to January 2014 in our hospital. Postoperative infection occured within 30 dayswere considered as infection group(n = 27),with uninfected patients as control group(n = 116).The possible risk factors reported in literature were analyzed by Logistic regression analysis in two groups to determine the independent risk factors for early infection. Results Massive blood loss in operation(OR = 1.000,95%CI = 1.000 ~ 1.001),ICU stay time after operation(OR = 1.702,95%CI = 1.025~2.828),prolonged parenteral nutrition(OR = 1.319,95%CI = 1.070 ~ 1.625)were the independent risk factors for infection in 30days after adult living donor livertransplantation of our organ transplant center. Conclusion In order to reduce the incidence of early postoperative infection in patients with living donor livertransplantation,medical personnel should reduce blood loss during the operation,shorten the postoperative ICU stay time and the parenteral nutrition time.
2015, (3): 142-145.
Objective To summarize and analyze the clinical characteristic of HEHE in ChinesepatientsMethods A patent with HEHE underwent liver transplant in Tianjin First Center Hospital,samplesstained by hematoxylin eosin(HE)the morphological characteristics of this cases of hepatic EH were observed.At the same time,detect the expressionof CD31,CD34 protein with En Vision two step immunohistochemical method. According to the clinical manifestations,pathological morphology and the review of the literature. Results The tumor occupied left lateral lobe and right posterior of the liver,Section 5 cm×2 cm×2 cm gray,gray red nodule count,the boundary is not clear,slightly hard matter. Microscopic examination of biopsy,tumor cells were oval or irregular in shape,arranged in cords,abundant cytoplasm is eosinophilic,necrosis and calcification can be seen insome areas,the boundaries of tumor and surrounding liver tissue is unclear. The results of immunohistochemistry fortumor cell CD31,CD34,HMB45,S-100,Vim are positive,Desmin negative,SMA. The patients were followed up for 5 years,alive,but liver,multiple metastases were foung in the liver ans lungs. Conclusion HEHE is a rare low-grade malignant tumor,which is easy misdiagnosed,understand the clinical and pathological characteristic of the tumors can help identify other tumor types confusing.
2015, (3): 146-148.
Objective To evaluate the effect of individualized health management on the long-term survival rate and life quality of liver transplanted patients. Methods 374 liver transplant patients who wereadmitted to the Armed Police General Hospital from January 2006 January 2009 were analyzed retrospectively. All participants in this study signed written informed consent and consistently in accord with ethical or legal standards.374 patients were randomly divided into the health model intervention group and the routine follow-up group. The health model intervention group was taken educational intervening during follow up and the routine group was not. The incidences of adverse events were compared between the two groups. Results The incidences of postoperative
adverse events were of statistically significant difference in these two groups(17.4% vs. 52.2%,χ2 = 8.326, P < 0.05). Conclusion Individualized health management can improve long-term survival rate and life quality of liver transplant patients.