BackgroundIn July 2017, the first affiliated hospital of Sun Yat-sen university carried out the world’s first case of ischemia-free liver transplantation (IFLT). This study aimed to evaluate the performance of medical services pre- and post-IFLT implementation in the organ transplant department of this hospital based on diagnosis-related groups, so as to provide a data basis for the clinical practice of the organ transplant specialty.MethodsThe first pages of medical records of inpatients in the organ transplant department from 2016 to 2019 were collected. The China version Diagnosis-related groups (DRGs) were used as a risk adjustment tool to compare the income structure, service availability, service efficiency and service safety of the organ transplant department between the pre- and post-IFLT implementation periods.ResultsIncome structure of the organ transplant department was more optimized in the post-IFLT period compared with that in the pre-IFLT period. Medical service performance parameters of the organ transplant department in the post-IFLT period were better than those in the pre-IFLT period. Specifically, case mix index values were 2.65 and 2.89 in the pre- and post-IFLT periods, respectively (p = 0.173). Proportions of organ transplantation cases were 14.16 and 18.27%, respectively (p < 0.001). Compared with that in the pre-IFLT period, the average postoperative hospital stay of liver transplants decreased by 11.40% (30.17 vs. 26.73 days, p = 0.006), and the average postoperative hospital stay of renal transplants decreased by 7.61% (25.23 vs.23.31 days, p = 0.092). Cost efficiency index decreased significantly compared with that in the pre-IFLT period (p < 0.001), while time efficiency index fluctuated around 0.83 in the pre- and post-IFLT periods (p = 0.725). Moreover, the average postoperative hospital stay of IFLT cases was significantly shorter than that of conventional liver transplant cases (p = 0.001).ConclusionThe application of IFLT technology could contribute to improving the medical service performance of the organ transplant department. Meanwhile, the DRGs tool may help transplant departments to coordinate the future delivery planning of medical service.

Purpose 18F-labeled amino acids (AAs) as tumor-specific imaging agents play a critical role in hepatocellular carcinoma (HCC) imaging. In this work, we evaluated the synthesis and biological properties of a simple 18F-labeled glutamate analogue, [18F]AlF-1,4,7-triazacyclononane-1,4,7-triacetic-acid-2-S-(4-isothiocyanatobenzyl))-l-glutamate ([18F]AlF-NOTA-NSC-GLU) for HCC imaging via one-step reaction sequence. Methods [18F]AlF-NOTA-NSC-GLU was synthesized via the one-step reaction sequence from NOTA-NSC-GLU. In order to investigate the imaging value of [18F]AlF-NOTA-NSC-GLU in HCC, we conducted PET/CT imaging and competitive binding of [18F]AlF-NOTA-NSC-GLU in human Hep3B tumor-bearing mice. The transport mechanism of [18F]AlF-NOTA-NSC-GLU was determined by competitive inhibition and protein incorporation experiments in vitro. Results [18F]AlF-NOTA-NSC-GLU was prepared without decay-corrected radiochemical yield of 29.3 ± 5.6% (n=10) within 20 min. In vitro competitive inhibition experiments demonstrated that Na+-dependent Systems XAG-, B0+, ASC and minor XC- were involved in the uptake of [18F]AlF-NOTA-NSC-GLU, with Na+-dependent System XAG- possibly playing a more dominant role. Protein incorporation studies of the Hep3B human hepatoma cell line found almost no protein incorporation. Micro-PET/CT imaging with [18F]AlF-NOTA-NSC-GLU showed good tumor-to-background contrast in Hep3B human hepatoma-bearing mouse models. After [18F]AlF-NOTA-NSC-GLU injection, the tumor-to-liver uptake ratio of [18F]AlF-NOTA-NSC-GLU was 2.06 ± 0.17 at 30 min post-injection. In vivo competitive binding experiments exhibited that the tumor-to-liver uptake ratio decreased by the addition of the inhibitors to block the system XAG-. Conclusion We have successfully synthesized [18F]AlF-NOTA-NSC-GLU as a novel PET tracer with good radiochemical yield and high radiochemical purity. Our findings indicate that [18F]AlF-NOTA-NSC-GLU might have good clinical potential as a PET tumor-detecting agent for HCC imaging.

Purpose 18F-labeled amino acids (AAs) as tumor-specific imaging agents play a critical role in hepatocellular carcinoma (HCC) imaging. In this work, we evaluated the synthesis and biological properties of a simple 18F-labeled glutamate analogue, [18F]AIF-1,4,7-triazacyclononane-1,4,7-triacetic-acid-2-S-(4-isothiocyanatobenzyl))-l-glutamate ([18F]AIF-NOTA-NSC-GLU) for HCC imaging via one-step reaction sequence. Methods [18F]AIF-NOTA-NSC-GLU was synthesized via the one-step reaction sequence from NOTA-NSC-GLU. In order to investigate the imaging value of [18F]AIF-NOTA-NSC-GLU in HCC, we conducted PET/CT imaging and competitive binding of [18F]AIF-NOTA-NSC-GLU in human Hep3B 2.1-7 tumor-bearing mice. The transport mechanism of [18F]AIF-NOTA-NSC-GLU was determined by competitive inhibition and protein incorporation experiments in vitro. Results [18F]AIF-NOTA-NSC-GLU was prepared with decay-corrected radiochemical yield of 29.3 ± 5.6% (n=10) within 20 min. In vitro competitive inhibition experiments demonstrated that Na+-dependent Systems XAG-, B0+, ASC and minor XC- were involved in the uptake of [18F]AIF-NOTA-NSC-GLU, with Na+-dependent System XAG- possibly playing a more dominant role. Protein incorporation studies of the Hep3B 2.1-7 human hepatoma cell line found almost no protein incorporation. Micro-PET/CT imaging with [18F]AIF-NOTA-NSC-GLU showed good tumor-to-background contrast in Hep3B 2.1-7 human hepatoma-bearing mouse models. After [18F]AIF-NOTA-NSC-GLU injection, the tumor-to-liver uptake ratio of [18F]AIF-NOTA-NSC-GLU reached the peak at 30 min post-injection (2.06 ± 0.17). In vivo competitive binding experiments exhibited that the tumor-to-liver uptake ratio decreased by the addition of the inhibitors to block the system XAG-. Conclusion We have successfully synthesized [18F]AIF-NOTA-NSC-GLU as a novel PET tracer with good radiochemical yield and high radiochemical purity. Our findings indicate that [18F]AIF-NOTA-NSC-GLU might have good clinical potential as a PET tumor-detecting agent for HCC imaging.