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31 December 2010, Volume 14 Issue 53 Previous Issue    Next Issue

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Modified self-confected low potassium dextran solution for preservation of isolated lung in canine lung transplantation: The longest preservation time Liang Chao-yang, Zhang Hai-tao, Wang Zai-yong, Bao Tong, Zhang Zhen-rong, Liu De-ruo 2010, 14 (53):  9881-9887.  doi: 10.3969/j.issn.1673-8225.2010.53.001 Abstract ( 416 )   PDF (1353KB) ( 395 )   Save BACKGROUND: Clinical application of low potassium dextran (LPD) solution has better effectiveness, but effective period of donor lung preservation is still short and price is expensive. OBJECTIVE: To observe changes of lung preservation after different periods preserved with modified self-confected LPD solution and to evaluate the storage term of lung in this solution. METHODS: In total 32 healthy dogs were randomly divided into the control group and experimental group. Dogs in the control group were perfused with LPD solution; and those in the experimental group were perfused with modified self-confected LPD solution. Changes of myeloperoxidase, malonaldehyde, wet to dry weight ratio (W/D), pathological result and super-micro structural results from donor lung tissues were compared at pre-perfusion, after perfusion, and 4-, 8-, 12-, as well as 24-hours of preservation. RESULTS AND CONCLUSION: For both groups: the values of myeloperoxidase, malonaldehyde and W/D were increasing as lung preservative period in vivo was prolonging; after 12-hour preservation, the value of myeloperoxidase was significant changed while the value of malonaldehyde and W/D were changed significantly after 8-hour preservation; the pathological and super-micro structural changes were reversible till lung preservative period reached 8-hour. Changes of lung preservation started to be significant after 8-hour preserved with modified self-confected LPD solution and irreversible historical changes appeared after 12-hour preservation. References | Related Articles | Metrics

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Expression of peroxisome proliferator activated receptor gamma in obliterative bronchiolitis following lung transplantation Liu Hong-xu, Wang Ge-bang, Liu Yang, Xu Shun, Zhang Lin 2010, 14 (53):  9888-9892.  doi: 10.3969/j.issn.1673-8225.2010.53.002 Abstract ( 252 )   PDF (1529KB) ( 342 )   Save BACKGROUND: Peroxisome proliferator activated receptor γ (PPAR γ) plays some roles in inhibiting tissue fibrosis and modulating immune activity. However, little is known about its function in solid organ transplantations. It might be an ideal factor for the inhibition of rejection response. OBJECTIVE: In order to investigate the mechanism of PPAR γ, we detected its expression in obliterative bronchiolitis after pulmonary transplantation. METHODS: After ectopic tracheal transplantation in mice, immunohistochemistry staining was employed to detect the location of PPAR γ in different kinds of cells at different stages of post-transplantation animals. The expression of PPAR γ mRNA in transplanted trachea was analyzed with RT-PCR. Airway fibroblasts was primarily cultured and treated with transforming growth factor-β1 (TGF-β1) at 5 mg/L. At different time points, the expression of PPAR γ mRNA in fibroblasts was analyzed with RT-PCR. The expression of α-smooth muscle antigen-the marker of myofibroblasts was examined with Western blot after the fibroblasts were treated with TGFβ-1 (5 mg/L) or PPAR γ ligand-Rosiglitazone (10 mmol/L) at specific time interval. The expression of α-smooth muscle antigen in cultured pulmonary fibroblasts was investigated by Western Blot. RESULTS AND CONCLUSION: In the inflammatory stage of post-transplantation, PPAR γ was found in the inflammatory cells, while in the fibroblasts in the fibrous proliferation stage. Markedly dropped of mRNA of PPAR γ was detected in the tissue homogenate of transplanted trachea. In the same way, the amount of PPAR γ mRNA remarkably diminished after the cultivated pulmonary fibroblasts were treated with TGF-β1. The addition of PPAR γ ligand-rosiglitazone could inhibit the production of α-smooth muscle antigen induced with TGF-β1. The results demonstrated that decreased expression of PPAR γ could be one of the most important factors contributing to the development of obliterative bronchiolitis after pulmonary transplantation. The activation of PPARγ could inhibit the differentiation of myofibroblasts induced by TGF-β1. Related Articles | Metrics

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Effects of tracheal epithelial cells on obliterative bronchiolitis in a rat tracheal heterotopic transplantation model Zhang Yu, Liu Jian, Chen Chang, Han Biao, Yang Zhen-hua, Hu Xue-fei 2010, 14 (53):  9893-9896.  doi: 10.3969/j.issn.1673-8225.2010.53.003 Abstract ( 301 )   PDF (355KB) ( 293 )   Save BACKGROUND: Many studies have demonstrated that tracheal epithelial cells play a key role in chronic inflammation. The tracheal epithelium plays an immune response “target organ” effects, which can activate cellular and humoral immune response. OBJECTIVE: To study the effects of tracheal epithelial cells on obliterative bronchiolitis in rat tracheal heterotopic transplantation. METHODS: The rats were prepared for tracheal heterotopic transplantation models and randomly divided into 4 groups: epithelium group: Wistar rat tracheal model (donor) subcutaneous implanted in the back of SD rat (recipient). In the epithelium-removed group, the procedure was performed similar to epithelium group exception of this group had no epithelial cells. Control group 1: Wistar rat tracheal heterotopic transplantation model with sodium chloride, the model subcutaneous implanted in the back of Wistar rat (recipient). Control group 2: the same way with control group 1, however, the tracheal model had no epithelial cells.  RESULTS AND CONCLUSION: The epithelium group occurred occlusion, and the occlusion rate was increased with time prolonged. There were no occlusions in the epithelium-removed group and control groups. The findings confirm that tracheal epithelial cells play an important role in the occurrence of bronchiolitis obliterans in a rat heterotopic tracheal transplantation model. Related Articles | Metrics

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Fluctuation of soluble intercellular adhesion molecule-1 prior to and after lung transplantation Zhang Di, Yu Jing-feng, Xiao Hua-long 2010, 14 (53):  9897-9901.  doi: 10.3969/j.issn.1673-8225.2010.53.004 Abstract ( 306 )   PDF (974KB) ( 366 )   Save BACKGROUND: The soluble intercellular adhesion molecule-1 (sICAM-1) assay is based on biotin-streptavidin (BSA) system and has been widely used due to high sensitivity.  OBJECTIVE: To establish sICAM-1 BAS time resolution fluoroimmunoassay method (sICAM-1 BAS-TRFIA) and to explore the sICAM-1 fluctuation and clinical significance prior to and after lung transplantation. METHODS: Two matching monoclonal antibodies served as capture immune body and the examination immune body, respectively. The europium-labeled streptavidin (SA-Eu 3+ ) served as tracer and combined with biotinylated immune body to establish the sICAM-1 BSA-TRFIA method. This method was used to detect sICAM-1 levels in 30 healthy adults and 26 recipients prior to and after lung transplantation. The clinical significance of sICAM-1 BSA-TRFIA method was evaluated. RESULTS AND CONCLUSION: The determine results of 30 healthy adults were (348.63±69.12) µg/L. There was no significant difference in sICAM-1 between control and prior to transplantation group. After transplantation, there was obviously difference  (P < 0.05). The sICAM-1 increased when acute rejection occurs but decreased after concurrent infection, but the differences had no significant. The findings demonstrated that, sICAM-1 BSA-TRFIA method is a novel non-radioactive labeled immunoassay with high sensitivity and wide scope. Monitoring of serum sICAM-1 is helpful to auxiliary diagnosis acute rejection following lung transplantation. Related Articles | Metrics

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Function changes of blood coagulation in dogs during single lung transplantation Wu An-shi, Zhou Hai-bin, Zhang Xue-na, Yue Yun 2010, 14 (53):  9902-9904.  doi: 10.3969/j.issn.1673-8225.2010.53.005 Abstract ( 316 )   PDF (576KB) ( 311 )   Save BACKGROUND: During the perioperative period of lung transplantation, there is activation of blood coagulation and fibrionlytic system in extracorporeal circulation. But the research addressing function changes of blood coagulation during the perioperative off-pump period of lung transplantation is relatively rare. OBJECTIVE: To detect the function changes of blood coagulation in recipient dogs during single lung transplantation. METHODS: Twenty-four healthy male dogs were randomly divided into donor group and recipient group, followed by single lung transplantation. Activated clotting time (ACT), clotting rate (CR), and platelet function (PF) in the recipient group were detected with Sonoclot coagulometer respectively at 20 minutes after anesthesia induction (T1), 10 minutes before reperfusion (T2), 10 minutes after reperfusion (T3) and 60 minutes after reperfusion (T4).   RESULTS AND CONCLUSION: Activated clotting time of T3 was obviously longer than T1, T2, and T4 (P < 0.001). CR and PF had no significant changes among the groups. These indicated that during the lung transplantation, activated clotting time was obviously prolonged 10 minutes after reperfusion, and returned to normal level one hour after reperfusion. CR and PF had no obvious changes at different time point. Related Articles | Metrics

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Protective effect of prostaglandin E1 on hepatic microcirculation in brain death rats Wu Lin-wei, Guo Zhi-yong, Tai Qiang, Ju Wei-qiang, Wang Dong-ping, He Xiao-shun 2010, 14 (53):  9905-9908.  doi: 10.3969/j.issn.1673-8225.2010.53.006 Abstract ( 341 )   PDF (844KB) ( 334 )   Save BACKGROUND: Brain death donor management has an important role on protecting the function of organs. Prostaglandin E1 (PGE1) is used widely in the filed of liver transplantation because of its effect on protecting the liver function, but its effect on the brain death donors and the grafts has not been illustrated. OBJECTIVE: To investigate the protective effect of PGE1 on hepatic microcirculation in brain death donor rats models. METHODS: Sprague-Dawley rats were inducted brain death by gradual on-set method. All rats were divided into 3 groups: brain death group, PGE1 group and contrast group. Blood and liver specimen were harvested at 2 and 4 hours after brain death induction. The activities of aspartate aminotransferase and alanine aminotransferase were detected by automatic biochemical analyzer, hyaluronic acid (HA) concentration was measured by radio immunoassay, and the ultrastructure changes of hepatic sinusoid were observed by Hitachi H-600 transmission electron microscope. RESULTS AND CONCLUSION: Hepatic function was dysfuncted at 2 hours after brain death, which aggravated at 4 hours. Liver enzymes in the PGE1 group were improved compared with the brain death group (P < 0.05). At 2 hours after brain death, HA levels were increased in the brain death group at 2 hours and continuous rose at 4 hours. After brain death, electron microscope showed the microstructure of the hepatocytes and sinusoids endothelial cells were damaged, Kupffer cells were activated. PGE1 management on the brain death donor can improve the microcirculation of liver, inhibit apoptosis of liver cells and activation of Kupffer cells, and then it can improve the quality of liver grafts from brain death donors. Related Articles | Metrics

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Comparison of hepatic regenerative capacity between male and female mice after partial hepatectomy Fang Fang, Xu Li-ping, Dong Pei-jie, Xie Hui-zhen, Zhang Ze-kai, Chen Can-wei, Ma Ning-fang 2010, 14 (53):  9909-9912.  doi: 10.3969/j.issn.1673-8225.2010.53.007 Abstract ( 367 )   PDF (783KB) ( 358 )   Save BACKGROUND: A significant gender difference can be found in the morbidity of liver cirrhosis and hepatoma between male and female. The liver has powerful ability to regenerate after injury or loss of tissue after operation, but whether or not a difference exists in the regeneration and succession of the hepatic cells remain unclear. OBJECTIVE: To compare the hepatic regenerative capacity between male and female mice after partial hepatectomy.    METHODS: Adult Kunming mice were subjected to partial hepatectomy. Both the resected and regenerated liver tissues were harvested, weighed, fixed and paraffin embedded for determination of proliferation. The 5-bromo-2-deoxyuridine (BrdU) was injected peritoneal 2 hours before the mice were sacrificed. The liver structure and the morphology of hepatic cells were observed; liver regeneration rate and BrdU labeling index were compared at 1, 3, 5, 7, 10 and 14 days after partial hepatectomy. RESULTS AND CONCLUSION: Hematoxylin-eosin staining showed that there was no significant difference in liver structure and the morphology of hepatic cells after partial hepatectomy. No difference could be found in both liver regeneration rate and BrdU labeling index between male and female mice (P > 0.05). There is no significant difference in the capacity of hepatic regeneration after partial hepatectomy between male and female mice. Related Articles | Metrics

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Influences of hepatic artery/portal vein early reflow on rat intestinal ischemia/reperfusion injury following liver transplantation Zhang Pei-jian, Zhuang Zhuo-nan, Tian Ming-xiang, Su Hui, Bu Ping, Meng Zhong-liang, Zhang Jie, Wu Xue-yan 2010, 14 (53):  9913-9916.  doi: 10.3969/j.issn.1673-8225.2010.53.008 Abstract ( 262 )   PDF (998KB) ( 333 )   Save BACKGROUND: It remains unclear that whether different time sequence of hepatic artery/portal vein early reflow can aggravate the intestinal ischemia/reperfusion (I/R) injury following liver transplantation. OBJECTIVE: To investigate the influence of hepatic artery/portal vein early reflow on rat small bowel I/R injury after liver transplantation. METHODS: Rat liver transplantation models with portal vein infusion were selected. A total of 78 SD rats were randomly divided into the 3 groups. The hepatic artery group (n=36): rats were underwent liver transplantation, and received infusion via portal vein using 40 C Ringer lactate solution, opened hepatic artery and inferior vena cava, followed by open portal vein 10 minutes later; the portal vein group: rats were underwent liver transplantation, open the hepatic artery at 10 minutes after portal vein; the sham-surgery group received abdominal cavity exposure and liver liberation. The microstructure and ultramicrostructure changes of the small bowels were observed, and the level of the nitric oxide (NO) was determined. RESULTS AND CONCLUSION: In each group at different periods after operation, the villi had occurred malposition or disorder. The mitochondria size of mucous membrane of small intestine cell were not the same, and engorged obviously, were almost buninoid, vacuolar degeneration were inside. The cristae of mitochondria were decreased, collapsed or disappeared. The NO level of small intestine tissue was raised. These changes reached the peak at 12 hours after operation. Compared with the portal vein group, the injury of microstructure and ultramicrostructure of small bowel and NO level of small intestine tissue of the hepatic artery group were higher. Through early oxygen supply of liver, hepatic artery early reflow can reduce transplantation liver damage, the delay in opening the portal vein increased small intestine of I/R injury of liver transplantation in rats. Related Articles | Metrics

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Relationship among interleukin-2, interleukin-10, human leukocyte antigen-G and liver acute rejection following liver transplantation Hu Wei-yu, Wu Li-qun, Li Yong, He Jian-shuai, Zhang Yong-ming 2010, 14 (53):  9917-9920.  doi: 10.3969/j.issn.1673-8225.2010.53.009 Abstract ( 297 )   PDF (866KB) ( 460 )   Save BACKGROUND: Liver acute rejection is one of the most severe complications that may blast the graft. Now liver biopsy is the main way to diagnose it, which may bring about some complications such as infections and hemorrhages. So it is one of the most important focal points in the field of liver transplantation to discover a non-invasion or less-invasion index to diagnosis and forecast of liver acute rejection. OBJECTIVE: To explore the relationship of the expression of interleukin-2, interleukin-10, human leukocyte antigen-G (HLA-G) and acute rejection in liver transplantation. METHODS: Fifty-nine blood samples were taken from cases after liver transplantation. The expression of interleukin-2, interleukin-10 and HLA-G was assayed by ELISA. The cases were divided into the acute rejection group and non-rejection group, and the latter group was divided into normal liver function group and abnormal group. The results were analyzed and ROC curve was made. Area under ROC curve and the sensibility and specificity of the cut-off point were analyzed statistically.  RESULT AND CONCLUSION: The expressions of interleukin-10 and HLA-G in serum of the acute rejection group was obviously lower than those in the non-rejection group (P=0.032, 0.002), while expression of interleukin-2 in acute rejection group was higher than that in the non-rejection group (P=0.002). The expression of interleukin-2 was statistically higher in the abnormal liver function group than that in the normal liver function group (P=0.02), while the expression of interleukin-10 and HLA-G had no statistical difference in the two groups (P=0.525, 0.084). The expression of interleukin-2, interleukin-10 and HLA-G is connected with liver acute rejection. And in the three factors HLA-G is the most effective index for diagnosis and forecast of liver acute rejection. Related Articles | Metrics

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Reduction of hepatitis B recurrence after liver transplantation using hepatitis B immunoglobulin combined with nucleoside analogs Li Zhu, Li Li, Ran Jiang-hua, Zhang Sheng-ning, Liu Jing, Li Lai-bang, Liu Dian-sheng, Wu Shu-yuan, Chen Juan 2010, 14 (53):  9921-9924.  doi: 10.3969/j.issn.1673-8225.2010.53.010 Abstract ( 281 )   PDF (665KB) ( 315 )   Save BACKGROUND: There is not a united method for preventing and treating hepatitis B recurrence after liver transplantation. OBJECTIVE: To investigate the control plans of hepatitis B recurrence after liver transplantation. METHODS: Totally 117 liver transplantation recipients with liver cirrhosis after chronic hepatitis B were analyzed retrospectively. Using three therapeutic scheme, the patients were divided into 5 groups according to the received treatment time: adefovir dipivoxil plus low dose hepatitis B immunoglobulin (HBIG) short-term group (group A), adefovir dipivoxil plus high dose HBIG mid-long-term group (group B, group B+), entecavir plus suitable dose HBIG individual therapy group (group C, group C+). Then the cumulating effective inhibition rate and powerful inhibition rate of HBV were observed. All of patients were followed-up 2 years at least. RESULTS AND CONCLUSION: The cumulating effective inhibition rate and powerful inhibition rate of HBV in group B, B+, C and C+ were much higher than that in group A (P < 0.05). The therapeutic effect of hepatitis B in groups C, C+ were better than that in group B, B+ respectively (P < 0.05). The results demonstrated that prevention of hepatitis B recurrence after liver transplantation is a long-term, even for a life time process, suitable dose of HBIG combined with antiviral drug is benefit for the prevention and cure of hepatitis B recurrence. Related Articles | Metrics

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Bone marrow stem cells combined with low-dose tacrolimus induce chimera formation following renal transplantation Sun Jian-jun, Chen Guo-yong, Xie Han-bing, Tang Gao-feng, Chen Jian-bin 2010, 14 (53):  9925-9928.  doi: 10.3969/j.issn.1673-8225.2010.53.011 Abstract ( 346 )   PDF (859KB) ( 304 )   Save BACKGROUND: The bone marrow cells are candidate approaches for inducing immunological tolerance. OBJECTIVE: To explore effects of bone marrow cell transplantation on immunological tolerance in rat kidney transplantation. METHODS: ①Forty Wistar rats, half males and half females, were randomly assigned into the control group (n=20) and experimental group (n=20). The female animals were injected bone marrow cell and normal salty in portal vein. After 30 days, the chimerism formation and rejection were observed by gross and under a light microscope. ②Living-related kidney transplantation comprised 5 pairs of living kidney transplantations (couples or relatives). Males served as donors and females were recipients. Tacrolimus was taken orally before operation. The donors were subcutaneous injected drugs to stimulate leukocyte growth. The leukocyte suspension liquid was collected, determined by flow cytometry and infused into recipients via peripheral vein. The procedure was repeated once after 10 days, and the transplantation was performed within 1 week. The renal function was examined after operation. Y gene fragment was determined after half years by fluorescence in situ hybridization. The control group received normal living-related kidney transplantation without bone marrow cells transplantation. RESULTS AND CONCLUSION: The rejection was slightly in the animal experimental group, with positive chimerism. Four cases showed chimerism-positive in the living transplantation group, but only 1 chimerism-positive in the control group. It is suggested that bone marrow cell injection can induce immunological tolerance, which relates to the chimerism formation of donor bone marrow cells injection before the transplantation. Related Articles | Metrics

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Clinical significance of donor-specific anti-HLA antibodies for sensitized renal transplantation recipients Guo Juan, Zhu Ming-hui, Jiang Xin, Miao Shu-zhai, Qu Qing-shan, Yang Lei 2010, 14 (53):  9929-9932.  doi: 10.3969/j.issn.1673-8225.2010.53.012 Abstract ( 339 )   PDF (283KB) ( 492 )   Save BACKGROUND: Sensitive techniques are able to detect low levels of circulating antibodies. However, clinical consequences of these antibodies still unknown. OBJECTIVE: To investigate the clinical significance of donor-specific anti-HLA antibodies (DSA) for sensitized renal transplantation recipients and it role in predicting early rejection after kidney transplantation. METHODS: Patients who received kidney transplantation were tested for pre-transplant complement-dependent cytotoxicity (CDC) crossmatches and panel reactive antibodies (PRA). Patients were considered to have circulating antibodies if PRA was equal to or greater than 10%. These patients were then analyzed for DSA. Clinical outcomes were compared in patients with and without DSAs. RESULTS AND CONCLUSION: In a total of 379 patients who underwent transplantation, 55 had PRA equal to or greater than 10%. Of these 55 patients, 75% had a history of a sensitizing event. Twenty out of 55 patients were DSA+. Patients with DSA detected by ELISA had higher rates of delayed graft function, acute rejection, and lower rates of graft survival. The detection of DSA was associated with significantly higher rates of graft dysfunction and immunological events. Conversely, the presence of antibodies but no DSA was associated with excellent outcomes. In patients with negative CDC crossmatches, the occurrence of low-level DSA could assist in identifying patients that require more aggressive immune monitoring or immunosuppressive strategies. Related Articles | Metrics

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Establishment of left kidney transplantation models in rats with bilateral kidney grafts and monitoring of kidney functions Fang Cheng, Liu Li, Hu Han-ning, Chen wei, Wang Jia-mou, Zhang Qi-feng, Qu Yong-hua 2010, 14 (53):  9933-9936.  doi: 10.3969/j.issn.1673-8225.2010.53.013 Abstract ( 222 )   PDF (621KB) ( 365 )   Save BACKGROUND: Kidney transplantation in rats is used as an important experimental model for researches of immune tolerance, immune suppression and orange resources. OBJECTIVE: To develop the kidney transplant models of tolerance, acute and chronic rejection, to investigate surgical technical modifications, and to develop a non-damaging examination of function of the kidney graft. METHODS: Orthotopic kidney transplantation was performed with end to end anastomosis. The left side kidney of the recipient was replaced by a donor allograft and a contralateral nephrectomy was performed 7 days later. The left and right kidney of the donor could be used apart in-order. Lewis recipients with a DA allograft served as acute rejection group. Lewis recipients with a F344 allograft served as chronic rejection group. Lewis rats of auto-transplantation served as immune tolerance groups. The application anatomies of bilateral kidney, the warm ischemia time and cold ischemia duration of graft, the success ratio of transplantation, as well as the survival curve and proteinuria changes were observed. RESULTS AND CONCLUSION: A total of 43 rats were anatomized, 29 kidneys were irrigated, and 21 grafts were transplantation. The warm ischemia duration less than 10 seconds, the cold ischemia duration was (47.2±3.7) minutes, and the success ratio of transplantation was 85.7% (18/21), including 3 rats in the autotransplantation group, 3 in the acute rejection group and 12 in the immune tolerance group. The present operation is simplified, stable, and economical. It avoids impairment of the abdomen aorta and the inferior vena cava of recipients．The survival curve and proteinuria trend showed significant differences between acute rejection, chronic rejection and immune tolerance groups. Related Articles | Metrics

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Correlation between early compaction and implantation potential on day 3 of fertilization Zhang Bo, Yang Jing, Yin Tai-lang, Yan Wen-jie, Rumana Jafarey 2010, 14 (53):  9937-9940.  doi: 10.3969/j.issn.1673-8225.2010.53.014 Abstract ( 466 )   PDF (259KB) ( 497 )   Save BACKGROUND: In spite of the fast development of the affiliated reproductive technology, the implantation rate of embryos is not very good. The correlation between early compaction and the implantation potential remains unclear.  OBJECTIVE: To determine the correlation of early compaction on day 3 and the implantation rate. METHODS: A total of 420 cases (1 016 embryos), who underwent controlled ovarian hyperstimulation and in vitro fertilization and embryo transfer were selected, and compared the implantation rate of day 3 embryos exhibiting early compaction and embryos without compaction. RESULTS AND CONCLUSIONS: There were 200 embryos exhibiting early compaction, including 48 implanted embryos. At the same time, there were 816 embryos without early compaction, including 133 embryos implanted. There were significantly differences between two groups (P < 0.05). The pregnancy rate of the cases who received three compacted embryos was 71.43%, for those who received two compacted embryos was 31.91%, and those who received three compacted embryos was 51.06%, those who received non-compacted embryos was 39.81%. Accordingly, early compaction can notably increase implantation rate based on presently selection criteria of embryos. However, the precise mechanism still needs to be investigated. Related Articles | Metrics

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Anti-injury treatment effects on transplant outcomes following cryopreserved ovarian tissue transplantation Zhang Shuang, Wang Dong, Jiang Ying-yan, Ren Bao-hong, Duan Chun-feng 2010, 14 (53):  9941-9945.  doi: 10.3969/j.issn.1673-8225.2010.53.015 Abstract ( 271 )   PDF (806KB) ( 340 )   Save BACKGROUND: Transplantation of ovarian tissue is performed without vascular reanastomosis. To ameliorate the tolerance of ovarian tissue to injuries is critical for follicular survival and for exerting functions of the cryopreserved graft. OBJECTIVE: To compare the effects of vascular endothelial growth factor (VEGF), vitamin E, milkvetch root anti-injury treatment on morphology and function of freeze ovarian tissue after cryopreserved ovarian tissue autologous heterotopic transplantation. METHODS: Adult female Wistar rats were randomly assigned to four groups: normal control group, ovariectomy group, autologous fresh ovarian tissue transplantation group (non-cryopreserved ovarian tissue, direct transplantation) and cryopreserved ovarian tissue transplantation group. The cryopreserved ovarian tissue transplantation group was divided into three subgroups: non-anti-injury treatment group, VEGF + vitamin E + milkvetch root group and VEGF + vitamin E anti-injury group. At 2 months posttransplantation, serum estradiol (E2) level was detected. Following hematoxylin-eosin staining, follicular morphology and number of normal ovarian follicle were observed. RESULTS AND CONCLUSION: E2 levels were increased in the VEGF + vitamin E + milkvetch root group compared with no drug group, and number of primary follicle was increased (P < 0.05). The anti-injury drug affected ovary shape and functional recovery. E2 levels and number of primary follicle were greater in the VEGF + vitamin E + milkvetch root group compared with VEGF + vitamin E anti-injury group, but no significant difference was found. We could not confirm that the milkvetch root anti-injury treatment obtained good outcomes. These indicate that VEGF + vitamin E + milkvetch root anti-injury treatment exerts effects on the recovery of ovary shape and function following autologous heterotopic transplantation. Related Articles | Metrics

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Intrathymic injection of allogenic antigen induces allograft immune tolerance in rats Yue Wei-jie, Cui Yong, Li Wei, Yue Lei, Xie Gang, Meng Qing-gang 2010, 14 (53):  9946-9949.  doi: 10.3969/j.issn.1673-8225.2010.53.016 Abstract ( 239 )   PDF (769KB) ( 261 )   Save BACKGROUND: Similar to other foreign tissues, allogeneic bones also have antigenicity, which can result in rejection following transplantation. Though the application of immunosuppressant can suppress immunological rejection, it has certain harmful effects to the body. OBJECTIVE: To investigate the effects of intrathymic injection of allogenic antigen on allograft immune tolerance in rats. METHODS: Totally 60 Wistar rats were prepared for bone defects models and randomly divided into allogeneic bone graft, autogenous bone graft + allo-antigen group and allogeneic bone graft + immunosuppressant groups. Prior to transplantation, rats in the allogeneic bone graft + allo-antigen group were received intrathymic injections of spleen cells extracted MHC antigens. X-ray examination, hematoxylin-eosin staining were used to observe bone healing at 1, 2, 4 and 6 weeks after transplantation. Meanwhile, the soluble interleukin-2 receptor and mixed lymphocyte were tested by immunological assays. RESULTS AND CONCLUSION: Gross observation, X-ray film and histological examination showed that there were inflammatory cell infiltration and new bone formation in the allogeneic bone graft + allo-antigen and autogenous bone graft groups. In the allogeneic bone graft + immunosuppressant group, the regenerated vessel was few, and the bone healing was delayed, the inflammatory cell infiltrate was notable, and no new bone was formed. It confirmed that intrathymic injections of spleen cells extracted MHC antigens can induce recipient tolerance to donors bone graft. Immunologic test showed that the bone formation in the allogeneic bone graft + allo-antigen group was similar to the autogenous bone graft group, which was better than the allogeneic bone graft + immunosuppressant group. Thus, intrathymic injection of allo-antigen can induced on the allograft immune tolerance. Related Articles | Metrics

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Antigenicity of freeze-dried irradiated pig dura mater Zhang You-lai, Zeng Yuan-lin, Zou Li-jin, Xin Guo-hua 2010, 14 (53):  9950-9952.  doi: 10.3969/j.issn.1673-8225.2010.53.017 Abstract ( 301 )   PDF (297KB) ( 320 )   Save BACKGROUND: Antigenicity is the main problem exists in allografts transplantation and decides the fate of transplantation.   OBJECTIVE: To observe the antigen changes of freeze-dried irradiated pig dura mater. METHODS: Freeze-dried porcine dura mater, irradiated porcine dura mater and freeze-dried and irradiated porcine dura mater were prepared by freeze-dried and (or) irradiated treatment and were transplanted into dura mater of white rabbits. Immunologic property was determined at 3 and 8 weeks after operation. RESULTS AND CONCLUSION: There was no significant difference of lymphocytes death rates in the freeze-dried group and irradiated group (P > 0.05), both of which were greater than that of the freeze-dried irradiated group (P < 0.05). The results demonstrated that, the pig freeze-dried irradiated dura mater has low antigenicity. Related Articles | Metrics

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Application of immunosuppressive agent to patients undergoing combined liver and kidney transplantation Song Ji-yong, Shi Bing-yi, Du Guo-sheng, Zhu Zhi-dong, Zheng De-hua, Zou Yi-ping 2010, 14 (53):  9953-9956.  doi: 10.3969/j.issn.1673-8225.2010.53.018 Abstract ( 267 )   PDF (530KB) ( 323 )   Save BACKGROUND: Different degrees of immunoreaction are stimulated in different isolated organ transplantation. Thus, the kind and the dose of immunosuppressive agent in different isolated organ transplantation patients are distinguishing. The application of immunosuppressive agent in combined organ transplantation is more complicated, which is one of the experiences that the transplant doctor should master. OBJECTIVE: To explore the suitable immunosuppressive project in combined liver and kidney transplantation (CLKT) patients. METHODS: A total of 10 patients underwent CLKT from the Organ Transplantation Center, the 309 Hospital of Chinese PLA from April 2002 to July 2009. The control groups were comprised of isolated liver transplantation (ILT) patients and isolated kidney transplantation (IKT) patients. The immunosuppressive project, which was based on tacrolimus, was adopted in the early postoperative period in these three groups. Basiliximab was used as immune inducer in these all cases. In the CLKT and ILT patients, 500 mg methyllprednisolone was used during the operation, then 160 mg in the first day after the operation. The administration was performed twice. The dose of methyllprednisolone was decreased 40 mg per day in the following days. 20 mg prednisone was given from the day 5 and the hormone was withdrawn by the end of the second month. Mycophenolate was also withdrawn in the end of the sixth month and tacrolimus was used only from then on. In the IKT patients, 1 000 mg methyllprednisolone was used during the operation, followed by 500 mg/d in the first three days after the operation. Prednisone was decreased from 50 mg/d to 10 mg/d gradually. Tacrolimus, mycophenolate and prednisone were all used perennially in IKT patients. RESULTS AND CONCLUSION: The dose of tacrolimus to patients undergoing CLKT in early period and sixth month was similar to patients undergoing ILT (P > 0.05), and was obviously lower than patients undergoing IKT (P < 0.05 and P < 0.01). Mycophenolate and prednisone to CLKT and ILT patients were both withdrawn in the first six months, the doses of which were obviously lower than to IKT patients. Mycophenolate and prednisone were used perennially in IKT patients. Individual difference for drug displayed in some patients of these three groups since 1 year after operation. There was no long-term hepatic insufficiency in the CLKT patients. Low-dose immunosuppressive agent has little effect on the patient’s immune system, so it brought lower infection rate. A satisfactory therapeutic efficacy to CLKT patients has been got when the immunosuppressive project of ILT patients was used. Mycophenolate and prednisone were withdrawn in the first six months. The dose of tacrolimus was lower than IKT patients. Related Articles | Metrics

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Clinical significance of urinary DYZ-1 following renal transplantation Zhou Wen-qiang, Shi Bing-yi, Cai Ming, Qian Ye-yong, Li Hai-bin, Xiao Li, Han Yong, Wu Hong-wen 2010, 14 (53):  9957-9959.  doi: 10.3969/j.issn.1673-8225.2010.53.019 Abstract ( 341 )   PDF (299KB) ( 296 )   Save BACKGROUND: Regular monitoring of recipient urine can be used to identify function and status of renal transplant. OBJECTIVE: To investigate the relation and clinical significance of urinary donor-derived DNA in acute rejection after kidney transplantation. METHODS: A total of 60 female renal transplantation recipients and male donors were selected and divided into early detection group (n=40), acute rejection group (n=10), and stable function group (n=10). Urine samples were collected regularly. PCR was applied to detect DYZ-1 (special gene fragment of Y-chromosome). RESULTS AND CONCLUSION: Donor cells were detected in urine of all the recipients on day 1 after operation. With increasing time, the intensity of donor DNA expression in urine was decreased generally. At 1 month, donor cells in urine disappeared only in 8 of 40 cases, and acute rejection happened in 1 case; in other 32 recipients, donor cells remained in urine, and 7 cases developed acute rejection; in 10 cases of acute rejection after transplantation over 3 months, 7 cases presented the expression of donor cells in urine, and 1 month following anti-rejection therapy, donor cells in urine were negative in 71.4 % cases. In 10 cases of sable renal function, only 1 case had positive expression of DYZ-1. Results show that detection of urinary DNA of donor cells could be a method for diagnosing acute renal rejection of long term recipients. Related Articles | Metrics

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Human leucocyte antigen genotyping and beads reaction patterns Wang Da-ming, He Liu-mei, Zhang Hong, Wei Tian-li, Li Qian, Zou Hong-yan 2010, 14 (53):  9960-9964.  doi: 10.3969/j.issn.1673-8225.2010.53.020 Abstract ( 293 )   PDF (673KB) ( 408 )   Save BACKGROUND: Flow-rSSO in combination with flow cytometry and PCR-SSO with high throughout subtyping are the most commonly used methods for human leucocyte antigen (HLA) genotyping at present in the countries outside China. OBJECTIVE: To select the beads reaction patterns of different alleles in the same group and standardize the HLA genotype method, hopefully to require a more specific and rapid genotype development.  METHODS: Genomic DNA was extracted automatically from 457 blood samples using TECAN DNA workstation. Each DNA sample was subjected to PCR amplification, molecular hybridization and Luminex magnetic beads analysis using One lambada rSSO HLA-A, B and DRB1 commercial kit. With reference to the HLA-A, B and DRBI provided by One Lambda Inc., the common alleles were analyzed and the correlation between common alleles and beads was studied. RESULTS AND CONCLUSION: The common alleles in the same group are closely related to a certain or some different beads except the same beads reaction situation. To the organ transplantation in the clinic, the adoption of DNA genotype of middle resolution is the best choice. It not only contributes to quick screening, but also reduces the difficulty of matching. The high resolution genotype is commonly adopted in research work. Related Articles | Metrics

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Improved establishment of a heterotopic heart transplantation model in mice Wang Xiang-fei, Zhang Guo-chao, Zhou Han-xin 2010, 14 (53):  9965-9967.  doi: 10.3969/j.issn.1673-8225.2010.53.021 Abstract ( 344 )   PDF (621KB) ( 311 )   Save BACKGROUND: Cervical or intraperitoneal transplantation is used in establishing heart transplantation. However, the transplanted heart is prone to adhere to surrounding tissues and restrict heart beat due to the stegnotic cervical space. Abdominal aorta is relative easily for anastomosing and has high vascular pass rate, which can be used for long-term observation of chronic graft vascular lesion. OBJECTIVE: To explore an improved technique of mouse ventral heterotopic heart transplantation and construct an animal model for the study of transplantation immunity. METHODS: The donor heart aorta and the recipient ventral aorta, the donor pulmonary artery and the recipient inferior caval vein, were anastomosed by using the end-to-side suture technique respectively. All animals were divided into 3 groups. Isograft group: C57 to C57 mice transplantation; Allograft group; Babl/c to C57 mice transplantation; Anti-CD45RB mAb group: Anti-CD45RB mAb (200 μg) were intraperitoneal injected into Babl/c to C57 mice. The transplanted heart beat strongly and the mouse survived for over 72 hours were considered signs of model success. The observation lasted for 40 days after transplantation. RESULTS AND CONCLUSION: The successful rates were 83.3% (30/36). In experiments, the recipient preparation time was (15±2) minutes, harvesting time of donors was (8±1) minutes, and the recipient operation time was (33±2) minutes. In CD45RB mAb group, the average of the survival of heart allograft had a significant difference compared with those of the no therapy group (P=0.001). The animal model is stable and can be used for the study of transplantation immunity. A single injection of CD45RB mAb in mice can induce stable long-term acceptance of heart allografts. Related Articles | Metrics

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Intrahepatic islet transplantation through the portal vein in rats Yang Shun-liang, Wu Zhi-xian, Ye Yong-feng, Cai Jin-quan, Wang Qing-hua, Huang Liang-hu, Lin Guo-zhang, Zhou Hao, Tan Jian-ming 2010, 14 (53):  9968-9972.  doi: 10.3969/j.issn.1673-8225.2010.53.022 Abstract ( 286 )   PDF (1110KB) ( 455 )   Save BACKGROUND: The liver is commonly used ideal site because the liver is not only the site of insulin action, but also a relative immunologically privileged site. Furthermore, the volume of liver is big enough for transplantation; the construction of sinus hepaticus and vein is profited for dwell and growth of islet cell. OBJECTIVE: To investigate the method of intrahepatic islet transplantation through portal vein in Sprague Dawley rats with type I diabetes. METHODS: Islet cells of Sprague Dawley rats were prepared by methods of a previous study. Type I diabetes mellitus was induced with streptozotocin in Sprague Dawley rats via intraperitoneal injection. The rats were divided into two groups. 1 000 IEQ islets (1.5 mL) were infused into the liver of Sprague Dawley rats by the main portal vein puncture as experimental group, and serum-free 1640 medium (1.5 mL) was infused as control group. No immunosuppressive drug was administered after operation. Bleeding volume, blood glucose, insulin level and histomorphological changes in the liver were observed. RESULTS AND CONCLUSION: All rats survived. Success rate of portal vein puncture was 90% with bleeding volume less than 0.5 mL. Duration of normal blood glucose after operation in experimental group was 1 to 6 days (3.7 ± 1.7) days. The islet graft survival duration was 2 to 15 days (8.4 ± 4.1) days. Serum insulin levels in experimental group were significantly higher compared with control group within 2 weeks post-operative (P < 0.05, P < 0.01). The pathologic examination has confirmed that the morphous of hepatocyte and structure of hepatic lobule were normal. There was no necrosis or infection lesion in liver parenchyma and thrombopoiesis. The stenosis of main portal vein did not occur. Islet graft was pathologically viable and functioning in hepatic sinusoids. These have suggested that intrahepatic islet transplantation through the main portal vein in rats is an acceptable method. Related Articles | Metrics

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Allograft tendon preserved in pure glycerine under normal temperature Song Yi-ping, Han Bing, Wang He-hong, Tong Xun, Zhao Ri-guang, Sun Yi-yan, Feng Hui, Chen Shuo 2010, 14 (53):  9973-9976.  doi: 10.3969/j.issn.1673-8225.2010.53.023 Abstract ( 298 )   PDF (858KB) ( 337 )   Save BACKGROUND: In order to preserve the greatest bioactivity of the tendon, a kind of allograft preserving liquid is needed. OBJECTIVE: To observe the cell morphology and tendon bioactivity at different time points, followed by protection of the rabbit tendon in pure glycerine under normal temperature. METHODS: After special procession, the rabbit tendons were tightly sealed in pure glycerine away from light under normal temperature. The organizational structure and cell morphology of tendon were observed under electron microscope with hemotoxylin and eosin (HE) staining for paraffin section, and the bioactivity was observed by superoxide dismutase zymetology experiment for 2, 4, 7 and 12 months, respectively. RESULTS AND CONCLUSION: HE stained paraffin section showed that in 2, 4, 7 and 12-month glycerine group, most cell membranes were intact, nucleuses inerratic, and tendon organizational structures existed. The electron microscope showed the cells were in static, and the nucleus patterns were normal. The superoxide dismutase zymetology experiment showed that the tendon owned the superoxide dismutase enzymatic activity. The results indicated that the organizational structure, most of cell morphology and bioactivity of the tendon were remained, following the tendon was specially processed and tightly sealed in pure glycerine away from light under normal temperature for 12 months.. Related Articles | Metrics

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Protective effect of SP600125 on hepatic ischemia/reperfusion injury in rats Qiu Ai-gang, Xu San-rong, Li Jie, Zhang Hai-ming, Gu Xiao-hai 2010, 14 (53):  9977-9981.  doi: 10.3969/j.issn.1673-8225.2010.53.024 Abstract ( 398 )   PDF (952KB) ( 338 )   Save BACKGROUND: As JNK kinase inhibitor, SP600125 can specific and selective block JNK signal transduction pathways. However, it is poorly understood the role of SP600125 on hepatic ischemia/reperfusion (IR) injury. OBJECTIVE: SP600125 was used to interfere in hepatic IR injury and to analyze the mechanism of JNK signaling pathway in this process. METHODS：Thirty normal male Sprague-Dawley rats were randomly divided into sham operation group, IR group and JNK inhibitor SP600125 group. The left medius lobe was blocked in the IR group. At half hour before operation, 15 mg/kg SP600125 were injected into rats in the SP600125 group. All rats were killed at 2 hours after reperfusion. Routine assays were performed for testing the levels of alanine aminotransferase (ALT) and aspartate aminotransferase (AST); the pathological changes in the liver was evaluated with hematoxylin-eosin staining and contents of maleicdialdehyde (MDA) and myeloperoxidase (MPO) in liver tissues were detected by colorimetric method. RESULTS AND CONCLUSION: Compared to the IR group, the levels of serum ALT, AST, contents of MPO and MDA, as well as expression of p-JNK in hepatic tissues decreased significantly in the SP600125 group. The pathological changes of hepatic IR injury could be alleviated obviously. The activation of JNK signal pathway plays a pivotal role in hepatic IR injury, which can be alleviated by SP600125 treatment. Related Articles | Metrics

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Danshensu interferes in heme oxygenase-1 expression during in vitro liver cold preservation Li Dong-sheng, Wang Kai, Zhang Xiao-bin, Gao Chuan-chang, Zou Shu-bing 2010, 14 (53):  9982-9986.  doi: 10.3969/j.issn.1673-8225.2010.53.025 Abstract ( 280 )   PDF (1118KB) ( 339 )   Save BACKGROUND: Previous studies have demonstrated that salvia miltiorrhiza can decrease inducible nitric oxide synthase (iNOS) mRNA expression, reduce nitrogen monoxidum production, inhabit tumor necrosis factor and interleukin secretion, as well as antioxidation. As a monomer component of salvia miltiorrhiza, whether Dasensu has the similar effects remain poorly understood. OBJECTIVE: To verify the intervention of Danshensu on heme oxygenase-1 (HO-1) expression protection on liver cold preservation in vitro. METHODS: Rats were prepared for models of liver hypothermic perfusion preservation and divided into 3 groups. Rats in the control group were intraperitoneal injected physiological saline preoperatively and infused by Ringer lactate solution; those in the experimental group were received intraperitoneal injection of physiological saline preoperatively and infused by Danshensu plus infused by Ringer lactate solution in the surgery; those in the inhibitor group were intraperitoneal injected original zinc porphyrin preoperatively and infused by Danshensu plus infused by Ringer lactate solution in the surgery. HO-1mRNA and protein expression was determined by RT-PCR; Mitochondrial calcium content and calcium ions ATP activity were detected, and the hepatocyte and mitochondrial morphological changes were observed under a electron microscopy, and the morphological changes of liver cells and lobular were observed under a light microscope. RESULTS AND CONCLUSION: Hepatic HO-1 mRNA and protein levels of the experimental group were significantly higher than that of the other groups (P < 0.05). Compared with the other groups, the liver mitochondrial calcium content was notably lower in the experimental group, but the Ca2+-ATP activity was greater. The results reveled that, Danshensu perfusion fluid can induce over-expression of HO-1 and prolong the liver cold preservation time. Related Articles | Metrics

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null Lü Zhan-hui, Wang Shu-feng, Kong Ling-gui, Zhang Lei, Cai Chang-ma 2010, 14 (53):  9987-9990.  doi: 10.3969/j.issn.1673-8225.2010.53.026 Abstract ( 286 )   PDF (709KB) ( 308 )   Save null References | Related Articles | Metrics

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Living donor kidney harvested through the 12th-rib supracostal incision in 37 cases: Evaluation of safety Gao Hong-jun, Luo Xiang-dong, Liang Tai-sheng, Wu Pei-zhong, Liang Fang-fang, Luo Huan, Lu Shang-guang, Tan Zhen 2010, 14 (53):  9991-9994.  doi: 10.3969/j.issn.1673-8225.2010.53.027 Abstract ( 250 )   PDF (638KB) ( 429 )   Save BACKGROUND: Living donor kidney transplantation has relationship with both lives of donors and recipients. It is required that operation for donor and recipient should be ensured to be successful. Because of large operation risk and high technical requirements, it is critical to choose the cutting method of donor kidney, in order to ensure the donor’s safety. OBJECTIVE: To summarize the clinical experiences about 37 cases of the 12th-rib supracostal incision through back and waist in relative living donor kidney cutting technique, and to evaluate its effect and reliability. METHODS: Totally 40 operations of relative living donor kidney transplantation have been completed at the Department of urinary surgery, RuiKang Hospital Affiliated to Guangxi Chinese Traditional Medicine College, from June 2007 to August 2008. Among the 40 operations, there were 37 operations adopting the 12th-rib supracostal incision technique to cut and take relative living donor kidney. The relevant clinical data of the donors and the recipients were reviewed and analyzed. Meantime, 40 cases received cadaveric renal transplantation at corresponding time periods were selected as controls. The differences of recovery times of serum creatinine, occurrence rates of acute rejection, delayed graft function, related complication were compared. RESULTS AND CONCLUSION: The operation was successful in all 37 cases. The operating times of all donors were 1.0-2.0 hours, the warm ischemic time of donor kidney was about 15 seconds, and the cold ischemic times were 1.0-2.0 hours. No much haemorrhage occurred during the process of operation. No surgical complication and medical complication occurred during the peri-operation period. The kidney function of recipient recovered rapidly after operation. All of the creatinine levels could be restored to normal in 1 week. Up till now, all donors and recipients survived. Moreover, the functions of transplanted kidney were in normal range. Compared with the 40 cases with cadaveric kidney transplantation in the same period, the donors of living-relative donor kidney transplantation have more advantages in the following aspects: shorter recover time for creatinine, lower occurrence rates of acute rejection and delayed graft function after transplantation. The opening cutting and taking donor kidney operation of the 12th-rib supracostal incision through back and waist not only has the advantages of short operation time and short warm ischemic time, but also has the advantage of reliability. Together with high survival rate of patient and kidney, the quality of the relative living donor kidney transplantation is also satisfied. Related Articles | Metrics

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Renoprotective treatment for perioperative hepatorenal syndrome in liver transplantation Jiang Tao, Wang Xuan, Lu Lei, Zhang Bin, Li Zeng-cai, Zhang Dong-hua, Liu Xian-zhong, Zhang Rong-sheng 2010, 14 (53):  9995-9999.  doi: 10.3969/j.issn.1673-8225.2010.53.028 Abstract ( 483 )   PDF (1162KB) ( 395 )   Save BACKGROUND: Renal impairment of varying degree is common at perioperative period of liver transplantation and especially has immediate impact on survival of hepatorenal syndrome (HRS) patients. OBJECTIVE: To investigate the role of perioperative comprehensive renoprotective treatment in improving the renal function and survival rate of HRS patients after liver transplantation. METHODS: All 54 patients with preoperative HRS were divided into two groups: The latter 34 patients received comprehensive renoprotective treatment (renoprotective group) and the former 20 patients did not (non-renoprotective group). Meanwhile, the serum level of creatinine (Cr) was measured and the incidence of postoperative acute renal failure, infection, morbidity, mortality and the ICU stay were determined and compared with the other 117 patients without preoperative HRS (control group). RESULTS AND CONCLUSION: The serum level of Cr-max was significantly lower and dropped faster in the renoprotective group as comparing with non-renoprotective group, the incidence of postoperative acute renal failure improved in the same way (χ2=6.523, P=0.011). The incidence of infection and perioperative mortality of renoprotective group were the same as that of control group (P > 0.05). Compared with the non-renoprotective group, the patients received comprehensive renoprotective treatment had significantly lower mortality (χ2=6.018, P=0.014), ICU stay and infection rate (P < 0.01). Perioperative comprehensive renoprotective treatment can effectively improve renal function, lower morbidity and promote survival rate in patients with HRS underwent liver transplantation. Related Articles | Metrics

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Transperitoneal laparoscopic versus retroperitioneoscopic radical nephrectomy in renal cell carcinoma: A Meta-analysis Zhang Wei-wei, Cao Run-fu 2010, 14 (53):  10002-10006.  doi: 10.3969/j.issn.1673-8225.2010.53.030 Abstract ( 293 )   PDF (430KB) ( 445 )   Save BACKGROUND: It remains controversial in term of the efficacy and safety for the two approaches laparoscopic surgery for treatment of localised renal cell carcinoma limited its further investigation. OBJECTIVE: To assess the difference of clinical outcomes in the comparative studies evaluating transperitoneal and retroperitoneal approaches for radical nephrectomy. METHODS: A systematic review of the literature was performed in January 2010, searching Medline, Embase, Cochrane Library, CBM, and CNKI from January 1966 to December 2009. A “random, semi-randomized controlled study of literature” protocol using the term laparoscopic radical nephrectomy was applied. The authors reviewed the records to identify comparative studies. A cumulative analysis was conducted using Review Manager software v.4.2. RESULTS AND CONCLUSION: We identified 5 prospective randomized controlled studies, meta analysis results showed that, there was no significant difference between transperitoneal laparoscopic radical nephrectomy and retroperitioneoscopic laparoscopic radical nephrectomy in estimated blood loss [SMD=-0.22, 95%CI(-0.52, 0.09)] and specimen weight [SMD=0.35, 95%CI (-0.17, 0.86)], significant difference was existed in operative time [SMD=0.72, 95%CI(0.41, 1.03)] and complication rate [OR=2.16, 95%CI(1.03, 4.51)]. The available data were not sufficient to prove the superiority of any surgical approach in terms of estimated blood loss and specimen weight. Retroperitioneoscopic laparoscopic radical nephrectomy is followed by significantly lower operative time, and complication than transperitoneal laparoscopic radical nephrectomy. Related Articles | Metrics

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Rejection mechanism of liver xenotransplantation Ding Li-min, Shi Jun 2010, 14 (53):  10007-10010.  doi: 10.3969/j.issn.1673-8225.2010.53.031 Abstract ( 302 )   PDF (348KB) ( 340 )   Save BACKGROUND: With the development of clinical medicine and the utilization of immunosuppressive agents, allotransplantation has gained remarkable effects. However, because of the shortage of human donor livers, the liver transplantation doctors realize the value of liver xenotransplantation again. The porcine is thought to be an alternative source for human. OBJECTIVE: The paper mainly takes pig for example to explore the major immunologic barriers, which include hyper acute rejection, acute vascular rejection and acute cellular rejection, and the research progress addressing how to overcome rejection and induce immune tolerance. METHODS: The databases of CNKI and SPRINGER were retrieved by the first author using key words of “liver transplantation, xenograft, immune rejection, mechanism” both in Chinese and English from 1994 to 2010. Documents closely related to the major immunologic barriers of liver xenotransplantation, how to overcome rejection, and induce immune tolerance were published in authoritative journals for the past few years were included, and the repetitive studies were excluded.  RESULTS AND CONCLUSION: Total 205 articles were gotten by computers according to criteria, of which 29 articles (2 Chinese texts, 27 English texts) were selected. The important direction of clinical application study in liver xenotransplantation is the immunologic barriers, how to overcome rejection and induce immune tolerance. With the development of liver xenotransplantation rejection, recognition and the utilization of new immunosuppressive agents, liver xenotransplantation would become an important way to solve donor liver shortage currently. Related Articles | Metrics

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Vein graft materials: Progress in restenosis treatment following vein graft transplantation Wang Wen-jun, Liu Ji-chun 2010, 14 (53):  10011-10015.  doi: 10.3969/j.issn.1673-8225.2010.53.032 Abstract ( 313 )   PDF (389KB) ( 367 )   Save BACKGROUND: It is may become a reality to prevent vein graft stenosis effectively with in-depth study of the mechanism of restenosis, further improvement of various treatment methods and the joint application. OBJECTIVE: To introduce the multiple causes of vein graft lesions and to explore new method for the prevention of delayed vein graft stenosis. METHODS: Using computer technology to retrieve the articles in VIP periodical full-text database, CNKI database, highwire full-text database and PubMed database published between January 1995 and December 2009 with key words of “heart surgery, vein transplantation, restenosis, prevention”. Literatures with regard to vein graft transplantation were included. Irrelevant and repetitive contents were excluded. Totally 40 literatures were selected for the further analysis.  RESULTS AND CONCLUSION: Surgical coronary artery bypass graft surgery is the main treatment for the patients suffered from left main coronary artery and severe multi-vessel lesions. However, great saphenous vein is a kind of graft material, and the postoperative restenosis rate is relatively high, which brings a lot of inconvenience for the clinical treatment. This paper summarizes the multiple causes of vein graft lesions and to explore new method for preventing delayed vein graft stenosis from the aspects of conservative treatment, surgery prevention, extravascular stent, drug therapy, gene therapy and laser and radiation therapy. Related Articles | Metrics

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Progress of percutaneous aortic valve replacement Liao Ran, Cheng Ying-zhang 2010, 14 (53):  10017-10020.  doi: 10.3969/j.issn.1673-8225.2010.53.033 Abstract ( 281 )   PDF (294KB) ( 430 )   Save BACKGROUND: Surgical aortic valve replacement is the primary treatment of aortic stenosis. However, percutaneous aortic valve replacement is preferred for patients with old age, multiple co-morbidities and high operative risks. OBJECTIVE: To summarize the application progress of pervutaneous aortic valve replacement in the treatment of cardiovascular diseases. METHODS: The databases of PubMed (http://www.ncbi.nlm.nih.gov/PubMed) and Wanfang (http://www.wanfangdata.com.cn) were retrieved by the first author using key words of “aortic stenosis, percutaneous aortic valve replacement and valve stent”. Repetitive studies were excluded. Totally 63 documents were initially searched, and 25 literatures were included in the further analysis. RESULTS AND CONCLUSION: Since the first percutaneous aortic valve replacement in 2002, valve stents and procedural approaches have got an unprecedented development. However, there are many defects in percutaneous aortic valve replacement, such as valve displacement or perivalvular leakage resulted from poor fixation of valve matrix, thrombosis, aortic insufficiency, and low popular rate. With the improvement of surgical methods and valve development, percutaneous aortic valve replacement would be a good method for patients with aortic stenosis. Related Articles | Metrics

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Effect and mechanism of salvia miltiorrhiza on flap ischemia-reperfusion injury He Zhi, Qiu Shu-lin 2010, 14 (53):  10021-10025.  doi: 10.3969/j.issn.1673-8225.2010.53.034 Abstract ( 412 )   PDF (1277KB) ( 348 )   Save BACKGROUND: The flap ischemia-reperfusion injury is a complex pathophysiological process, but the specific mechanism is not yet clearly. The traditional Chinese medicine Danshen (salvia miltiorrhizae) has a role to reduce ischemia reperfusion injury and the necrosis of skin flap after flap transplanting. OBJECTIVE: To discuss the research progress of salvia miltiorrhizae on protects the flap from ischemia-reperfusion injury. METHODS: Elsevier database and CNKI was retrieved by computer with key words of “salvia miltiorrhizae, flap, ischemia-reperfusion” to search papers published between January 1980 and April 2010. Related papers addressing medical dressings were selected. According to inclusion criteria, 50 literatures were selected in this study. RESULTS AND CONCLUSION: The studies regarding salvia miltiorrhiza preventing and treat heart, liver, brain, kidney, intestines and other organs ischemia-reperfusion injury are more, which shows that salvia miltiorrhiza may be from the cell level, gene level and micro-circulation, through numbers of channels, varieties of mechanisms to reduce ischemia reperfusion injury. But the studies on salvia miltiorrhiza protecting the flaps ischemia-reperfusion injury are fewer, and the exact mechanism is not entirely clear. Thus, the protective effect of salvia miltiorrhiza to flaps’ ischemia-reperfusion injury need to be further explored. Related Articles | Metrics

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Neuroprostheses and neurogenic bladder Yan Peng, Yang Xiao-yu, Gao Qi, Liu Jian, Yang Mao-guang　 2010, 14 (53):  10026-10030.  doi: 10.3969/j.issn.1673-8225.2010.53.035 Abstract ( 330 )   PDF (891KB) ( 406 )   Save BACKGROUND: Due to interrupt of neural pathway after spinal cord injury, bladder loss normal control, and lead to urinary retention or renal damage. The reconstruction of bladder function has been the difficulty of the nervous urology. Neuroprostheses transplantation is considered an effective method to reconstruct functions. OBJECTIVE: To investigate the latest development of neuroprostheses for the treatment of neurogenic bladder after spinal cord injury. METHODS: CNKI and springer database were searched by computer for papers related to neuroprostheses for the treatment of neurogenic bladder after spinal cord injury published from January 1988 to December 2009. In the title and summary, “neuroprostheses, implantion, treat, neurogenic bladder, electrical stimulation” were served as key words. These articles were linked to neuroprostheses transplantation to treat neurogenic bladder and published in the authoritative journal were selected. Totally 44 articles were included according to the inclusive criteria.  RESULTS AND CONCLUSION: At present, there is no significant progress in spinal cord regeneration. Neurolprostheses has become the primary means to reconstruction nerve function. There are two neuroprostheses to treat neurogenic bladder in clinical: one is Finetech-Brindley bladder system, the other is InterStim-Therapy bladder system. In recent years, the launch of four new technology bring revolutionary changes to neurogenic bladder treatment, including: anoda blocking technique, conditional electrical stimulation, injectable neuroprostheses and electrical stimulate the pudendal nerve branches. Related Articles | Metrics

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Progress of tissue-engineered tendon transplantation Zhang Hui-xing, Zhang Ying 2010, 14 (53):  10031-10034.  doi: 10.3969/j.issn.1673-8225.2010.53.036 Abstract ( 309 )   PDF (728KB) ( 301 )   Save BACKGROUND: Tendon transplantation is a major means for reconstructing injured tendon. Currently, autoallergic tendon, allogeneic tendon, xenogeneic allogeneic tendon, artificial tendon, tissue-engineered tendon are widely used with each characteristics. OBJECTIVE: To summarize the treatment progress of currently used tendon transplantations for tendon defects, and to provide theoretical basis for tissue-engineered tendon. METHODS: Databases of PubMed, Wangfang and VIP were searched by the first author using key words of tendon tissue engineering, tendon allograft, transplantation” both in Chinese and English. Inclusive criteria: ①Development history of repair of tendon injury. ②Autoallergic tendon or allogeneic tendon transplantation for tendon injury. ③Animal experiment and clinical application. A total of 30 documents were included in this paper. RESULTS AND CONCLUSION: With the development of tissue engineering, tissue-engineered tendon, which constructed by utilizing cell biology, molecular biology and biological materials, has aroused increasing attention. However, further animal experiment and clinical researches are required to study the rejection, adhesion and prognosis following allogeneic tendon transplantation. Related Articles | Metrics

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Utilization of human fresh amnion transplantation in the treatment of pterygium Tang Guo-fen, Dong Wei-li, Wang Dong-hua, Wang Yue-li 2010, 14 (53):  10035-10038.  doi: 10.3969/j.issn.1673-8225.2010.53.037 Abstract ( 248 )   PDF (331KB) ( 383 )   Save BACKGROUND: The morbidity of pterygium was higher in the north of China. When we used the traditional operation to cut off pterygium, the cornea may shape the astigmatism and recrudesce was higher. Patient may need second treatment or more. OBJECTIVE: To observe the curative effect of human fresh amnion transplantation in treating pterygium. METHODS: A total of 48 cases with pterygium (58 eyes) were randomly divided into the transplantation and traditional operation groups, which were underwent fresh amnion transplantation or simple pterygium excision under a microscope. All cases were followed up for 6-12 months. The recurrence of pterygium and repair of cornea were observed. RESULTS AND CONCLUSION: At the last followed-up visit, 27 eyes were healed and 2 eyes were recurrence in the transplantation group, the recurrence rate was 6%. 25 eyes were healed and 4 eyes were recurrence in the traditional operation group, the recurrence rate was 13%. There were significance differences between two groups (P < 0.05). Transplanting of fresh amnion in the pterygium cutting operation can effectively reduce the recurrence of pterygium, but its long-term effect needs further verified. Related Articles | Metrics

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Treatment for biliary tract stricture through T tube or its fibrous tract following orthotopic liver transplantation Li Hu-cheng, Ao Guo-kun, Du Guo-sheng, Zou Yi-ping, Liu Ji-kui, Chen Fei, Wang Xiao-jun 2010, 14 (53):  10039-10042.  doi: 10.3969/j.issn.1673-8225.2010.53.038 Abstract ( 323 )   PDF (250KB) ( 323 )   Save BACKGROUND: Biliary complication commonly occurred after orthotopic liver transplantation, which is one of the main reasons for failure of transplantation. OBJECTIVE: To discuss feasibility of interventional management through T tube or its fibrous tract for treating biliary tract complications after orthotopic liver transplantation. METHODS: Totally 16 patients suffering biliary tract complications after orthotopic liver transplantation and in totally received 46 times of cholangiography and balloon dilation were included, one of which underwent biliary stent implantation. One patient underwent 11 times of cholangiography and balloon dilation. All patients were followed-up. RESULTS AND CONCLUSION: After biliary balloon dilation, 2 cases of stricture with leaks, 1 cases of biliary anastomotic stricture and 4 cases of multiple strictures were recovered. One multiple stricture patient had a hepatic hematoma after biliary balloon dilation and received a second transplantation. Six cases of multiple strictures with biliary sludge were catabatic. One case of multiple strictures with biliary sludge received the stent treatment, but much sludge blocked the tract and stent. Only one case was not catabatic and received a second transplantation. The interventional management through T tube or its fibrous tract for biliary tract stricture after orthotopic liver transplantation is efficient, convenient, and minimally invasive. It may be an effective way for these complications. However, a second liver transplantation should be performed for parts of patients who had uncontrollable stenosis. Related Articles | Metrics

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Peripheral blood lymphocyte karyotype analysis of 323 female children with short stature in Jiangsu Province Pan Mei, Zhang Xiao-qiong, Li Hua 2010, 14 (53):  10043-10045.  doi: 10.3969/j.issn.1673-8225.2010.53.039 Abstract ( 315 )   PDF (462KB) ( 332 )   Save BACKGROUND: Short stature is very common in pediatrics, which is caused by many reasons, such as polygenetic aspects, chrosomal disease, metabolic disease, endocrine disease, malnutrition and so on. Among them, sex chromosome abnormality is a very important etiologic agent causing short stature in female children. OBJECTIVE: To explore the cytogenetic reason of short female children. METHODS: Karyotype analysis of peripheral blood lymphocytes was performed on 323 female children with short stature, who were recruited at Affiliated Nanjing Children’s Hospital of Nanjing Medical University from September 2007 to September 2009, including 51 children below 6-year-old, 234 children between 6- and 13-year-old, and 38 children more than 13-year-old. RESULTS AND CONCLUSION: In total, 87 cases out of the 323 girls had abnormal chromosome (26.93%). Among them one case was autosome abnormal, and the other 86 cases were X chromosome abnormal (26.6%). Sex chromosome abnormality is a very important etiologic agent causing short stature in female children. This should be highly emphasized by the clinicians. Related Articles | Metrics

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Bladder malignancies following renal transplantation in 4 cases: Literature review Cheng Zhou, Zhu Tong-yu, Xu Ming, Rong Rui-ming, Wang Guo-min 2010, 14 (53):  10046-10048.  doi: 10.3969/j.issn.1673-8225.2010.53.040 Abstract ( 291 )   PDF (187KB) ( 262 )   Save BACKGROUND: The people/renal survival rates have been improved greatly after renal transplantation, however, the long-term utilization of immunosuppressant enlarge the risk of malignancies. OBJECTIVE: Combined with literatures to retrospective analyze the bladder malignancies following renal transplantation in 4 cases. METHODS: Totally 4 cases with bladder malignancies following renal transplantation at the Department of Urinary Surgery, Zhongshan Hospital, Fudan University, from March 2007 to February 2008 were selected. All of them received triple immunosuppressive therapy after renal transplantation, including 3 females; mean aged 52.3 years when first diagnosed as bladder tumor, which was 7.3 years after renal transplantation. The cases were retrospective analyzed combined with literatures. RESULTS AND CONCLUSION: Though bladder malignancy was rare following renal transplantation, it was still aroused increasing attention due to fast progression, easy recurrence and high malignancy. Follow-up for transplantation patients are necessary, ultrasonographic image examination should be performed once yearly, especially for those who appeared gross hematuria or microscopic hematuria. Early diagnosis and active treatment for bladder malignancy play an important role in the long-term survival of patients received renal transplantation. Related Articles | Metrics

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Infusion of bone marrow mesenchymal stem cells through transplanted renal artery in renal transplantation: A 3-case report Xu Lu, Liao De-huai, Chen Zheng, Ma Jun-jie, Li Guang-hui, Fang Jia-li, Du Yang-chun, Bi Wen-hao, Pan Guang-hui 2010, 14 (53):  10049-10052.  doi: 10.3969/j.issn.1673-8225.2010.53.041 Abstract ( 211 )   PDF (759KB) ( 275 )   Save BACKGROUND: Bone marrow mesenchymal stem cells (BMSCs) have emerged as a promising cell population for inducing immune tolerance. Currently, it is difficult to predict which route of administration is going to give the best clinical results for infusion of BMSCs in renal transplantation. Experiments in rats demonstrated that BMSCs injected into the renal artery retain in glomeruli and can reduce glomerulonephritis. No clinical experiments concerning infusion of BMSCs through transplanted renal artery were reported. OBJECTIVE: To investigate the operability of infusing BMSCs directly into the transplanted renal artery. METHODS: Three uremic patients with live donor kidney transplantation from Octobem 2009 to December 2009 were selected. During transplantation procedure, an indwelling needle was fixed at the renal artery stoma, which infusing BMSCs from transplanted renal artery directly to renal allograft when opening blood flow of transplanted kidney. Potential complications and the recovery of transplanted kidney were observed. RESULTS AND CONCLUSION: The course of the operation was smoothly, without complications, such as embolism, infection, rejection and graft-versus-host disease in three months. The results demonstrated that it is feasible to infusion BMSCs to renal transplants from transplanted renal artery, but the long-term complications, such as ectopic differentiation or tumor, need to be further confirmed. Related Articles | Metrics

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Ischemic preconditioning improves hepatic regeneration with reduced injury following reduced-size rat liver transplantation Liu Xian-zhong, Yao Ai-hua, Wang Xuan, Zhong Ji-wei, Li Xiang-cheng 2010, 14 (53):  10053-10057.  doi: 10.3969/j.issn.1673-8225.2010.53.042 Abstract ( 363 )   PDF (394KB) ( 344 )   Save BACKGROUND: Recently, liver transplantation technique has been developed rapidly, and prevention of ischemia/reperfusion injury and protection of liver regeneration have become a research focus. Ischemic preconditioning (IPC) is an effective method for protecting liver ischemic injury. However, the mechanism remains controversial. OBJECTIVE: To investigate the mechanism of IPC on hepatic injury and regeneration after reduced-size rat liver transplantation. METHODS: Animals were randomly divided into 3 groups. Rat reduced-size liver transplantation model was established in liver transplantation group. IPC +liver transplantation group underwent first porta hepatis blocking for 10 minutes before liver graft reperfusion, followed by reperfusion for 15 minutes. The ligament around the liver was dissociated in the sham-surgery group. The samples were collected 0.5, 2, 6 and 24 hours post-operation. The hepatic injury was examined by the serum alanine aminotransferase (ALT) and hepatic tissue histopathology analysis of grafts. Semi-quantitative immunohistochemistry and westernblotting were used to examine the redox factor-1 (Ref-1) protein expression. The hepatic regeneration of the grafts was examined by the expression of proliferating cell nuclear antigen (PCNA) in hepatic cells. RESULTS AND CONCLUSION: Compared with liver transplantation group, the ALT values at 6 and 24 hours after operation in IPC group decreased significantly (P < 0.05; P < 0.01). Pathological analysis indicated that there were lots of inflammation cells around the portal veins, the serious sinus hepaticus dilation and damage of hepatic tissue in liver transplantation group. However, the tissue injury observed in IPC group was comparatively slight. Semi-quantitative immunohistochemistry revealed that Ref-1 protein was more abundant in IPC grafts tissue compared to liver transplantation group. These observations were supported by westernblotting studies where Ref-1 protein was shown to be over-expressed in IPC specimens at 24 hours after reduced-size liver transplantation (P < 0.05). In addition, the number of PCNA-positive cells in IPC group was more than liver transplantation group at 2, 6 and 24 hours after operation (P < 0.05). IPC improves hepatic regeneration and relieves grafts injury in earlier period after reduced-size rat liver transplantation, which is associated with the over-expression of Ref-1 protein. Related Articles | Metrics

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Repair of knee articular cartilage defects using cryopreserved osteochondral allografts Tan Qi, Tian Qing-ye, Liu Guang-jun, Ma Zhen-jie, Li Ai-hua 2010, 14 (53):  10058-10062.  doi: 10.3969/j.issn.1673-8225.2010.53.043 Abstract ( 248 )   PDF (379KB) ( 440 )   Save BACKGROUND: The survival rate of articular chondrocytes is low after traditional cryopreservation, and great differences existed in chondrocytes from surface layer and deep layer, which easily result in graft degeneration and lead to surgery failure. OBJECTIVE: To establish rabbit allograft models of graded frozen articular cartilages with holes made before cryopreservation, and to observe the effect of holed cryopreservation on the rabbit articular cartilages. METHODS: Osteochondral plugs taken aseptically from 2 months old rabbits were randomly divided into 3 groups: the experimental group, making holes (3 mm × 3 mm) in articular cartilages and graded freezing; non-hole graded freezing group, non-making holes and graded freezing; cryopreservation group: non-making holes and rapid freezing. The grafts were thawed and transplanted into the relevant articular cartilage defects of recipient rabbits. The grafts differences were observed by gross observation, histochemistry and immunohistochemistry staining. RESULTS AND CONCLUSION: The gross observation, histochemistry and immunohistochemistry staining of the experimental group were superior to the cryopreservation group. Though there were no significant differences between the non-hole graded freezing group and the experimental group, however, the experimental group enhanced the protective effect on cartilage tissue in the middle layer. The graded cryopreservation of articular cartilage gets an advantage over rapid cryopreservation. And the articular cartilage with holes could be preserved successfully in graded cryopreservation, which assures the survival and function of chondrocytes and slows down degrading process of the articular cartilage tissue after thawed and transplanted. Related Articles | Metrics

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Pneumocystis carinii pneumonia following renal transplantation A retrospective study of 36 cases Liu Yong-guang, Guo Ying, Li Min, Yue Liang-sheng, Li Liu-yang, Zhao Ming 2010, 14 (53):  10063-10066.  doi: 10.3969/j.issn.1673-8225.2010.53.044 Abstract ( 335 )   PDF (204KB) ( 350 )   Save BACKGROUND: Pneumocystis carinii pneumonia (PCP) is a severe and life-threatening complication in renal transplantation patients. It is associated with high mortality, occult onset and rapid progression, so the clinicians who care organ transplant patients need in-depth study and understanding the law of occurrence, development and therapy of the disease to achieve the better outcome. OBJECTIVE: To retrospective analyze the etiopathogenisis, clinical characteristics, diagnosis, as well as the prognoses of PCP in renal transplant recipients. METHODS: A total of 36 patients who suffered complication of PCP after renal transplantation in the Organ Transplantation Center, Zhujiang Hospital, were retrospective analyzed. The general information of cases, clinical manifestation, therapeutic regimen, and prognoses were analyzed. The diagnosis and intervention measures were summarized. RESULTS AND CONCLUSION: Among 36 patients, 22 were male and 14 were female. Three patients died of complicated acute respiratory distress syndrome, the rest were cured with good renal graft functions. Among 36 PCP patients, 31 cases were occurred within 6 months, and 5 in 7-18 months. Pneumocystis carinii was examined in bronchoalveloar lavage fluid or lung tissues of 15 cases (41.7%), which was not be checked out in the other 21 cases. Most of patients were cured and the transplanted renal function was well after reducing immunosuppressive agent doses, administrating compound sulfamethoxazole and supportive treatment. The findings demonstrated that PCP common occurred with 6 months after renal transplantation, with typical clinical symptom but indiscoverable pathogen. Its early stage diagnosis was based on clinical history, symptom, and image examination. Among organ transplantation cases, PCP is a severe opportunistic infection, but with early diagnosis and proper treatment the prognosis remains good. Related Articles | Metrics

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Sequential bilateral lobar transplantation A case report Zhang Zhen-rong, Liu De-ruo, Guo Yong-qing, Shi Bin, Song Zhi-yi, Tian Yan-chu, Shou Yan-ning, Liang Chao-yang, Zhang Hai-tao, Chen Jing-yu, Wang Zai-yong, Bao Tong, Ma Qian-li,Qiang Guang-liang, Fen 2010, 14 (53):  10067-10070.  doi: 10.3969/j.issn.1673-8225.2010.53.045 Abstract ( 320 )   PDF (197KB) ( 310 )   Save BACKGROUND: Lung transplantation can improve quality of life of patients who get terminal pulmonary disease and also it can help to get better survival. Now it has become one of the best therapeutic methods for terminal pulmonary disease. However, limited donors leave the development of lung transplantation in dilemma. The emergence of living lobar transplantation and cadeveric lobar transplantation let this procedure much easier. OBJECTIVE: To evaluate the clinical probability of bilateral lobar transplantation. METHODS: Sequential bilateral lobar transplantation was performed for one 26 years old cystic fibrosis female. Cardiac pulmonary bypass was used during operation. Anti-rejection (Tacrolimus, mycophenolate, etc) and anti-infection was used postoperatively. RESULTS AND CONCLUSION: The recovery course postoperatively was smooth, and the recipient got out of hospital 7 weeks later. Bilateral lobar transplantation could offer satisfied short-term pulmonary function. The long term results should be further evaluated. Related Articles | Metrics