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Role of colectomy in preventing recurrent primary sclerosing cholangitis in liver transplant recipients

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World Journal of Gastroenterology 2018年第28期24卷 3171-3180页

作者： Bettina M Buchholz Panagis M Lykoudis Reena Ravikumar Joerg M Pollok Giuseppe K Fusai Department of HPB Surgery and liver transplantation Royal Free Hospital London

AIM To study the published evidence on the impact of colectomy in preventing recurrent primary sclerosing cholangitis(r PSC). METHODS An unrestricted systematic literature search in Pub Med, EMBASE, Medline Ovid SP, ISI Web of Science, Lista(EBSCO) and the Cochrane library was performed on clinical studies investigating colectomy in liver transplantation(LT) recipients with and without r PSC in the liver allograft. Study quality was evaluated according to a modification of the methodological index for non-randomized studies(MINORS) criteria. Primary endpoints were the impact of presence, timing and type of colectomy on r PSC. Overall presence of inflammatory bowel disease(IBD), time of IBD diagnosis, posttransplant IBD and immunosuppressive regimen were investigated as secondary *** The literature search yielded a total of 180 publications. No randomized controlled trial was identified. Six retrospective studies met the inclusion criteria of which 5 studies were graded as high quality articles. Reporting of IBD was heterogenous but in four publications, either inflammatory bowel disease, ulcerative colitis or in particular active colitis post-LT significantly increased the risk of r PSC. The presence of an intact(i.e., retained) colon at LT was identified as risk factor for r PSC in two of the high quality studies while four studies found no effect. Type of colectomy was not associated with r PSC but this endpoint was underreported(only in 33% of included studies).Neither tacrolimus nor cyclosporine A yielded a significant benefit in disease recurrence of primary sclerosing cholangitis(PSC).CONCLUSION The data favours a protective role of pre-/peri-LT colectomy in r PSC but the current evidence is not strong enough to recommend routine colectomy for r PSC prevention.

关键词： Recurrent primary sclerosing cholangitis Risk factor Ulcerative colitis Colectomy liver transplantation

Critical Update on the Diagnosis and Management of COVID-19 in Advanced Cirrhosis and liver Transplant Recipients

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Journal of Clinical and Translational Hepatology 2021年第6期9卷 947-959页

作者： Cyriac Abby Philips Mohamed Rela Arvinder Singh Soin Subhash Gupta Sudhindran Surendran Philip Augustine Department of Clinical and Translational Hepatology and The Monarch liver Laboratory The Liver InstituteCenter of Ex-cellence in Gastrointestinal SciencesRajagiri HospitalAluvaKeralaIndia institute of liver disease and liver Trans-plantation Dr.Rela Institute&Medical CentreBharath Institute of Higher Education and ResearchChennaiIndia In-stitute of liver transplantation and Regenerative Medicine MedantaThe MedicityGurgaonIndia Max Centre for liver and Biliary Sciences Max Saket HospitalNew DelhiIndia Gastrointestinal Surgery and Solid Organ transplantation Amrita Institute of Medical Sciences and Research CentreAmrita Vishwa VidyapeethamKochiKeralaIndia Gastroen-terology and Advanced GI Endoscopy Center of Excellence in Gastrointestinal SciencesRajagiri HospitalAluvaKeralaIndia

The novel coronavirus disease 2019(COVID-19)pandemic has impacted health care worldwide,with specific patient populations,such as those with diabetes,cardiovascular disease,and chronic lung disease,at higher risk of infection and others at higher risk of disease *** with decompensated cirrhosis fall into the latter category and are a unique group that require specific treatment and management decisions because they can develop acute-on-chronic liver *** liver transplant recipients,the atypical immunity profile due to immunosuppression protects against downstream inflammatory responses triggered by *** exhaustive review discusses the outcomes associated with COVID-19 in patients with advanced cirrhosis and in liver transplant *** focus on the immunopathogenesis of COVID-19,its correlation with the pathogenesis of advanced liver disease,and the effect of immunosuppression in liver transplant recipients to provide insight into the outcomes of this unique patient population.

关键词： Coronavirus Cirrhosis Portal hypertension Acute-on-chronic liver failure Sepsis Hepatic encephalopathy Multiple-organ failure Critical care

Approach from the laboratory to the field: New strategies in the control of mosquito-borne infectious diseases

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Science China Life Sciences 2025年第1期 303-305页

作者： Ziqian Xu Lianpan Dai Jun Liu National Key Laboratory of Intelligent Tracking and Forecasting for Infectious diseases (NITFID) National Institute for Viral Disease Control and PreventionChinese Center for Disease Control and Prevention CAS Key Laboratory of Pathogen Microbiology and Immunology Institute of MicrobiologyChinese Academy of Sciences

Vector-borne viruses, transmitted among humans and animal hosts through bites of vectors such as mosquitoes and ticks,pose a great and ongoing threat to public health and biosafety(Yang et al., 2022).Among them, dengue virus-induced epidemics, have dramatically increased worldwide in recent decades. The report released by the World Health Organization(WHO) at the end of 2023 showed that dengue epidemic globally surged in2023, with the number of reported cases nearing a historical peak.

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Organ transplantation management in the midst of the COVID-19 outbreak: a synopsis

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Hepatobiliary Surgery and Nutrition 2020年第2期9卷 250-252页

作者： Bo-Han Zhang Lyu-Nan Yan Jia-Yin Yang Department of liver Surgery and liver transplantation Center Organ Transplantation CenterWest China Hospital of Sichuan UniversityChengdu 610041China

On December 8,2019,the first case of unexplained pneumonia was reported in China,in Wuhan,Hubei Province(1).By March 6,2020,over 100,000 confirmed cases of coronavirus disease 2019(COVID-19),and more than 3,400 deaths have been reported worldwide(data from National Health Commission of the People’s Republic of China,Official Channels of Hong Kong,Macao and Taiwan,and World Health Organization).COVID-19,which is caused by severe acute respiratory syndrome coronavirus 2(SARS-CoV-2),is bound to have widespread ramifications on the clinical management system,organ transplantation being a prime *** on the transplant waitlist are generally in poor ***,post-transplant patients with weak immunity stemming from the long-term and regular administration of immunosuppressants are more likely to contract the SARS-CoV-2 infection than are healthy ***,when considering transplant patient safety,balancing organ allocation principles with epidemic prevention and control is a dilemma for transplant teams.

关键词： prevention Taiwan likely

Different techniques for harvesting grafts for living donor liver transplantation: A systematic review and meta-analysis

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World Journal of Gastroenterology 2017年第20期23卷 3730-3743页

作者： Hui Li Jun-Bin Zhang Xiao-Long Chen Lei Fan Li Wang Shi-Hui Li Qiao-Lan Zheng Xiao-Ming Wang Yang Yang Gui-Hua Chen Gen-Shu Wang Department of Hepatic Surgery and liver transplantation Center of the Third Affiliated Hospital Organ Transplantation InstituteSun Yat-Sen University Organ transplantation Research Center of Guangdong Province Journal Publishing Center of The Third Affiliated Hospital Sun Yat-Sen University Department of Hepatobiliary Surgery Yijishan Hospital Affiliated to Wannan Medical College Guangdong Key Laboratory of liver disease Research the Third Affiliated Hospital of Sun Yat-Sen University

AIM To perform a systematic review and meta-analysis on minimally vs conventional invasive techniques for harvesting grafts for living donor liver transplantation. METHODS PubMed, Web of Science, EMBASE, and the Cochrane Library were searched comprehensively for studies comparing MILDH with conventional living donor hepatectomy (CLDH). Intraoperative and postoperative outcomes (operative time, estimated blood loss, postoperative liver function, length of hospital stay, analgesia use, complications, and survival rate) were analyzed in donors and recipients. Articles were included if they: (1) compared the outcomes of MILDH and CLDH; and (2) reported at least some of the above outcomes. RESULTS Of 937 articles identified, 13, containing 1592 patients, met our inclusion criteria and were included in the meta-analysis. For donors, operative time [weighted mean difference (WMD) = 20.68, 95% CI: -6.25-47.60, p = 0.13] and blood loss (WMD = -32.61, 95% CI: -80.44-5.21, p = 0.18) were comparable in the two groups. In contrast, analgesia use (WMD = -7.79, 95% CI: -14.06-1.87, p = 0.01), postoperative complications [odds ratio (OR) = 0.62, 95% CI: 0.44-0.89, p = 0.009], and length of hospital stay (WMD): -1.25, 95% CI: -2.35-0.14, p = 0.03) significantly favored MILDH. No differences were observed in recipient outcomes, including postoperative complications (OR = 0.93, 95% CI: 0.66-1.31, p = 0.68) and survival rate (hr = 0.96, 95% CI: 0.27-3.47, p = 0.95). Funnel plot and statistical methods showed a low probability of publication bias. CONCLUSION MILDH is safe, effective, and feasible for living donor liver resection with fewer donor postoperative complications, reduced length of hospital stay and analgesia requirement than CLDH.

关键词： Living donor hepatectomy Graft harvesting Minimally invasive techniques Conventional invasive approaches Meta-analysis

Immunotherapy of hepatocellular carcinoma: strategies for combinatorial intervention

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Science China(Life Sciences) 2019年第9期62卷 1138-1143页

作者： Mengxin Tian Yinghong Shi Weiren Liu Jia Fan Department of liver Surgery & transplantation Center Liver Cancer InstituteZhongshan HospitalFudan University/Key Laboratory of Carcinogenesis and Cancer Invasion of Ministry of EducationShanghai 200032China institute of Biomedical Sciences Fudan UniversityShanghai 200032China

Hepatocellular carcinoma(HCC) is the most frequent primary liver cancer,leading to 74.6 thousand deaths *** prognosis of HCC over the last few decades has remained unsatisfactory,and over half of patients with early-stage HCC develop recurrence by the time of *** intervention has emerged as a novel,effective treatment to delay the progression of aggressive tumors and suppress tumor recurrence and ***,few clinical immunotherapy trials have been conducted in HCC patients,and there is an unmet need for novel therapeutic *** combination of conventional treatments with specific immunotherapeutic approaches may dramatically improve the efficacy of HCC treatment and the clinical outcome of HCC *** this review,we briefly summarize immunotherapy strategies and discuss new advances in combined immunotherapeutic approaches for the treatment of patients with liver cancer.

关键词： hepatocellular carcinoma immunotherapy immune checkpoint inhibitor strategy combination therapy

Clinical application of COVID-19 vaccine in liver transplant recipients

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Hepatobiliary & Pancreatic diseases International 2024年第4期23卷 339-343页

作者： Feng-Chao Liu Man Xie Wei Rao Division of Hepatology Liver Disease CenterThe Affiliated Hospital of Qingdao UniversityQingdao 266000China Organ transplantation Center The Affiliated Hospital of Qingdao UniversityQingdao 266000China institute of Organ Donation and transplantation of Qingdao University Qingdao 266000China Department of Gastroenterology The Affiliated Hospital of Qingdao UniversityQingdao 266000China

Background:Solid organ transplant(SOT)activities,such as liver transplant,have been greatly influenced by the pandemic of coronavirus disease 2019(COVID-19),a disease caused by severe acute respiratory syndrome coronavirus 2(SARS-CoV-2).Immunosuppressed individuals of liver transplant recipients(LTRs)tend to have a high risk of COVID-19 infection and related ***,COVID-19 vaccination has been recommended to be administered as early as possible in *** sources:The keywords“liver transplant”,“SARS-CoV-2”,and“vaccine”were used to retrieve articles published in ***:The antibody response following the 1st and 2nd doses of vaccination was disappointingly low,and the immune responses among LTRs remarkably improved after the 3rd or 4th dose of *** the 3rd or 4th dose of COVID-19 vaccine increased the antibody titer,a proportion of patients remained ***,recent studies showed that SARS-CoV-2 vaccine could trigger adverse events in LTRs,including allograft rejection and liver ***:This review provides the recently reported data on the antibody response of LTRs following various doses of vaccine,risk factors for poor serological response and adverse events after vaccination.

关键词： liver transplant COVID-19 SARS-CoV-2 Vaccine Antibody response

Non-invasive real-time assessment of hepatic macrovesicular steatosis in liver donors:Hypothesis,design and proof-of-concept study

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World Journal of Hepatology 2021年第10期13卷 1208-1214页

作者： Allwyn S Rajamani Ashwin Rammohan VV Raghavendra Sai Mohamed Rela Department of Applied Mechanics Indian Institute of Technology MadrasChennai 600036India institute of liver disease and transplantation Dr.Rela Institute and Medical CentreBharath Institute of Higher Education and ResearchChennai 600044India

Macrovesicular Steatosis(MS)is an independent risk factor for adverse post-liver transplant(LT)*** degree of MS is intimately related to the viability of the liver graft,which in turn is crucial to the success of the *** ideal liver graft should have no MS and most centres would find it unacceptable to use a donor liver with severe MS for *** a formal liver biopsy is the goldstandard diagnostic test for MS,given the logistical and time constraints it is not universally *** tests like a frozen section biopsy are plagued by issues of fallibility with reporting and sampling bias making them inferior to a liver ***,the development of an accurate,non-invasive,easy-to-use,handheld,real-time device for quantification of MS would fill this lacuna in the deceased donor selection *** present the hypothesis,design and proof-ofconcept of a study,which aims to standardise and determine the feasibility and accuracy of a novel handheld device applying the principle of diffuse reflectance spectroscopy for real-time quantification of MS.

关键词： Macrovesicular steatosis Deceased donors liver transplantation Real-time devices Diffuse reflectance spectroscopy

Indocyanine green fluorescence imaging: A novel technique in liver transplantation

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liver Research 2021年第4期5卷 204-208页

作者： Junkai Ren Chao Yuan Tong Zhang Department of Hepatic Surgery and liver transplantation Center The Third Affiliated Hospital of Sun Yat-sen UniversityGuangzhouChina liver transplantation Center of Sun Yat-sen University GuangzhouChina Organ transplantation institute of Guangdong Province GuangzhouChina

Indocyanine green(ICG)is a fluorescent dye that is widely used in hepatobiliary surgery for fluorescence *** is selectively absorbed by the liver after intravenous injection and then secreted into the ***'s unique catabolism and fluorescence characteristics allow for multiple applications in liver *** have divided the applications of ICG fluorescence imaging in liver transplantation into:(i)cholangiography,(ii)evaluation of liver transplantation vessels,(iii)liver mapping,and(iv)evaluation of donor liver *** this review,we summarize the current status of applications of ICG fluorescence imaging in liver transplantation.

关键词： Indocyanine green(ICG) Fluorescence imaging liver transplantation liver Surgery