器官移植

2017 Vol. 8, No. 3

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Clinical Researches

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Editorials

2017, 8(3): 181-185. doi: 10.3969/j.issn.l674-7445.2017.03.001

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2017, 8(3): 186-189. doi: 10.3969/j.issn.1674-7445.2017.03.002

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Original Articles

Effect of different transplantation approaches of human umbilical cord menchymal stem cells on repairing hepatic ischemia-reperfusion injury in rat models

Gu Shijie, Chen Yunhao, Zhao Hui, , Liu Wei, , Yi Shuhong

2017, 8(3): 190-194, 231. doi: 10.3969/j.issn.1674-7445.2017.03.003

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Objective To investigate the effect of different transplantation approaches of human umbilical cord menchymal stem cells (HU-MSCs) on repairing hepatic ischemia-reperfusion injury (HIRI) in rat models. Methods Forty male SD rats were randomly divided into the A (control group), B (model group), C (portal vein transplantation of MSCs group) and D (tail vein transplantation of MSCs group) groups (n=10 for each group). In the B, C and D groups, HIRI rat models were established by Pringle maneuver. MSC transplantation was not delivered in the B group, and chloromethyl-benzamidodialkylcarbocyanine (CM-DiL) labeled-HU-MSCs (10⁶) were transplanted via portal vein or tail vein in the C or D groups. Blood samples were collected for detection of the expression levels of alanine aminotransferase(ALT) and tumor necrosis factor (TNF)-α before and 1, 3 and 5 d after transplantation. At 5 d post-transplantation, all rats in each group were sacrificed. The liver tissues were prepared for hematoxylin-eosin (HE) and terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling(TUNEL) staining for evaluation of liver injury. The distribution of HU-MSCs in the rat liver in each group was observed under laser confocal microscope. Results After HU-MSCs transplantation, the expression levels of ALT in the C and D groups were significantly down-regulated compared with that in the B group, and the level of ALT in the C group was significantly lower than that in the D group (all P < 0.05). The expression levels of inflammatory cytokine TNF-α in the C and D groups were significantly lower than that in the B group and the TNF-α level in the C group was considerably lower than that in the D group (all P < 0.05). HE staining of the liver tissue prompted that the liver injury was the most severe in the B group, and the liver injury in the C group was less severe compared with that in the D group. TUNEL staining of the liver tissue revealed that the apoptosis index (AI) in the C and D groups was significantly lower than that in the B group, and the AI in the C group was significantly lower compared with that in the D group (all P < 0.05). Under laser confocal microscope, CM-DiL-labeled HU-MSCs were noted in the C and D groups after transplantation, and the quantity of HU-MSCs in the C group was significantly higher than that in the D group (all P < 0.05). Conclusion Transplantation of HU-MSCs can mitigate the severity of HIRI. And transplantation via portal vein transplantation yields higher clinical efficacy compared with the tail vein route.

Effect of azitromycin on Th17/Treg balance in bronchiolitis obliterans mice after lung transplantation

Yang Zhenkun, Li Huixing, Wang Wei, Zhao Jingjing, Wei Dong, Chen Jingyu

2017, 8(3): 195-199. doi: 10.3969/j.issn.1674-7445.2017.03.004

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Objective To evaluate the effect of azitromycin upon the bronchiolitis obliterans and T helper (Th)17/regulatory T cell (Treg) balance after lung transplantation. Methods Twenty-four specific pathogen free(SPF) C57BL/6 mice were used as the donors and 48 Balb/c mice were utilized as the recipients. The Balb/c mice were randomly divided into the control (C group), azitromycin control (Cazm group), transplantation (T group) and transplantation + azitromycin groups (Tazm group), 12 mice in each group. In the T and Tazm groups, heterotopic tracheal transplantation models were established to simulate bronchiolitis obliterans after lung transplantation. From 1 d post-transplantation, intragastric administration of azitromycin was given at a dose of 30 mg/kg three times per week in the Cazm and Tazm groups. At 14 and 28 d after transplantation, the transplanted trachea was removed and peripheral blood was collected. The tracheal sample was prepared for hematoxylin-eosin (HE) staining for pathological observation. The expression levels of ROR-t and Foxp3 messenger ribonucleic acid (mRNA) in the peripheral blood were quantitatively measured by reverse transcription polymerase chain reaction (RT-PCR). The variation in the related cytokines levels of Th17 cells and Treg in the plasma was detected by enzyme linked immunosorbent assay (ELISA). Results After heterotopic tracheal transplantation, compared with the C group, the tracheal occlusion accompanied with inflammatory infiltration was observed in the T and Tazm groups. The severity of relevant symptoms in the Tazm group was slighter than that in the T group. Compared with the T group, the expression level of ROR-γt mRNA in the Tazm group was significantly down-regulated (P < 0.05). No statistical significance was identified in the expression of Foxp3 mRNA between two groups (P>0.05). Compared with the T group, the levels of interleukin (IL)-6 and IL-17 cytokines in the Tazm group were significantly down-regulated (all P < 0.05). Conclusion Persistent therapy of azitromycin can delay the progression of bronchiolitis obliterans after transplantation, which is probably associated with inhibiting Th17 cell differentiation and inflammation.

Establishment of male rat models for fertility after liver transplantation

Chen Xiaolong, Wang Genshu, Zhang Junbin, Lin Guoli, Feng Zhiying, Jin Hai, Yang Jianxu

2017, 8(3): 200-204. doi: 10.3969/j.issn.1674-7445.2017.03.005

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Objective To establish male rat models for fertility following liver transplantation. Methods Male Sprague-Dawley (SD) rats were used as the donors and recipients of liver transplantation. The donor liver was transplanted with two-cuff technique. Liver transplantation was performed in 15 male SD rats. At 3 weeks after liver transplantation, 5 rats were randomly sacrificed for detection of sperm deformity rate. The remaining male rats were mixed bred and mated with healthy female SD rats at a ratio of 1︰2. General conditions of the rats undergoing liver transplantation were recorded. Liver function parameters were detected after liver transplantation. Postoperative sperm deformity rate was observed. The pregnant status of female rats and health situation of their offsprings was monitored. Results All 15 rats (100%) underwent liver transplantation successfully. Nine rats (9/10) survived longer than 8 weeks. Liver function parameters were normal in male rats following liver transplantation. The sperm deformity rate was ranged from 0.5% to 1.3%. Ten male rats undergoing liver transplantation were mixed bred with female rats at a ratio of 1︰2 for 1 week. All female rats were successfully mated and delivered their offsprings after 3 weeks. The offsprings had no evident physiological deformity. Conclusion Male rat models for fertility are successfully established after liver transplantation, which serve as an animal model to evaluate the fertility performance in male patients undergoing liver transplantation.

Study on variation characteristics of anti-donor specific antibodies in different species of sensitized mice after skin transplantation

Liao Tao, Zhao Daqiang, Li Siwen, Han Fei, Luo Zihuan, Liu Xiaonan, Sun Qiquan

2017, 8(3): 205-208. doi: 10.3969/j.issn.1674-7445.2017.03.006

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Objective To compare the change features of anti-donor specific antibody (DSA) in different species of sentitized mice after skin transplantation. Methods All mice were divided into the Balb/c→C57BL/6 (6 pairs) and Balb/c→C3H skin transplantation groups (6 pairs). At d0, d2, d4, d7, d13, d17, d28, d35, d42, d49 and d56 after skin transplantation, the serum sample was prepared for detection of DSA-IgG and DSA-IgM levels. Results Moderate increase was noted in the DSA-IgG level in the sensitized mice within 1 week after skin transplantation. The IgG level was significantly increased within 1-4 week and peaked and stabilized within 4-8 week. No significant variation was observed in the DSA-IgM level at 8 weeks after skin transplantation. In the Balb/c→C57BL/6 skin transplantation group, the DSA-IgG level was significantly lower than that in the Balb/c→C3H group. Statistical significance was identified in the IgG levels between two groups at d2, d17, d28, d35, d42, d49 and d56 after skin transplantation (all P < 0.05). No statistical significance was noted in the DSA-IgM levels between two groups at each time point (all P>0.05). Conclusion Advancing the time of renal transplantation after skin transplantation moderately in the Balb/c→C3H group, or changing to the lower immunoreactive combination of Balb/c→C57BL/6 are aimed to establish AMR mouse models with mild rejection reaction.

MicroRNA-101 inhibits epithelial-mesenchymal transition in human liver carcinoma MHCC97H cells via USP22

Bao Jie, Zhang Juan, Wang Jing

2017, 8(3): 209-214. doi: 10.3969/j.issn.1674-7445.2017.03.007

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Objective To investigate the effect and underlying mechanism of micro ribonucleic acid (miR)-101 on the epithelial-mesenchymal transition in human hepatocellular carcinoma MHCC97H cells. Methods MHCC97H cell lines were transfected with miR-101 mimics (M101 group) and negative control mimic (NCM group), and the cell lines without transfection were used as the control group. The expression levels of miR-101 in cells of 3 groups were quantitatively measured using reverse transcription polymerase chain reaction (RT-PCR). Transwell assay was performed to evaluate the cell migration and invasion ability of 3 groups. The expression levels of vimentin, -catenin, E-cadherin and USP22 proteins in cells of 3 groups were measured by Western blot. The relationship between miR-101 and USP22 was analyzed by dual-luciferase assay. Results In the M101 group, the expression level of miR-101 was significantly up-regulated, which was approximately 761 times of that in the control group (P < 0.05). In the M101 group, the quantity of migrating cells was 15.7±1.6, significantly lower than 94.1±1.8 in the control group (P < 0.05). In the M101 group, the quantity of invasive cells was 9.1±0.4, significantly lower compared with 51.6±0.9 in the control group (P < 0.05). In the M101 group, the expression levels of vimentin and USP22 protein were significantly down-regulated, whereas the expression levels of -catenin and E-cadherin protein were significantly up-regulated. Dual-luciferase assay revealed that USP22 was the target gene of the downstream miR-101 signaling pathway. Conclusion miR-101 regulates the expression of epithelial-mesenchymal transition-related proteins and suppresses the epithelial-mesenchymal transition of hepatocellular carcinoma MHCC97H cells probably through down-regulating the expression level of USP22.

Clinical Researches

Analysis of risk factors of herpes zoster after renal transplantation in a single center

He Tenghui, Qian Yeyong, Fan Yu, Li Gang, Xie Junjie

2017, 8(3): 215-219. doi: 10.3969/j.issn.1674-7445.2017.03.008

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Objective To investigate the clinical characteristics and risk factors of the incidence of herpes zoster after renal transplantation. Methods Clinical data of 830 recipients undergoing renal transplantation for the first time in the Organ Transplantation Research Institute of the 309th Hospital of Chinese People's Liberation Army from March 2009 to March 2012 were retrospectively analyzed. Univariate and multivariate Logistic regression analyses were performed to identify the risk factors of the incidence of herpes zoster after renal transplantation. Results Among 830 patients, 42 (5.1%) suffered from herpes zoster postoperatively. Clinical manifestations of herpes zoster mainly included varicella-zoster rash in the head, face, trunk and limbs. No patient died from herpes zoster. Post-herpetic neuralgia (PHN) was the most common complication of herpes zoster. Univariate Logistic regression analysis revealed that advanced age and adrenal cortical hormone (hormone) shock therapy could increase the risk of herpes zoster viral infection after renal transplantation (OR=2.414, P=0.016; OR=2.936, P=0.003). Multivariate Logistic regression analysis demonstrated that advanced age and hormone shock therapy were the independent risk factor of the incidence of herpes zoster following renal transplantation (OR=2.238, P=0.030; OR=2.755, P=0.005). Conclusions Herpes zoster after renal transplantation is clinically manifested with varicella-zoster rash. Advanced age and hormone shock therapy are the independent risk factor of the incidence of herpes zoster after renal transplantation.

Empirical treatment of nontuberculosis mycobacterium infection after liver transplantation: one case report and literature

Mao Jiaxi, Zou You, Guo Wenyuan

2017, 8(3): 220-224. doi: 10.3969/j.issn.1674-7445.2017.03.009

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Objective To summarize the clinical experience of diagnosis and treatment of nontuberculosis mycobacterium (NTM) infection after liver transplantation. Methods Clinical experience of effective treatment of 1 case with NTM at 7th month after liver transplantation at the Shanghai Changzheng Hospital affiliated to the Second Military Medical University was summarized and literature review was performed. Results Following liver transplantation, the NTM patient was clinically manifested with fever in the afternoon. CT scan prompted the progression of the disease. The lesions were enlarged and fused with thin-walled cavity in the right upper lung. The diagnosis of NTM infection was validated by fiberoptic bronchoscopy (brush or lavage approach), spot test of T cells infected with mycobacterium tuberculosis (T-SPOT.TB), multiple phlegm culture and empirical anti-tuberculosis therapy. The patient was effectively treated and successfully discharged after diagnostic quadruple anti-tuberculosis therapy. The patient was followed up until the day of manuscript submission. The patient was physically stable without the symptoms of fever and cough with asthma. The liver function was normal. Conclusions The incidence of NTM infection is rare and inneglectable after liver transplantation. Application of fibrobronchoscopy via brush or lavage approach can enhance the positive diagnostic rate. Diagnostic quadruple anti-tuberculosis therapy is efficacious for NTM infection.

Effect of preoperative hyperbaric oxygen therapy on the incidence of hypoxemia after renal transplantation

Xia Yang, Fan Mingqi, Huang Chibing

2017, 8(3): 225-228. doi: 10.3969/j.issn.1674-7445.2017.03.010

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Objective To investigate the effect of preoperative hyperbaric oxygen therapy upon the incidence of hypoxemia in patients after renal transplantation. Methods In the experimental group, 55 patients received hyperbaric oxygen therapy prior to renal transplantation, and 66 counterparts in the control group underwent conventional renal transplantation. Postoperatively, the incidence of hypoxemia, pulmonary infection, time of in-bed oxygen inhalation and length of hospital stay were statistically compared between two groups. Results In the experimental group, 12 among 55 patients (22%) presented with hypoxemia after renal transplantation, and 20 of 66 (30%) in the control group. In the experimental group, 4 cases suffered from pulmonary infection with an incidence of 7%, and 14 (21%) in the control group. In the experimental group, the incidences of hypoxemia and pulmonary infection were lower than those in the control group (both P < 0.05). In the experimental group, the time of in-bed oxygen inhalation and length of hospital stay were (5.9±2.0) d and (17.7±3.7) d, significantly shorter compared with (6.8±2.6) d and (20.5±4.2) d in the control group (both P < 0.05). Conclusions Prior to renal transplantation, hyperbaric oxygen therapy can significantly reduce the risk of hypoxemia and pulmonary infection after renal transplantation, which can be served as a conventional preventive measure against the incidence of hypoxemia following renal transplantation.