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Importance of genetic polymorphisms in liver transplantation outcomes

World Journal of Gastroenterology 2020年第12期26卷 1273-1285页

作者： Tomislav Kelava Petra Turcic Antonio Markotic Ana Ostojic Dino Sisl Anna Mrzljak Laboratory for Molecular Immunology Croatian Institute for Brain ResearchUniversity of ZagrebSchool of MedicineZagreb 10000Croatia Department of Pharmacology Faculty of Pharmacy and Biochemistry of University of ZagrebZagreb 10000Croatia Center for Clinical Pharmacology University Clinical Hospital MostarMostar 88000Bosnia and Herzegovina Department of Medicine Merkur University HospitalZagreb 10000Croatia Department of Medicine Merkur University HospitalSchool of MedicineUniversity of ZagrebZagreb 10000Croatia

Although,liver transplantation serves as the only curative treatment for patients with end-stage liver diseases,it is burdened with complications,which affect survival *** addition to clinical risk factors,contribution of recipient and donor genetic prognostic markers has been extensively studied in order to reduce the burden and improve the *** of single nucleotide polymorphisms(SNPs)is one of the most important tools in development of personalized transplant *** provide a better insight in recent developments,we review the studies published in the last three years that investigated an association of recipient or donor SNPs with most common issues in liver transplantation:Acute cellular rejection,development of new-onset diabetes mellitus and non-alcoholic fatty liver disease,hepatocellular carcinoma recurrence,and tacrolimus concentration *** studies confirmed previously established SNP prognostic factors,such as PNPLA3 rs738409 for nonalcoholic fatty liver disease development,or the role of CYP3A5 rs776746 in tacrolimus concentration *** also identified several novel SNPs,with a reasonably strong association,which have the potential to become useful predictors of post-transplant ***,as the studies were typically conducted in one center on relatively low-to-moderate number of patients,verification of the results in other centers is warranted to resolve these ***,of 29 reviewed studies,28 used gene candidate approach and only one implemented a genome wide association *** wide association multicentric studies are needed to facilitate the development of personalized transplant medicine.

关键词： Single nucleotide polymorphisms Liver transplantation Acute rejection Non-alcoholic fatty liver disease New-onset diabetes mellitus Hepatocellular carcinoma Tacrolimus

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Pre-and intraoperative predictors of acute kidney injury after liver transplantation

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World Journal of Clinical Cases 2020年第18期8卷 4034-4042页

作者： Anna Mrzljak Lucija Franusic Jadranka Pavicic-Saric Tomislav Kelava Zeljka Jurekovic Branislav Kocman Danko Mikulic Ivan Budimir-Bekan Mladen Knotek Department of Medicine Merkur University HospitalSchool of MedicineUniversity of ZagrebZagreb 10000Croatia General Hospital Dubrovnik Dubrovnik 20000Croatia Department of Anesthesiology and Intensive Medicine Merkur University HospitalSchool of MedicineUniversity of ZagrebZagreb 10000Croatia Laboratory for Molecular Immunology Croatian Institute for Brain ResearchUniversity of ZagrebSchool of MedicineZagreb 10000Croatia Department of Medicine Merkur University HospitalZagreb 10000Croatia Department of Surgery Merkur University HospitalZagreb 10000Croatia

BACKGROUND Acute kidney injury(AKI)after liver transplantation(LT)is a frequent and multifactorial event related to increased morbidity and *** factors for AKI after LT still need to be *** To identify the predictors of acute kidney injury after liver *** The frequency and pre-and intraoperative predictors of AKI within the first 7 d after LT were evaluated in adult liver transplant candidates in a single LT center in *** was defined according to the Kidney Disease:Improving Global Outcomes *** Out of 205 patients(mean age 57±10 years;73.7%males,52.7%with alcoholrelated liver disease)93(45.36%)developed AKI,and the majority of them(58.06%)had stage *** 5.38%of patients required renal replacement therapy after *** majority of patients(82.8%)developed AKI within the first two days after the *** logistic regression identified pre-LT body mass index(OR=1.1,95%CI:1.05-1.24)and red blood cell transfusion(OR=1.66,95%CI:1.09-2.53)as independent predictors of early post-LT AKI occurrence.30-d survival after LT was significantly better for patients without AKI(P=0.01).CONCLUSION Early AKI after LT is a frequent event that negatively impacts short-term *** pathogenesis of AKI is multifactorial,but pre-LT BMI and intraoperative volume shifts are major contributors.

关键词： Acute kidney injury Liver transplant Body mass index Red blood cell Survival

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