26, 27 Liver is a sinusoid-enriched organ and thus may contain niche cells capable of sustaining HSCs. Still, in this study, the formal possibility cannot be excluded that these cells were blood HSPCs adherent to ABT-888 datasheet the endovascular compartment of the liver, which could not be perfused out. Moreover, after LT, either donor HSPCs generate mature HSCs inside grafted liver or circulate to recipient BM for hematopoiesis. These possibilities remain to be determined in future studies. The authors thank the Liver Transplantation Center at Queen Mary hospital of the University of Hong
Kong for outstanding clinical liver transplantation care. The authors also thank Ms. Kammy Yik, Banny Lam, and Waiyee Ho for data organization of LT donors and recipients. The authors also thank Dr. Mo Yang at the Department of Pediatrics and Adolescent Medicine of the University of Hong Kong for his useful help on the experiment. The authors also thank Ms Amy Lam Ixazomib and Mr. Jimmy Chen of Applied Biosystems for their technical support. “
“Surgery in the patient
with cirrhosis is problematic, as encephalopathy, ascites, sepsis and bleeding are common in the postoperative period. Accurate preoperative assessment and planning, and careful postoperative management have the potential to reduce the frequency and severity of such complications, and reduce the length of hospital stay, but there is little literature evidence to prove this. Operative mortality and other risks correlate
with the severity of the liver disease, co-morbidities and the type of surgery. The Child-Turcott-Pugh 上海皓元 (CTP) score or model for end-stage liver disease (MELD) score may be used to determine the severity of the liver disease, but must also take into account recent changes in the patient’s condition. Surgery that does not involve opening the peritoneum may have slightly better outcomes, as the risk of ascitic leak, sepsis and difficult fluid management are reduced. Mortality rates range from 10% in CTP-A patients to 82% in CTP-C patients. The presence of portal hypertension is an important negative predictor, especially in abdominal surgery, as refractory ascites may occur. Careful monitoring in the postoperative period and early intervention of complications are essential. Hepatic resections in cirrhosis are associated with other considerations such as leaving sufficient liver tissue to prevent liver failure, and are beyond the scope of this review. Surgical procedures in patients with liver cirrhosis carry a significant risk of complications and have a high mortality. Accurate preoperative risk stratification can be difficult, and occasionally the patient is only found to have cirrhosis at the time of surgery. Even when the patient has previously diagnosed liver disease, the severity may easily be miscalculated as many of the tools we use are imprecise. The literature in this field is sparse, and outdated with respect to contemporary surgical technology.