ObjectiveTo explore perioperative management model of ABO-incompatible liver transplantation. MethodsThe clinical data of ABO-incompatible caderveric liver transplantions without urgency performed in our center from July 2006 to May 2010 were analyzed retrospectively. Four patients had received an ABO-incompatible graft: AB to O in three, AB to A in one. All the cases were diagnosed as end-stage liver disese, one of them was primary hepatocellular carcinoma. ResultsFour survived to now （11 to 19 months） without severe infections and acute rejections. Two experienced coagulative disturbance and one of them had a second exploration. One developed acute renal failure and recovered with help under continuous veno-venous hemofiltration. All the cases were given 20 mg basiliximab two hours before revascularization and on day 4 after operation respectively. Splenectomy was performed in three, intravenous immunoglobulin was given in all more than seven days. Isohemagglutinin titers were basically stable and not relevant to the clinical manifestations. Antibiotic prophylaxis and immunosuppression protocol was same as the ABO compatible transplants except a 3-month-delay for steroid withdrawal. ConclusionABO-incompatible liver transplantation could be performed with appropriate perioperative management, such as basiliximab induction, splenectomy, intravenous immunoglobulin administration, and routine immunosuppression.
Objective To investigate the current status of occupational environment support, occupational satisfaction, and job competence of hospital infection prevention and control personnel, and to explore the mediating effect of occupational satisfaction on the relationship between occupational environment support and job competence, in order to provide reference and guidance for effectively improving the job competence of hospital infection prevention and control personnel. Methods A survey questionnaire was distributed to various levels and types of medical institutions in Shanghai through the platform of the Shanghai Hospital Infection Quality Control Center. The questionnaire included the Occupational Environment Support Scale, Occupational Satisfaction Scale, and Job Competency Assessment Scale. The mediating effect of occupational satisfaction on the relationship between occupational environment support and job competency of hospital infection prevention and control personnel was analyzed. Results A total of 1027 hospital infection prevention and control personnel from 728 medical institutions participated in this survey, with 989 valid questionnaires and an effective response rate of 96.3%. There were statistically significant differences in the job competency scores of hospital infection prevention and control personnel based on gender, years of experience in infection control work, professional background, highest education level, professional title, job nature, type of medical institution, and annual income (P<0.05). The total score of job competence for hospital infection prevention and control personnel was 301.0 (267.5, 326.0), the total score of occupational environment support was 21.44±3.66, and the total score of occupational satisfaction was 19.25±2.78. The occupational environment support of hospital infection prevention and control personnel was positively correlated with occupational satisfaction and job competence (r=0.373, 0.339; P<0.001), and occupational satisfaction was positively correlated with occupational environment support (r=0.547, P<0.001). The mediating effect of job satisfaction on the occupational environment support and job competence was 0.085, accounting for 22.8% of the total effect. Conclusion Occupational satisfaction partially mediates the relationship between occupational environment support and job competence, and the mediating effect is significant.
Objective To investigate the current status of healthcare-associated infection (HAI) management in medical institutions in Shanghai, analyze the implementation of HAI surveillance indicators, and provide evidence to support the improvement of refined and scientific HAI management. Methods Using the Shanghai Three-Network Linkage Platform, a survey was conducted from April to May 2025 covering HAI management practices in the preceding year at medical institutions in Shanghai. Investigation and analysis were conducted on the HAI information systems, staffing of infection prevention and control (IPC) professionals, and implementation of HAI surveillance indicators. Results A total of 56 medical institutions in 16 administrative districts of Shanghai were surveyed. Among them, there were 45 tertiary medical institutions and 11 secondary medical institutions. There were 48 comprehensive medical institutions and 8 specialized medical institutions. All 56 medical institutions had established fully functional HAI information systems (100.0%). The structure and training compliance of IPC personnel were generally satisfactory; however, 4 institutions (7.1%) had insufficient IPC staffing levels. No statistically significant differences were observed between tertiary and secondary hospitals in the scores for implementation of HAI surveillance indicators (P>0.05). In contrast, significant differences were found between general and specialty hospitals in scores for rates of three types of device-associated infections (P=0.005) and hand hygiene compliance (P=0.041). After standardization of indicator implementation scores, the five lowest-scoring indicators requiring priority attention were, in descending order: blood culture submission rate for patients with pneumonia and fever ≥38.5°C; blood culture submission rate for patients with central venous catheters retained for ≥5 days; timing of perioperative prophylactic antimicrobial use for Class Ⅰ surgical incisions; catheter-related urinary tract infection incidence; and consumption of liquid soap and alcohol-based hand rub in wards. Conclusions Overall, HAI information system construction and management frameworks in Shanghai medical institutions are well established and functioning effectively. Nevertheless, gaps remain in IPC staffing allocation and in the clinical implementation of certain core HAI surveillance indicators. Continued efforts are required to advance the standardization and refinement of HAI management.
