BACKGROUND Ischemia-reperfusion injury is considered an inevitable event that compromises posttransplant outcomes. Numerous treatments have been proposed to reduce its impact. However, most of them have had limited success, as none of them can completely avoid graft ischemia. METHODS Ischemia-free liver transplantation (IFLT) comprises surgical techniques to enable continuous oxygenated blood supply to brain-dead donor livers during procurement, preservation and implantation using normothermic machine perfusion technology. In this nonrandomized study, 38 donor livers were transplanted using IFLT and were compared to 130 livers procured and transplanted using a conventional procedure (CLT). RESULTS One patient (2.6%) suffered early allograft dysfunction in the IFLT group, compared with 43.8% of patients in the CLT group (absolute risk difference, 41.2 percentage points; 95% confidence interval, −31.3, −51.1). The median (range) peak aspartate aminotransferase levels within the first week (336, 149-4112 vs. 1445, 149-25083 U/L, P<0.001), and the median (range) total bilirubin levels on day 7 (2.11, 0.68-12.47 vs. 5.11, 0.56-51.97 mg/dL, P<0.001) posttransplantation were much lower in the IFLT than in the CLT group. The IFLT recipients had less need for renal replacement therapy (2.6% vs. 16.9%, P=0.02), shorter median (range) intensive care unit stay (34, 12-235 vs. 43.5, 7-936 hours, P=0.003), and higher one-year recipient survival (97.4% vs. 84.6%, P=0.02) and graft survival (94.7% vs. 83.8%, P=0.04) rates than the CLT recipients. The extended criteria donor livers in IFLT yielded faster posttransplant recovery than the standard criteria donor livers in CLT. CONCLUSIONS IFLT provides a new approach to minimize ischemia-reperfusion injury and improve post-transplant outcomes.

KEYWORDSPapillary thyroid cancer, serum lipid level, tumor size, lipid metabolism 2 Abstract Background: Papillary thyroid cancer (PTC) is the most common type of thyroid cancer and the incidence of PTC continued to increase over the past decades. Many studies showed that obesity is an independent risk factor for PTC and obese PTC patients tend to have a relative larger tumor size and higher grade of tumor stage. Obesity is closely related with lipid metabolism, while the correlation between serum lipid and PTC remains unclear. Therefore, this study aimed to investigate the association between serum lipid level and PTC.Methods: We retrospectively analyzed 1018 PTC patients diagnosed and treated in our hospital, all these cases were first diagnosed with PTC and had complete clinical information including ultrasound reports before surgery, serum lipid (CHOL, TG, HDL-c, LDL-c, Apo-A1, Apo-B, Apo-E, Lp (a)) results, surgical records and pathological reports.Results: All these serum lipid biomarkers did not associated with tumor size in the female group. In the male group, on crude analysis, Apo-A1 and Lp (a) showed a marginally significant association with tumor size OR and 95% CI 0.158 (0.021-1.777), p=0.072; 0.997 (0.993-1.000) p=0.082 respectively.After adjusting for age and multifocality, Apo-A1 and Lp (a) showed a significant association with