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Machine perfusion and the prevention of ischemic type biliary lesions following liver transplant:What is the evidence?

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World Journal of Gastroenterology 2023年第20期29卷 3066-3083页

作者： Manuel Durán Rafael Calleja Angus Hann George Clarke Ruben Ciria Anisa Nutu rebeca sanabria-mateos María Dolores Ayllón Pedro López-Cillero Hynek Mergental Javier Briceño M Thamara P R Perera Department of Liver Transplantation Reina Sofía University HospitalCórdoba 14004Spain The Liver Unit Queen Elizabeth Hospital BirminghamBirmingham B152THUnited Kingdom Centre for Liver and Gastrointestinal Research Institute of Immunology and ImmunotherapyUniversity of BirminghamBirmingham B152THUnited Kingdom

The widespread uptake of different machine perfusion(MP)strategies for liver transplant has been driven by an effort to minimize graft injury.Damage to the cholangiocytes during the liver donation,preservation,or early posttransplant period may result in stricturing of the biliary tree and inadequate biliary drainage.This problem continues to trouble clinicians,and may have catastrophic consequences for the graft and patient.Ischemic injury,as a result of compromised hepatic artery flow,is a well-known cause of biliary strictures,sepsis,and graft failure.However,very similar lesions can appear with a patent hepatic artery and these are known as ischemic type biliary lesions(ITBL)that are attributed to microcirculatory dysfunction rather than main hepatic arterial compromise.Both the warm and cold ischemic period duration appear to influence the onset of ITBL.All of the commonly used MP techniques deliver oxygen to the graft cells,and therefore may minimize the cholangiocyte injury and subsequently reduce the incidence of ITBL.As clinical experience and published evidence grows for these modalities,the impact they have on ITBL rates is important to consider.In this review,the evidence for the three commonly used MP strategies(abdominal normothermic regional perfusion[A-NRP],hypothermic oxygenated perfusion[HOPE],and normothermic machine perfusion[NMP])for ITBL prevention has been critically reviewed.Inconsistencies with ITBL definitions used in trials,coupled with variations in techniques of MP,make interpretation challenging.Overall,the evidence suggests that both HOPE and A-NRP prevent ITBL in donated after circulatory death grafts compared to cold storage.The evidence for ITBL prevention in donor after brain death grafts with any MP technique is weak.

关键词： Liver transplant Ischemic type biliary lesions Hypothermic oxygenated machine perfusion Normothermic machine perfusion Abdominal normothermic regional perfusion Donation after circulatory death

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Total hepatectomy and liver transplantation as a two-stage procedure for fulminant hepatic failure: A safe procedure in exceptional circumstances

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World Journal of Hepatology 2016年第4期8卷 226-230页

作者： rebeca sanabria mateos Niamh M Hogan Dimitri Dorcaratto Helen Heneghan Venkatesh Udupa Donal Maguire Justin Geoghegan Emir Hoti Hepatobiliary and Liver Transplant Surgical Unit St. Vincent’s University Hospital

AIM: To evaluate the outcomes of two-stage liver transplant at a single institution, between 1993 and March 2015.METHODS: We reviewed our institutional experience with emergency hepatectomy followed by transplantation for fulminant liver failure over a twenty-year period. A retrospective review of a prospectively maintained liver transplant database was undertaken at a national liver transplant centre. Demographic data, clinical presentation, preoperative investigations, cardiocirculatory parameters, operative and postoperative data were recorded.RESULTS: In the study period, six two-stage liver transplants were undertaken. Indications for transplantation included acute paracetamol poisoning(n = 3), fulminant hepatitis A(n = 1), trauma(n = 1) and exertional heat stroke(n = 1). Anhepatic time ranged from 330 to 2640 min. All patients demonstrated systemic inflammatory response syndrome in the first post-operative week and the incidence of sepsis was high at 50%. There was one mortality, secondary to cardiac arrest 12 h following re-perfusion. Two patients required re-transplantation secondary to arterial thrombosis. At a median follow-up of 112 mo, 5 of 6 patients are alive and without evidence of graft dysfunciton.CONCLUSION: Two-stage liver transplantation represents a safe and potentially life-saving treatment for carefully selected exceptional cases of fulminant hepatic failure.

关键词： Two-stage liver transplantation Fulminanthepatic failure Liver transplant Survival

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Immunometabolic bases of type 2 diabetes in the severity of COVID- 19

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World Journal of Diabetes 2021年第7期12卷 1026-1041页

作者： rebeca Viurcos-sanabria Galileo Escobedo Research Division Hospital General de MéxicoMexico City 06720Mexico Laboratorio de Proteómica Dirección de InvestigaciónHospital General de Mexico“Dr.Eduardo Liceaga”Mexico City 06720Mexico

The outbreak of coronavirus disease 2019(COVID-19)is caused by the novel severe acute respiratory syndrome coronavirus-2(SARS-CoV-2).COVID-19 and type 2 diabetes(T2D)have now merged into an ongoing global syndemic that is threatening the lives of millions of people around the globe.For this reason,there is a deep need to understand the immunometabolic bases of the main etiological factors of T2D that affect the severity of COVID-19.Here,we discuss how hyperglycemia contributes to the cytokine storm commonly associated with COVID-19 by stimulating monocytes and macrophages to produce interleukin IL-1β,IL-6,and TNF-αin the airway epithelium.The main mechanisms through which hyperglycemia promotes reactive oxygen species release,inhibition of T cell activation,and neutrophil extracellular traps in the lungs of patients with severe SARS-CoV-2 infection are also studied.We further examine the molecular mechanisms by which proinflammatory cytokines induce insulin resistance,and their deleterious effects on pancreaticβ-cell exhaustion in T2D patients critically ill with COVID-19.We address the effect of excess glucose on advanced glycation end product(AGE)formation and the role of AGEs in perpetuating pneumonia and acute respiratory distress syndrome.Finally,we discuss the contribution of preexisting endothelial dysfunction secondary to diabetes in the development of neutrophil trafficking,vascular leaking,and thrombotic events in patients with severe SARS-CoV-2 infection.As we outline here,T2D acts in synergy with SARSCoV-2 infection to increase the progression,severity,and mortality of COVID-19.We think a better understanding of the T2D-related immunometabolic factors that contribute to exacerbate the severity of COVID-19 will improve our ability to identify patients with high mortality risk and prevent adverse outcomes.

关键词： COVID-19 SARS-CoV-2 Type 2 diabetes Inflammation Hyperglycemia Prothrombotic state

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Morphological Characterization with STM and SEM of CdSe Nanostructures in Function of pH

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材料科学与工程（中英文A版） 2019年第4期9卷 153-161页

作者： Gabriela Sánchez Legorreta Porfirio Domingo Rosendo Francisco rebeca Vargas sanabria Oscar Olea Mejía Facultad de Ciencias UAEMCampus“El CerrilloPierdas Blancas”Carretera Toluca-IxtlahuacaKm.15.5CP.50200 Toluca de LerdoMéxico Centro Conjunto de Investigación en Química S

In this paper,we have interest in the CdSe(cadmium selenide)semiconductor due to their physical and optical properties that depend on their morphology and size,as well as their possible applications in electronic and optoelectronic fields,for example,in the fabrication of solar cells or nanotransistors.For this reason,we synthetized nanoparticles of CdSe using the colloidal method,and varied the pH value:8 to 12,to know the effect of pH on the samples.The nanoparticles were characterized using the SEM(scanning electron microscope)and STM(scanning tunneling microscope)to know the morphology and electronic cloud on the surface of the samples.In each case,we found different sizes(from 6 to 11.5 nm)and shapes as filaments(fibbers),bars and spheres of CdSe nanoparticles and the 3D-FFT was obtained too.

关键词： CdSe pH value colloidal synthesis SEM STM

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