Use of livers infected with Clonorchis sinensis as donor organs for transplantation is controversial because of the potential associated risks. The low availability of donor livers at Tianjin First Center Hospital since 2003 prompted us to undertake cadaveric liver transplantation in 14 patients using donor livers infected with C. sinensis. None of the donors had been diagnosed with liver fluke infection before organ procurement, and in none of them was there laboratory evidence of abnormal liver function. After livers had been harvested and preserved, dead liver flukes were found in the bile of each donor; subsequent pathological examination of the flukes confirmed the diagnosis of clonorchiasis. Conventional orthotopic liver transplantation, with insertion of a T- tube, was undertaken in all 14 patients. Praziquantel, 25 mg/kg three times daily for two days, was administrated to the recipients starting on postoperative day 2. Results of tests of liver function improved rapidly after the operation in all of the patients. The median duration of follow-up was 31 months. The 1- and 3-year survival rates of the grafts were 85.7% and 78.6%, respectively. Postoperative biliary complications occurred in 2 patients (14.3%). No ova were detected in the bile or feces of any of the patients postoperatively. These findings suggest that livers infested with C. sinensis can be used as donor organs for liver transplantation. Further studies are required to establish definitive criteria for determining whether such donor organs may be used in a liver transplantation program.

Objective:To explore the pathogenesis and prognostic factors of brain metastasis of hepatocellular carcinoma(HCC)after liver transplantation(LT).Methods:Retrospective review was performed for 17 HCC cases with brain metastasis after liver transplantation from 2000 to 2020.All cases were diagnosed as hepatitis B cirrhosis complicated with HCC.All of them were beyond the Milan Criteria.The immunosuppressive regimen consisted of baliximab + mycophenolate mofetil + calcineurin inhibitors(CNIs)+ corticosteroids in early postoperative period with a gradual tapering of corticosteroids and mycophenolate mofetil.Three patients received sirolimus immunotherapy after tumor recurrence and withdrew CNIs.One of three cases received sorafenib.Results:Other organ involvements included lung metastasis( n=16, 94.1%), bone metastasis( n=5, 29.4%)and liver metastasis( n=6, 35.3%). The median survival time after brain metastasis was 7 months and the 1-year cumulative survival rate 29.4%.The median survival time post-LT was 14 months and the 1-year cumulative survival rate 64.7%.Among 7 patients with a resection of brain metastasis, two deaths at Month 1 post-operation were due to cerebral hemorrhage.The longest survival time was 214 months and the median survival time 9 months. Conclusions:The prognosis of brain metastasis post-LT remains poor.However, early detection and reasonable treatment can prolong patient survival time and even achieve long-term survival.Most brain metastases are accompanied by lung metastases.And the finding of lung metastatic tumor hints at a presence of intracranial lesions.

OBJECTIVE:To review the development of adult and pediatric liver transplantation in Tianjin First Center Hospital, and to enhance academic exchanges, improve technological innovation, and jointly promote the progress and maturity in the field of liver transplantation.METHODS:The development of liver transplantation in Tianjin First Center Hospital was analyzed. The clinical data of adult and pediatric liver transplantation from September 1998 to September 2018 were collected. The important events and technological innovation achievements of liver transplantation during the 20 years were summarized.RESULTS:The first clinical liver transplantation was attempted in Tianjin First Central Hospital in April 1980. The first long-term survival adult liver transplantation in China was completed in 1994 (11 years survival after the operation). The specialized team of liver transplantation was formally established in September 1998. The 20-year clinical exploration and progress reflected the characteristics of era changes and technological innovation during the rapid development of liver transplantation in China. Our center performed liver re-transplantation in January 1999, reduced-size pediatric liver transplantation in August 2000. In May 2001, we organized the formulation for the preventive and treatment plan for hepatitis B recurrence after liver transplantation. We performed combined liver and kidney transplantation in July 2002, split liver transplantation (SLT) in April 2004, the first domino liver transplantation (DLT) in August 2005. Pediatric living donor liver transplantation (LDLT) was initiated in October 2006, adult LDLT was carried out in August 2007. In September 2007, the first living donor combined liver and kidney transplantation from the same donor in Asia was performed. The first domino+living donor double grafts liver transplantation in the world was performed in January 2009. In March 2011, we performed laparoscopically assisted right hepatic lobe liver transplantation (LDLT) with middle hepatic vein. In May 2014, living donor laparoscopic left lateral lobe procurement was successfully established. In April 2016, simultaneous liver, pancreas and kidney multi-organ transplantation was completed. Domino donor-auxiliary liver transplantation was performed in February 2017. In December 2017, extracorporeal membrane oxygenation (ECMO)-supported liver transplantation in a patient with severe pulmonary hypertension was successfully completed. Liver transplantation combined with partial splenectomy was established in April 2018. Cross-domino liver transplantation (hypersensitive kidney transplantation with auxiliary liver transplantation+pediatric liver transplantation) was performed in May 2018. During the 20 years, the team has performed or assisted other centers in Beijing, Shanghai, Guangzhou and Shenzhen to carry out more than 10 000 cases of liver transplantations. A total of 7 043 cases of various types of liver transplantation were performed in the single center of the hospital (6 005 adult liver transplantations and 1 038 pediatric liver transplantations). Concerning adult liver transplantation, the cumulative 1-year, 3-year and 5-year survival rate from September 1998 to March 2003 were 83.1%, 73.0% and 69.0%, from April 2003 to March 2009 were 85.3%, 76.2% and 72.1% and from April 2009 to September 2018 were 87.5%, 79.2% and 75.1%, respectively. The cumulative 1-year, 3-year and 5-year survival rate for pediatric liver transplantation were 93.5%, 92.2% and 90.2%, respectively. The nucleoside (acid) analogue combined with low dose hepatitis B immunoglobulin (HBIG) was developed to prevent the recurrence of hepatitis B after liver transplantation, this plan has reduced the recurrence rate of hepatitis B and the 5-year re-infection rate of hepatitis B virus (HBV) after liver transplantation significantly. The risk assessment system for tumor recurrence after liver transplantation was established and individual treatment method was established based on this assessment system. Continuous exploration and improvement of liver transplantation for liver cancer, liver re-transplantation, liver transplantation with portal vein thrombosis, SLT, DLT and multi-organ combined transplantation have significantly improved the clinical efficacy of patients and the post-operative survival rate.CONCLUSIONS:The liver transplantation team of Tianjin First Center Hospital has carried out a scientific and technological exploration on the key problems and technical difficulties of clinical liver transplantation. This work strongly has initiated and promoted the rapid development of liver transplantation in China. The restrictive barrier of hepatitis B recurrence after liver transplantation has been overcome. The risk prevention and control system of tumor recurrence after liver transplantation has been established. A series of innovative achievements that can be popularized have been achieved in the field of complex liver transplantation and expansion of donor liver source. The iterative progress and sustainable development of liver transplantation have been realized.

1 病例资料 患者,男,2004年10月因胰岛细胞癌行胰体尾切除术+脾切除术,术后病理证实胰岛细胞癌,术后规律随访.2008年3月因肿瘤复发肝转移于天津市第一中心医院进行术前评估,未发现肝外转移证据,并行肝移植手术,术后恢复顺利.术后规律随访,肝移植术后4年半发现肝脏左叶占位,考虑肿瘤复发,并于2012年10月行肝左外叶切除术,术后恢复顺利.2014年1月发现肿瘤纵膈转移并行肿物切除手术,术后病理证实为原发病复发.2016年复查发现纵隔肿瘤再次复发并切除.自2017年10月患者因肿瘤多次行放化疗治疗,并于2018年2月行PD-1治疗3个月,效果不佳,并出现肝功能衰竭表现.入我院评估,为挽救患者生命,于2018年6月行再次肝移植手术,术后肝脏功能恢复不良,表现为酶学、胆红素上涨,胆汁量少性状可.术后CT显示肝脏大面积低灌注区域,部分肝坏死.考虑供肝灌注不良导致肝脏部分坏死.经过改善微循环以及移植术后常规治疗,患者术后5周后复查CT提示肝脏低灌注区域消失,同时肝功能恢复正常,随访存活至今.

The rat orthotopic liver transplantation model with extremely short anhepatic phase was established to study its protective effect on the recipients and graft. One hundred fifty adult male Wistar rats were randomly divided into three groups: group A (n = 30), using magnetic rings for the suprahepatic vena cava reconstruction; group B (n = 30), using 7/0 Prolene sutures for suprahepatic vena cava running anastomosis as control; and a sham-operated group (n = 30) as a blank control group. The changes in liver enzyme, serum creatinine, endotoxin, and cytokine levels and histopathology were recorded. The serum creatinine, potassium, alanine transaminase, and alkaline phosphatase levels at different points in time in group A were lower than those in group B (P < .05). The level of portal vein blood endotoxin in group A was significantly lower than that in group B at each point (P < .01). At the same time, all the cytokines in group B were higher than those in group A, and the two groups were higher than those in the sham operation group. The mean levels of tumor necrosis factor-α (TNF-α), interferon-γ, (IFN-γ), and interleukin-1ß (IL-1ß) at 3 hours were higher than at 6 hours in group A. IL-10 and tissue inhibitor of metalloproteinase-1 (TIMP-1) were all higher at 3 hours in groups A and B. Levels of monocyte chemotactic protein-1, L-selectin, and TIMP-1 in group A and IL-10, monocyte chemotactic protein-1, L-selectin, and TIMP-1 in group B were higher in blood than in the liver. Levels of TNF-α, IFN-γ, IL-1, IL-10, and intracellular adhesion molecule-1 in group A and TNF-α, IFN-γ IL-1ß, and intracellular adhesion molecule-1 in group B were higher in the liver than in blood. We conclude that the extremely short anhepatic phase has protective effects on recipients and grafts in rat liver transplantation because it is related to alleviating ischemia-reperfusion injury and reducing the endotoxin release.

Multiple primary cancers are usually defined as primary malignant tumors of different histological origins in one person. The present study reports the case of a 58-year-old male patient who was admitted to Tianjin first central hospital with hepatitis B for 20 years and right upper abdominal pain for the latest 2 weeks. Abdominal CT showed the liver cirrhosis, and left liver had a bulky lesions of 10.0 cm * 8.3 cm, tumor thrombus had formed in the portal vein and left branch, the superior of right kidney had been found a 4.6 cm * 4.5 cm lesions. Liver function: Child-Pugh grade A; Detection of the Viral Hepatitis B showed: HBsAg (+), HBeAg (+), HBcAb (+) and the AFP was 39962 ng/ml. Under the impression of primary liver cancer, hepatitis B cirrhosis and right renal cell carcinoma; the patient underwent the left semi-hepatectomy and right nephrectomy on January 12, 2010 after a preoperative assessment of liver function. Pathological examination confirmed the diagnosis of hepatocellular carcinoma (Low and medium differentiated) and clear cell renal carcinoma. The patient was discharged 21 days after surgery with normal liver function. One month after initial discharge, the patient underwent chemotherapy with oral Sola Feeney for about one month, and Two months later, the treatment of hepatic arterial chemoembolization (TACE) was performed in order to prevent the residual tumor and recurrence of liver resection margin. A follow-up examination of 15 months after surgery revealed that the patient was still alive and had returned to work, with no obvious symptoms or evidence of recurrence.

Objective To compare long-term outcome of primary liver transplantation and salvage liver transplantation in treating patients with primary liver cancer,and discuss the clinical feasibility of salvage liver transplantation.Methods We retrospectively analyzed the clinical data of 1 420 patients with primary liver cancer,including 170 cases treated with salvage liver transplantation and 1 250 cases with direct liver transplantation from Transplantation Center of Tianjin First Center Hospital between June 2005 and March 2015.The survival curve and 1,3,5-year survival rates were also compared between the two groups.Results Postoperative 1,3,5-year survival rates were 77.2％,59.4％,54.6％ in the primary liver transplantation group and 70.3％,48.1％,41.8％ in the salvage liver transplantation group,respectively.Significant statistical differences were observed (all P ＜ 0.05).Conclusions Salvage liver transplantation resulted in lower long-term survival rates in salvage liver transplantation than primary liver transplantation.Nevertheless,as one of the major treatment options,salvage liver transplantation is feasible for patients with recurrent liver cancer.

Objective To assess the effects of the risk factors of grafts from donors after cardiac death (DCD) on the prognosis of liver transplantation (LT).Methods In this retrospectively study,215 cases of LT using DCD donor grafts were performed at our institution from September 2013 to January 2017.Due to the loss to follow-up in 4 cases,211 cases were enrolled in the study.The following DCD donor data were collected:gender,age,primary disease,ABO blood type,body mass index (BMI),medical history (fatty liver,hypertension),ICU hospitalization time,mechanical ventilation time,warm ischemia time,cold ischemia time,and indexes of routine laboratory test before donation.Statistical analyses using the Kaplan-Meier method,log-rank test,multivariate step-wise Cox regression were performed.Results Of the 211 donors,univariate analysis showed that the overall 6-month,1-,and 3-year survival rate after DCD LT was 88％,84％,and 82％,respectively.Univariate analysis showed that donor serum sodium level ＜136 mmol/L (P =0.018) and cold ischemia time ＞9 h (P =0.013) were all significant risk factors affecting overall survival after DCD LT.Additionally,donor BMI ＞30 kg/m2 (P =0.011) and donor age ＞60 years (P =0.025) were significantly associated with postoperative complications.Multivariate analysis showed that donor serum sodium level (P=0.025) was an independent risk factor of survival after DCD LT.Conclusion To select suitable DCD liver allografts and control risk factors of donor can help to improve outcomes of recipients.

Objective To explore clinical application efficacy of Lifeport machine perfusion in improving the quality of elderly donor kidneys from donation after citizens death (DCD).Methods The clinical data of 47 DCD kidney donors more than 60 years old in our center from January 2013-December 2015 were retrospectively analyzed.The donors were divided into hypothermic mechanical perfusion group (HMP) group (n =32) and static cold preservation group (SC) (n =15) accordance with kidney preservation methods.The incidence of postoperative one-year delayed graft function (DGF),blood creatinine and the survival rate of the renal grafts were compared between two groups.Results The incidence of DGF in HMP group (6.3％) was decreased as compared with SC group (13.2％) (P＜0.24).The average length of hospital stay in HMP group was 16.6 days,shorter than in SC group (P =0.37).One year after renal transplantation,the average blood creatinine level in HMP group was lower than in SC group (125.8 μmol/L vs.198.6μmol/L,P =0.42).The 1-year graft survival rate in HMP group was higher than in SC group (96.9％ vs.80％,P =0.057).Conclusion Lifeport machine perfusion preservation can objectively evaluate the renal function of elder DCD donors and improve quality of donor kidneys.

OBJECTIVE:To evaluate the feasibility and outcome of liver transplantation in the treatment of liver metastatic cancer.METHODS:Four patients with pathologically confirmed liver metastatic cancer underwent liver transplantation, including one of liver metastases from pancreatic endocrine tumor, one from rectal endocrine tumor, one from stomach stromal tumor and one from colorectal carcinoma. Classic surgical method was adopted, i. e. orthotopic liver transplantation for the recipients and transplants came from cadaveric donors.RESULTS:All the four patients had a smooth operation, an uneventful early postoperative recovery and good living quality. The patient with liver metastases from pancreatic endocrine tumor had liver tumor recurrence at four and a half years after the transplantation, and then underwent left lateral hepatic lobectomy, without any recurrence until now. The patient with liver metastases from rectal endocrine tumor had right renal and pelvic tumor metastasis at 16 months after the operation, and died of tumor recurrence 5 years after the liver transplantation. The patient with liver metastases from gastric stromal tumor had extensive pelvic metastases at five and a half months after the transplantation, and survived with tumor for 4 years and 6 months after the operation. The patient with liver metastases from colorectal carcinoma had extensive bilateral lung metastases at 3 months after the transplantation and died one and a half years after the operation.CONCLUSION:For well-differentiated unresectable metastatic liver cancers, liver transplantation may serve as a treatment option and better treatment results can be achieved for some highly selected patients.

>Dear Editors,Ischemic-type biliary lesions(ITBLs)significantly reduce patient and graft survival rates.Research data regarding the causes of ITBL are rare.ITBLs is an important cause of post liver transplantation graft loss and patient death.The exact cause of this type of biliary complication remains unclear.To establish strategies for ITBL treatment or prevention,the risk factors of ITBL must be elucidated.The objective of this single-center retrospective study was to investigate the risk factors of ITBL in orthotopic liver transplantation(OLT)patients.

AIM:To determine whether diabetes mellitus (DM) affects prognosis/recurrence after liver transplantation (LT) for hepatitis B virus (HBV)-related hepatocellular carcinoma (HCC).METHODS:A retrospective study was conducted between January 2000 and August 2013 on 1631 patients with HBV-related HCC who underwent LT with antiviral prophylaxis. Patient data were obtained from the China Liver Transplant Registry (https://www.cltr.org/). To compare the outcomes and tumor recurrence in the HBV-related HCC patients with or without DM, statistical analyses were conducted using χ2 tests, Mann-Whitney tests, the Kaplan-Meier method, log-rank tests and multivariate step-wise Cox regression analysis.RESULTS:Univariate analysis of 1631 patients who underwent LT found overall 1-, 3- and 5-year survival rates of 79%, 73% and 71% respectively in the DM patients, and 84%, 78% and 76% in the non-DM patients respectively. Overall survival rate differences after LT between the two groups were significant (P = 0.041), but recurrence-free survival rates were not (P = 0.096). By stratified analysis, the overall survival rates in DM patients for age > 50 years (P = 0.002), the presence of vascular invasion (P = 0.096), tumors ≤ 3 cm (P = 0.047), two to three tumor nodules (P = 0.007), Child-Pugh grade B (P = 0.018), and pre-LT alanine aminotransferase levels between 40 and 80 IU/L (P = 0.017) were significantly lower than in non-DM patients. Additionally, serum α-fetoprotein level > 2000 ng/mL (P = 0.052) was associated with a significant survival difference trend between DM and non-DM patients. Multivariate analysis showed that the presence of DM (P < 0.001, HR = 1.591; 95%CI: 1.239-2.041) was an independent predictor associated with poor survival after LT.CONCLUSION:HBV-related HCC patients with DM have decreased long-term overall survival and poor LT outcomes. Prevention strategies for HCC patients with DM are recommended.

OBJECTIVE To analyse and explore the indications and efficacy of liver transplantation for benign liver tumor. METHODS From Jan.2001 to Dec.2014, 6 patients, incluing 3 males and 3 females, with benign liver tumor underwent liver transplantation in our department.There were 2 cases of hepatic epithelioid hemangioendothelioma, 1 case of hepatic cavernous hemangioma, 1 case of liver mesenchymal hamartoma, 1 case of hilar bile duct mucinous cystadenoma, and 1 case of hepatic adenoma. The data of surgical procedure, perioperative complications, postoperative management, and the outcome of follow-up were analyzed. RESULTS Six orthotopic liver transplantation from one living donor and five cadaveric donors were performed. One patient died in the perioperative period, and other patients were discharged with normal liver and kidney function. Within the follow-up time of 22 to 88 months, these patients could live the normal lives with stable graft function and nutritional status. CONCLUSIONS Liver transplantation is the most efficient treatment for unresectable and symptomatic benign lesions, with the favourable outcome.

Aim: The study aimed to investigate the indications and results of liver transplantation for benign liver tumor. Methods: From January 2001 to December 2014, 16 patients (8 males and 8 females) with benign liver tumors were subjects of liver transplantation in our department. The surgical procedure, perioperative complications, postoperative management, and follow-up results were analyzed. Results: Two patients died in the perioperative period, and the remaining patients were discharged with proper perioperative liver and kidney function. All 14 of these patients have survived to date with an absence of abdominal symptoms, improved nutritional status, and normal work and social activities. Within the follow-up time frame of 17 to 161 months, the longest postoperative patient survival is now over 13 years. Conclusions: Transplantation is an effective and sometimes the only treatment option for unresectable benign liver lesions, especially for patients with severely handicapping hepatomegaly, but the shortage of donors remains an important factor to consider.

Objective To investigate the characteristics of liver function recovery in steatotic liver graft transplantations.Method From August 1st 2013 to July 20th 2014,a prospective clinical cohort study of liver transplantations was performed in Tianjin First Central Hospital.Multiple linear regression analyses were made for related factors with the degree of donor liver steatosis and the average total bilirubin (TBil) levels on the post-operative day 6 to 8,week 4,and month 3 and 6,respectively.Result Of 82 cases used for analysis,there were 28 cases of mild steatotic grafts and 54 cases of non steatotic grafts.The multiple linear regression analysis revealed the average TBil level on the post-operative day 6 to 8 was the only one index related with the degree of graft steatosis.By the same means,recipient age,the aspartate aminotransferase (AST) level on the post-operative day 1,the average AST level on the post-operative day 2 to 3,and the degree of graft steatosis were associated with the average TBil level on the post-operative day 6 to 8.The AST level on the postoperative day 1,the average AST level on the post-operative day 2 to 3,and the degree of graft steatosis were associated with the average TBil level on the post-operative week 4.But only the AST level on the post-operative day 1 and the average AST level on the post-operative day 2 to 3 were associated with the average TBil level on the 3th and the 6th month post-operation.Conclusion Mild steatotic liver graft can result in increased TBIL level within perioperative period,but the graft function is not affected by it.The average AST level on the post-operative day 2 to 3 can effectively predict the prognosis of the graft.Objective Methods Results Conclusion

Objective To investigate the clinical outcomes of patients with cirrhosis and hepatorenal syndrome (HRS) who received a liver transplantation,and analyze factors relevant to renal outcome and survival prognosis.Method Seventy-three cases of adult patients undergoing liver transplantation for cirrhosis and HRS were followed up.The information on demographics of patients and surgical materials were retrospectively collected,and the living conditions after liver transplantation were analyzed.Forty-one patients ultimately having a reversal of HRS after liver transplantation served as HRS group,and the remaining 32 patients without a reversal of HRS as HRS+ group.1-,3-,and 5-year cumulative survival rate was analyzed after liver transplantation.73 cases of adult patients underwent liver transplantation for cirrhosis and HRS were followed up in Oriental Organ Transplant Center of Tianjin First Central Hospital.Retrospectively collected information on patient demographics,surgical materials,HRS reversal and living conditions.41 patients (56.2％) ultimately had a reversal of HRS after liver transplantation were placed in HRSgroup,while the other 32 patients didn't,and therefore remaining in HRS+ group.1-,3-,5-year cumulative survival rates were analyzed after liver transplantation.Result HRS+ group had a significantly higher pretransplant serum creatinine level and model for end-stage liver disease (MELD) score than HRSgroup (P＜0.05).1-,3-,and 5 year cumulative survival rate in HRS+ group was 56.3％,50％ and 43.8％,significantly higher than in HRS-group (87.8％,82.9％ and 61％ respectively,P＜0.05).Conclusion Increased pretransplant serum creatinine level and MELD score significantly predict the HRS non-reversal.Patients can obtain a comparatively ideal long-term survival after liver transplantation.

Objective To explore the modified technique in situ split liver and assess outcomes in pediatric split liver transplantation (SLT) recipients.Method A retrospective analysis was conducted on 5 cases of pediatric recipients using split donors.The donor livers were split in situ using modified split technique and the clinical effects were analyzed.Result We used modified technique to split donor liver in situ for 5 cases of brain dead donors.We split liver parenchyma in situ and distributed blood vessels in the background processing.Then the split donor livers were transplanted to 5 pediatric recipients,and no biliary complications occurred after surgery.Conclusion Modified technology in situ split liver can shorten the donor liver cold ischemia time and the splitting time in situ,and can reduce the influence of circulatory instability on donor liver,and thus improve the outcomes of children after liver transplantation.

Objective To compare the clinical effects of different regimens for prophylaxis of hepatitis B recurrence post liver transplantation in different times of a single center,summarize and optimize the treatment protocol. Methods Nine hundred and eighty-four adult patients diagnosed as hepatitis B related end stage benign liver diseases underwent primary liver transplant between May 1994 and December 2012,of whom 62 recipients died within 30 days after transplantation and were not included for statistical analysis. The remaining 922 patients were grouped as non-treatment,famciclovir,lamivudine and nucleos(t)ide analogues combined with hepatitis B immune globulin(HBIG)group based on 4 different regimens for prophylaxis of hepatitis B recurrence post liver transplantation. Results Hepatitis B recurrence occurred in 27 patients. Among them,all the 3 patients of non-treatment group(underwent transplant between 1994-1999)showed recurrence,all the 2 patients in famciclovir group (underwent transplant between 1998-1999)showed recurrence,6 patients(40.0%)in lamivudine group(underwent transplant between 1998-2001)showed recurrence,and 16 patients(1.8%)in nucleos(t)ide analogues combined with HBIG group(underwent transplant between 1999-2012)showed recurrence. Both cumulative hepatitis B recurrence rates (χ2=48.99,P=0.000) and cumulative patient survival rates (χ2=62.694,P=0.000) showed significant statistical significance among these four groups of patients. Conclusion With the successful development and widespread marketing of nucleos(t)ide analogues and HBIG,regimens for prophylaxis of hepatitis B recurrence after liver transplantation have been optimized gradually in our center. Nucleos(t)ide analogues combined with HBIG was proved effective,and has been applicated by many other centers throughout our whole country,which provides strong support for the outcomes of liver transplantation in HBV-related end stage liver diseases.