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Tan Y.-L.,Capital Medical University | Bai Z.-G.,Capital Medical University | Zou W.-L.,Organ Transplantation Institute | Ma X.-M.,Capital Medical University | And 7 more authors.
Clinics and Research in Hepatology and Gastroenterology

Identification of new biomarkers for aggressiveness of hepatocellular carcinoma (HCC) to supplement the current group of prognosis algorithms is a significant clinical need. To clarify expression levels of microRNA-744 (miR-744) in HCC tissues and to explore its clinicopathological significance in HCC patients following liver transplantation (LT), we quantified miR-744 using real-time quantitative reverse transcription polymerase chain reaction in 96 paired cancerous tissues and para-cancerous normal liver tissues. We investigated relationships among miR-744 expression, clinicopathological parameters, and overall survival (OS). Of 96 paired samples, 68 cancer tissues expressed low miR-744 compared with their matched normal liver tissues. Patients with microvascular invasion or multi-tumor nodules showed significantly lower miR-744 expression; miR-744 was further decreased in patients with post-LT HCC recurrence compared with non-recurring patients. Patients with lower miR-744 expression showed significantly poorer recurrence-free survival and OS than individuals with higher miR-744 levels. Multivariate analysis revealed that lower miR-744 was an independent predictor of poor prognosis. Our results associate decreased miR-744 expression with HCC recurrence and prognosis, and also suggest that miR-744 is an independent predictor of survival in HCC patients after LT and may therefore be a potential biomarker for their prognosis. © 2014. Source

Wang J.,Organ Transplantation Institute | Wang Q.-H.,Organ Transplantation Institute | Xia T.,Chinese University of Hong Kong | Tan J.-M.,Organ Transplantation Institute
Chinese Medical Journal

Up till 2000 when Edmonton group introduced islet transplant procedure in conjunction with a novel glucocorticoid-free immunosuppressive regimen rendering 100% (n=7) of patients with type 1 diabetes insulin-independent for at least 1 year, islet transplant was taken into the clinic. Although significant progress in clinical islet transplant has occurred during recent years, challenges remain, including shortage of available donor organs, technical aspects of islet preparation and transplantation, immunological rejection post-transplant, unclear long-term outcomes of islet transplantation. Special attention is given to current limitation in islet transplantation together with new possible strategies that raise expectations for the widespread use of islet transplantation in the future. Source

Yang S.-L.,Organ Transplantation Institute | Gao X.,Organ Transplantation Institute | Wang Q.-H.,Organ Transplantation Institute | Cai J.-Q.,Organ Transplantation Institute | And 4 more authors.
National Medical Journal of China

Objective: To establish a formula for estimating area under the concentration-versus-time curve (AUC) of mycophenolate sodium in Chinese renal allograft recipients with a limited sampling model. Methods: A total of 35 renal allograft recipients were recruited from 2010 to 2013 to receive enteric-coated mycophenolate sodium (EC-MPS), calcineurin (CNI) and prednisone as immunosuppressive triple therapy. The serum concentration of mycophenolic acid (MPA) was assayed by enzyme multiplied immunoassay technique (EMIT) at pre-dose (C0), 0.5 (C0.5), 1.0 (C1), 1.5 (C1.5), 2.0 (C2), 3.0 (C3), 4.0 (C4), 6.0 (C6), 8.0 (C8) and 12.0 (C12) h post-dose respectively. Pharmacokinetic parameters of MPA (C0, C12, Cmax, Tmax, AUC0-12h) were calculated by software WINNOLIN. Simplified formulae for estimation of MPA-AUC in tacrolimus (Tac) group or cyclosporin A (CsA) group were established by multiple stepwise regression analysis. Results: There were variable MPA AUC0-12 h levels between 14 and 67 mg · h/L (mean: 37 ±14). The MPA trough level (C0) had no correlations with MPA AUC0-12h(r2=0.090). The simplified MPA AUC formula for Tac group was AUC=5.678 + 1.718 × C4 + 2.853 × C6 +1.812 × C8 + 3.413 × C12 with four sampling points (C4, C6, C8, C12). Estimated AUC with the formula had correlations with AUC0-12 h(r=0.890). The mean absolute predict error (APE) was 3.45% (0.41% -24.71%) and the proportion of APE above 15% stood at 11.1% (2/18). In CsA group, the simplified MPA AUC formula was AUC=1.072 + 1.525 × C3 + 1.558 × C4 + 1.573 × C6 + 2.285 × C8. The correlation was r=0.952, mean APE was 6.50% (0.02%-12.91%) and proportion of APE above 15% stood at 0. The above formulae were observed to have agreement with AUC0-12h by Bland-Altman analysis. Conclusion: The simplified MPA AUC formulae with 4-point sampling provide an effective approach for estimating full MPA AUC0-12h in Chinese renal recipients on EC-MPS plus tacrolimus or cyclosporin A. Copyright © 2013 by the Chinese Medical Association. Source

Niu Y.,Organ Transplantation Institute | Chen X.,Organ Transplantation Institute | Feng L.,Capital Medical University | You H.,Capital Medical University | And 5 more authors.
Clinics and Research in Hepatology and Gastroenterology

Background: The use of serum anti-hepatitis B core antibody (HBc)-positive/hepatitis B surface antigen (HBsAg)-negative liver donors for patients with hepatitis B virus (HBV)-related liver disease (HBRLD) is a promising means of expanding the organ donor pool and does not increase the risk of HBV recurrence. However, whether such donors will compromise the histology of the liver grafts is unclear. Methods: Among 84 patients who underwent transplantation for HBRLD and who did not have post-transplant HBV recurrence (non-detectable serum HBsAg and HBV DNA), 19 underwent liver biopsy (eight received anti-HBc-positive/HBsAg-negative liver grafts; 11 received anti-HBc-negative liver grafts) and were included in the study. Intrahepatic total HBV DNA and covalently closed circular DNA (cccDNA) were detected using real-time polymerase chain reaction; histological characteristics were evaluated with the Batts-Ludwig semi-quantitative scoring system. Result: Of the 19 recipients, nine (47.4%) were positive for intrahepatic HBV DNA; 82.5% (7/8) received grafts from anti-HBc-positive donors and 18.2% (2/11) received grafts from anti-HBc-negative donors (P= 0.003). HBV cccDNA was not detectable in the liver grafts of the 19 recipients. Ten patients had mild inflammation and minimal fibrosis in the portal area: four of the eight in the anti-HBc-positive group and six of the 11 in the anti-HBc-negative group (P> 0.05). Conclusion: Anti-HBc-positive/HBsAg-negative donors for HBRLD pose a higher risk of occult HBV infection post-liver transplant but do not cause liver damage. Thus, anti-HBc-positive grafts may be considered an effective and safe means of expanding the pool of liver donors for patients with HBRLD. © 2014 Elsevier Masson SAS. Source

Hou Y.-H.,The 309th Hospital of Chinese PLA | Zhao S.-Y.,Organ Transplantation Institute | Qi Q.,The 309th Hospital of Chinese PLA | Liu L.-H.,Organ Transplantation Institute | And 11 more authors.
Chinese Journal of Tissue Engineering Research

BACKGROUND: Currently, hematopoietic stem cell transplantation mainly depends on unrelated donors. Mental state of the unrelated donors is very important to ensure the successful cell transplantation. OBJECTIVE: To compare mental and physical health status of relative and unrelated donors during the hematopoietic stem cell collection. METHODS: We compared the mental (Symptom Checklist-90) and physical (temperature, breath, pulse, and blood pressure) health status of relative and unrelated donors at admission, 1 day before cell collection, and 1-2 days after cell collection. RESULTS AND CONCLUSION: At admission, there was no difference in the mental health status of relative and unrelated donors (P > 0.05), while the scores on Symptom Checklist-90 were significantly higher in the unrelated donors than the relative donors, including total score, forced, depression, anxiety, hostility, and fear (P < 0.05). The physical signs were steady in the unrelated and relative donors, but the difference in breath and systolic blood pressure was of great significance before and after cell collection in the two groups. These findings indicate that during cell collection, the unrelated donors exhibit heavier mental load than the relative donors, and psychological counseling and health guidance are necessary. Source

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