General Surgery Liver Transplantation Center

| Basic Overview |--------------

The Huashan Hospital Liver Transplantation Center was established at the beginning of the 21st century, and the Institute of Organ Transplantation of Fudan University was also formally established at Huashan Hospital. Together, they have participated in and witnessed the development of liver transplantation in China. Since 2014, under the leadership of Professor Wang Zhengxin, liver transplantation at Huashan Hospital has taken off, progressing “from existence to strength.” As of November 2024, more than 2,200 liver transplantation procedures of various types have been completed in total. Each year, more than 200 adult and pediatric liver transplantation procedures of various types can be performed, including whole-liver, living-donor, split, auxiliary, and domino liver transplantation. The perioperative survival rate is above 95%. The center has become one of the largest liver transplantation centers in China, achieving dual leadership in medical volume and quality. In July 2023, the General Surgery Liver Transplantation Center was formally established. With a new starting point and new opportunities, the center is continuously striving toward comprehensive development in medical care, education, and research.

| Team Composition and Specialty Features |--------------

The General Surgery Liver Transplantation Center currently has 7 clinical physicians, including 1 professor and chief physician, 3 deputy chief physicians, 2 attending physicians, and 1 resident physician. There is 1 doctoral supervisor, 1 master’s supervisor, 1 Shanghai Leading Talent, and 3 recipients of the Shulan Excellence Project—Organ Transplantation Talent Overseas Training Support Program. In addition, there are 4 jointly appointed professors, including Changjiang Scholars, National Distinguished Young Scholars, and Overseas High-Caliber Young Scholars.

Group photo of department members

The Liver Transplantation Center currently has 26 open beds, including 6 intensive-care beds, and nearly 1,000 admissions and discharges annually. It also has four types of outpatient services: a special-needs expert clinic, an expert clinic, a specialty clinic for liver transplantation and liver tumors, and an MDT clinic for difficult diseases related to liver transplantation. These services provide end-stage liver disease patients and patients after liver transplantation with comprehensive, individualized medical care throughout the entire course of treatment. Nearly 6,000 outpatient visits are recorded annually, forming an outpatient service structure centered on expert clinics and supplemented by specialty clinics.

Dual Leadership in Medical Volume and Quality

The Liver Transplantation Center has distinctive specialty features and can perform all types of adult and pediatric liver transplantation, including highly difficult procedures such as adult and pediatric living-donor liver transplantation and split liver transplantation. It enjoys an excellent reputation. The center performs more than 200 liver transplantation procedures annually. The annual volume of adult liver transplantation has ranked among the highest in China for many consecutive years, and the number of liver transplantations per bed and per person has ranked first nationally for many consecutive years. At the same time, the perioperative survival rate is above 95%, ranking among the highest in China. The center has truly achieved dual leadership in medical volume and quality.

Center for the Treatment of Difficult, Critical, and Complex Liver Transplantation Cases

With the determination to “never give up on any patient lightly,” the Liver Transplantation Center has taken on the challenge of complex, difficult, and highly challenging liver transplantation procedures, including transplantation for acute critical illness and second and third liver transplantation, and has developed the Huashan model for the full-process treatment of liver transplantation in patients with severe liver failure. Patients with severe liver failure are characterized by acute onset, severe disease, and great difficulty in treatment. In 2023, the number of patients with severe liver failure treated by the Liver Transplantation Center ranked among the highest in China. The perioperative survival rate after liver transplantation was approximately 85%, and the treatment success rate ranked among the highest nationally, fully demonstrating the overall strength of the Liver Transplantation Center and Huashan Hospital. After more than 10 years of clinical practice and technological innovation, for patients with complex, difficult, or critical liver disease awaiting transplantation, the Liver Transplantation Center has developed a full-process, highly efficient treatment chain supported by multiple disciplines: before surgery, surgical ICU support centered on bundled blood purification; during surgery, liver transplantation techniques centered on maintaining circulatory stability, together with anesthesia and monitoring management and extracorporeal circulation support; and after surgery, precise infection prevention and control, comprehensive organ-function maintenance, and individualized immune regulation. The success rate of treatment has increased substantially, making the center a highly reputed liver transplantation treatment center for patients with severe end-stage liver disease.

Individualized Multidisciplinary Diagnosis and Treatment System for Liver Cancer and Liver Transplantation

In recent years, the Huashan Hospital Liver Transplantation Center has received support for several national key projects focusing on liver cancer and liver transplantation. To address difficult and critical issues in the treatment of recurrence and metastasis among liver cancer liver transplant recipients, the Huashan Hospital Liver Transplantation Center has joined forces with the Departments of Medical Oncology, Radiation Oncology, Radiology, Interventional Oncology, the Endoscopy Center (ERCP), and Pathology to establish an MDT clinic for difficult and complex diseases related to liver transplantation. The clinic provides liver cancer liver transplant patients with one-stop multidisciplinary diagnosis and treatment, including comprehensive assessment of surgical indications before transplantation, individualized tumor downstaging treatment while awaiting transplantation, postoperative chemoradiotherapy for recurrence and metastasis, molecular subtyping and targeted therapy, immunotherapy, surgery, and ablation therapy, greatly improving treatment outcomes. Since its establishment, the program has received wide acclaim and was selected for two consecutive years, 2022 and 2023, as a “Research-Oriented Hospital Multidisciplinary Diagnosis and Treatment MDT Demonstration Project” by Fudan University Shanghai Medical College.

Liver Transplantation Treatment for Rare Diseases and Inherited Metabolic Diseases in Children

The Huashan Hospital Liver Transplantation Center has performed more than 300 pediatric liver transplantation procedures of various types, covering biliary atresia, liver failure, malignant liver tumors, and various rare and inherited metabolic diseases.

Technical features: Mature microsurgical techniques, with a 100% success rate for microsurgical arterial anastomosis; laparoscopic procurement of donor livers, with the first laparoscopic living-donor procurement of the left lateral lobe of the liver in East China completed by the center. The procedure is short, involves little blood loss, allows rapid donor recovery, and has reached an internationally advanced level.

“May every small act of kindness create great love in the human world.” Since initiating and establishing the Children’s Liver Transplantation Charity Fund in 2015, the Huashan Hospital Liver Transplantation Center has devoted itself to charitable assistance for children undergoing liver transplantation. With the help of caring people from all sectors of society, it has raised charitable assistance funds and helped more than 300 impoverished children with liver transplantation. In 2023, the center launched the public-welfare program “Everything for the Children—Huashan Hospital Full-Cost Assistance Program for Pediatric Liver Transplantation,” providing full financial assistance for the transplantation surgery and the donor’s surgical hospitalization expenses for impoverished children. This has relieved the worries of families of impoverished children undergoing liver transplantation and brought hope to more children with end-stage liver disease.

| Research and Awards and Honors |--------------

The Liver Transplantation Center undertakes more than 10 national- and provincial/ministerial-level research projects, including the 14th Five-Year National Key Research and Development Program of the Ministry of Science and Technology, the Organ Transplantation Special Project of the National Natural Science Foundation of China, subprojects of the 13th Five-Year Major Science and Technology Special Project, and the Shanghai Shenkang Precision Diagnosis and Treatment of Difficult Diseases Initiative, as well as other national, provincial, and municipal key research projects. Total research funding has exceeded 20 million yuan. In the past 5 years, more than 50 papers and monographs have been published in various academic journals, and 1 clinical monograph has been edited as chief editor.

The center places great emphasis on innovation in clinical techniques and concepts.

① The center pioneered internationally several technological innovations: 1. the laparoscopic left hepatic vein-first approach; 2. the bidirectional-flip exposure technique for arterial anastomosis; and 3. bile duct transection under indocyanine green fluorescence imaging. It also published the first research article from mainland China in the field of minimally invasive technical innovation for living-donor liver procurement in the authoritative top international journal Liver Transplantation. As a co-initiating and co-corresponding institution, it worked with the liver transplantation centers of major hospitals nationwide, including West China Hospital of Sichuan University and the Third Affiliated Hospital of Sun Yat-sen University, to formulate and publish the Expert Consensus on Minimally Invasive Surgery for Living Liver Donors;

② The center led the world’s largest clinical research project on vaccine protection against COVID-19 infection in liver transplant patients, involving 7 centers and 1,881 cases. The findings were published in the authoritative journal in the field of infectious diseases, Emerging Microbes & Infections. Together with experts in transplantation and infectious diseases from across the country, including the National Medical Center for Infectious Diseases, the center led the publication of China’s first Expert Consensus on the Diagnosis and Treatment of Novel Coronavirus Infection in Solid Organ Transplant Recipients (2023 Edition);

③ Focusing on precision diagnosis and treatment of recurrence and metastasis in liver cancer liver transplant patients, the center used artificial intelligence and radiomics to develop noninvasive subtyping that can take into account both beneficiary selection for liver cancer liver transplantation and assessment of response to immune downstaging therapy. It successfully established risk prediction and stratified treatment strategies for high-risk populations with recurrent and metastatic liver cancer after liver transplantation. Related findings have been published in domestic and international journals, including Advanced Science, providing support for individualized diagnosis and treatment and improved efficacy in liver cancer liver transplant patients.

④ Focusing on the efficacy and safety of immune checkpoint inhibitors in the field of liver cancer and liver transplantation, this center, together with major organ transplantation centers in China, including You’an Hospital affiliated with Capital Medical University, led the publication of the first Expert Consensus on the Application of Immune Checkpoint Inhibitors in Chinese Liver Cancer Liver Transplant Recipients (2024 Edition) in both Chinese and English. It provides an industry reference for the use of immune checkpoint inhibitors in liver cancer liver transplant patients.

⑤ Focusing on key difficulties in organ-transplantation rehabilitation, including transplant infections, enhanced recovery, metabolic diseases, and standardized diagnosis and treatment of complications, the center collaborated with major organ transplantation centers nationwide and led the publication of China’s first Guidelines for Organ Transplantation Rehabilitation in the fields of liver, kidney, heart, lung, pancreas, multivisceral transplantation, pediatric transplantation, and others, providing an industry reference standard for enhanced recovery after organ transplantation.

⑥ Focusing on medical science popularization, the center’s animated educational work Children’s Liver Transplantation Health Education stood out in the “Health Knowledge Popularization Initiative—2022 New Era Health Science Popularization Works Collection Competition,” jointly organized by the National Health Commission, the Ministry of Science and Technology, the National Administration of Traditional Chinese Medicine, the National Disease Control and Prevention Administration, and the China Association for Science and Technology. It won the Award of Excellence in the Long-Video Category and became an industry benchmark for public education through liver transplantation videos.

⑦ Focusing on technological innovations in liver transplantation diagnosis and treatment, including innovation in living-donor liver transplantation techniques, precise assessment of donor-liver function, prediction of recurrence and metastasis after liver cancer liver transplantation, precise regulation of anti-rejection drugs, and prevention and control of perioperative infections in liver transplantation, the center received the Second Prize of the 2021 Shanghai Medical Science and Technology Award. These innovations have been promoted at 9 large liver transplantation centers nationwide, leading and facilitating improvements in the efficacy of liver transplantation.

Winner of the Second Prize of the 2021 Shanghai Medical Science and Technology Award

The Organ Transplantation Rehabilitation Professional Committee of the Chinese Association of Rehabilitation Medicine received the honorary title of Excellent Branch under the leadership of its chair, Wang Zhengxin.

Professor Wang Zhengxin led the publication of the Guidelines for Organ Transplantation Rehabilitation.

| Teaching and Talent Development |--------------

The General Surgery Liver Transplantation Center undertakes teaching for the Department of Surgery of Fudan University Shanghai Medical College, participating in teaching tasks including undergraduate lectures, clinical demonstrations, and animal experiments. It organized and offered the ideological and political education practical project of Fudan University, “Public Awareness of Organ Donation and Transplantation: Problems and Countermeasures.” The Liver Transplantation Center has a strong faculty, including 1 doctoral supervisor, 1 master’s supervisor, and 4 jointly appointed professors, including Changjiang Scholars, National Distinguished Young Scholars, and Overseas High-Caliber Young Scholars. It has trained more than 10 doctoral and master’s graduate students and has 3 participants in the Shulan Excellence Project—Organ Transplantation Talent Overseas Training Support Program. The center also undertakes standardized residency training and national and Shanghai specialist physician training. In the field of organ transplantation, the center has organized and hosted national academic annual meetings and training courses on many occasions, led the chief editing of several clinical professional guidelines and expert consensuses, including the Guidelines for Organ Transplantation Rehabilitation, and conducted public science education through new media and the internet to promote the clinical experience and academic concepts of the Huashan Hospital Liver Transplantation Center in liver transplantation.

| Introduction to the Current Department Director |--------------

Professor Wang Zhengxin, director of the department, is the chief scientist of the National Key Research and Development Program, a leading talent of the Shanghai Oriental Talent Program, chair of the Organ Transplantation Rehabilitation Professional Committee of the Chinese Association of Rehabilitation Medicine, and deputy chair of the Organ Transplantation Professional Committee of the Shanghai Medical Association. Over the past 5 years, he has led more than 10 national and provincial/ministerial-level research projects, including the National Key Research and Development Program of the Ministry of Science and Technology and the Organ Transplantation Special Project of the National Natural Science Foundation of China. Total research funding has exceeded 15 million yuan. He has received multiple provincial/ministerial-level medical achievement awards and Shanghai Medical Science and Technology Awards. Over the past 5 years, he has published 54 papers in journals including Adv Sci, Emerg Microbes Infect, and Liver Transpl. He was chief editor of the Guidelines for Organ Transplantation Rehabilitation and led the publication of multiple organ transplantation expert consensuses. In 2022, he received 1 Second Prize of the Shanghai Medical Science and Technology Award as the first recipient, and in 2013 he received the Second Prize of the Military Medical Achievement Award as the first recipient. He has personally completed more than 3,000 liver transplantation procedures.