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Management of cytomegalovirus infection after liver transplantation

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World Journal of transplantation 2024年第3期14卷 30-39页

作者： Zeynep Burcin Yilmaz Funda Memisoglu Sami Akbulut Infectious Diseases and Clinical Microbiology Inonu University Faculty of MedicineMalatya 44280Türkiye Surgery and liver Transplant Institute Inonu University Faculty of MedicineMalatya 44280Türkiye

Cytomegalovirus(CMV)infection is one of the primary causes of morbidity and mortality following liver transplantation(LT).Based on current worldwide guidelines,the most effective strategies for avoiding post-transplant CMV infection are antiviral prophylaxis and pre-emptive ***-IgG serology is the established technique for pretransplant screening of both donors and *** clinical presentation of CMV infection and disease exhibits variability,prompting clinicians to consistently consider this possibility,partic-ularly within the first year post-transplantation or subsequent to heightened *** annual symposia to discuss CMV prevention and how treatment outcomes can be improved,evidence on the incorporation of immune functional tests into clinical practice is presented,and the results of studies with new antiviral treatments are *** there are ongoing studies on the use of letermovir and maribavir in solid organ transplantation,a consensus reflected in the guidelines has not been *** the most appro-priate strategy at the individual level appears to be the key to enhancing *** prevention strategies reduce the risk of CMV disease,the disease can still occur in up to 50%of high-risk patients.A balance between the risk of infection and disease development and the use of immunosuppressants must be considered when talking about the proper management of CMV in solid organ transplant *** objective of this study was to establish a compre-hensive framework for the management of CMV in patients who have had LT.

关键词： liver transplantation Cytomegalovirus Antiviral prophylaxis Preemptive treatment Valganciclovir Ganciclovir

Coexistent Kaposi sarcoma and post-transplant lymphoproliferative disorder in the same lymph nodes after pediatric liver transplantation:A case report

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World Journal of Clinical Cases 2022年第25期10卷 9004-9011页

作者： Shu-Hong Zhang Guang-Yong Chen Zhi-Jun Zhu Lin Wei Ying Liu Jing-Yi Liu Department of Pathology Beijing Friendship HospitalCapital Medical UniversityBeijing 100050China liver transplantation Center National Clinical Research Center for Digestive DiseasesBeijing Friendship HospitalCapital Medical UniversityBeijing 100050China Clinical Center for Pediatric liver transplantation Capital Medical UniversityBeijing 100050China Department of Critical liver Diseases Liver Research CenterBeijing Friendship HospitalCapital Medical UniversityBeijing 100050China

BACKGROUND Kaposi sarcoma and post-transplant lymphoproliferative disorder have been occasionally reported in post-liver transplant ***,the simultaneous occurrence of these two diseases in the same lymph nodes is very *** SUMMARY We report the case of a 19-mo-old boy,who presented with intermittent fever and enlarged cervical lymph nodes after liver *** cervical lymph nodes were biopsied,and the histopathological examinations revealed multifocal hyperplasia of spindle cells around small blood vessels,extravasated erythrocytes,and heavy infiltration of plasma cells in the cortex and medulla of the lymph *** immunohistochemical analyses of spindle cells revealed positive expression of CD34,CD31,erythroblast transformation-specific-related gene,friend leukemia integration 1,and human *** lymphoproliferative lesions expressed CD38,CD138,and multiple myeloma ***-Barr encoded RNA in situ hybridization demonstrated Epstein-Barr virus-positive lymphoid ***,we diagnosed the coexistence of Kaposi sarcoma and post-transplant lymphoproliferative disorder(plasmacytic hyperplasia)in the same lymph *** strategy included anti-CD20 monoclonal antibody(rituximab)and discontinuation of the immunosuppressant *** node biopsies during follow-up examinations revealed lymphoid *** The rare coexistence of Kaposi sarcoma and post-transplant lymphoproliferative disorder in the same lymph nodes post-liver transplantation possibly associates with immunodeficiency and Epstein-Barr virus and human herpesvirus-8 coinfection.

关键词： Kaposi sarcoma Post-transplant lymphoproliferative disorder liver transplantation Epstein-Barr virus infections Human herpesvirus-8 Case report

Impact of sex on the outcomes of deceased donor liver transplantation

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World Journal of transplantation 2024年第1期14卷 120-129页

作者： Oya M Andacoglu Isabel S Dennahy Nicole C Mountz Luisa Wilschrey Arzu Oezcelik Division of transplantation and Advanced Hepatobiliary Surgery University of UtahSalt Lake CityUT 84112United States Department of Surgery University of EssenEssen D-45122Germany Department of Surgery The University of Oklahoma Health Sciences CenterOklahoma CityOK 73117United States Department of Surgery University of Oklahoma College of MedicineOklahoma CityOK 73117United States

BACKGROUND Data examining the impact of sex on liver transplant(LT)outcomes are *** is clear that further research into sex-related differences in transplant patients is necessary to identify areas for *** of these differences may help to identify specific areas of focus to improve on the organ matching process,as well as the peri-and post-operative care of these *** To utilize data from a high-volume Eurotransplant center to compare characteristics of male and female patients undergoing liver transplant and assess association between sex-specific variables with short-and long-term post-transplant *** A retrospective review of the University of Essen’s transplant database was performed with collection of baseline patient characteristics,transplant-related data,and short-term *** of these data were made with Shapiro-Wilk,Mann-Whitney U,χ2 and Bonferroni tests applied where appropriate.A P value ofliver failure and lower incidences of alcohol-related or viremic liver disease(P=0.001).Female patients were more likely to have received an organ from a female donor with a higher donor risk index score,and as a high urgency offer(all Pliver Disease score and donor cause of death were associated with long-term outcomes in ***-operative diagnosis of hepatocellular carcinoma,age at time of listing,duration of surgery,and units transfused during surgery,were associated with long-term outcomes in *** of complications was associated with long-term outcomes in both *** survival was similar in both males and females;however,when stratified by age,females<50 y

关键词： liver transplant Outcomes Survival Peri-and post-operative care

Oxygen vacancy boosting Fenton reaction in bone scaffold towards fighting bacterial infection

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International Journal of Extreme Manufacturing 2024年第1期6卷 296-311页

作者： Cijun Shuai Xiaoxin Shi Feng Yang Haifeng Tian Pei Feng State Key Laboratory of Precision Manufacturing for Extreme service Performance College of Mechanical and Electrical EngineeringCentral South UniversityChangsha 410083People’s Republic of China Institute of Additive Manufacturing Jiangxi University of Science and TechnologyNanchang 330013People’s Republic of China College of Mechanical Engineering Xinjiang UniversityUrumqi 830017People’s Republic of China

Bacterial infection is a major issue after artificial bone transplantation due to the absence of antibacterial function of bone scaffold,which seriously causes the transplant failure and even amputation in severe *** this study,oxygen vacancy(OV)defects Fe-doped Ti O2(OV-FeTiO2)nanoparticles were synthesized by nano TiO2and Fe3O4via high-energy ball milling,which was then incorporated into polycaprolactone/polyglycolic acid(PCLGA)biodegradable polymer matrix to construct composite bone scaffold with good antibacterial activities by selective laser *** results indicated that OV defects were introduced into the core/shell-structured OV-FeTiO2nanoparticles through multiple welding and breaking during the high-energy ball milling,which facilitated the adsorption of hydrogen peroxide(H2O2)in the bacterial infection microenvironment at the bone transplant *** accumulated H2O2could amplify the Fenton reaction efficiency to induce more hydroxyl radicals(·OH),thereby resulting in more bacterial deaths through·OH-mediated oxidative *** antibacterial strategy had more effective broad-spectrum antibacterial properties against Gram-negative Escherichia coli(***)and Gram-positive Staphylococcus aureus(***).In addition,the PCLGA/OV-FeTiO2scaffold possessed mechanical properties that match those of human cancellous bone and good biocompatibility including cell attachment,proliferation and osteogenic differentiation.

关键词： bacterial infection bone scaffold selective laser sintering Fenton reaction antibacterial properties

Machine learning-based comparison of factors influencing estimated glomerular filtration rate in Chinese women with or without nonalcoholic fatty liver

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World Journal of Clinical Cases 2024年第15期12卷 2506-2521页

作者： I-Chien Chen Lin-Ju Chou Shih-Chen Huang Ta-Wei Chu Shang-Sen Lee Department of Nursing Kaohsiung Armed Forces General HospitalKaohsiung 802Taiwan Department of Obstetrics and Gynecology Tri-Service General HospitalNational Defense Medical CenterTaipei 114Taiwan Chief Executive Officer's Office MJ Health Research FoundationTaipei 114Taiwan Department of Urology Taichung Tzu Chi HospitalBuddhist Tzu Chi Medical FoundationTaichung 427Taiwan School of Medicine Tzu Chi UniversityHualian 970Taiwan Department of Urology Tri-Service General HospitalNational Defense Medical CenterTaipei 114Taiwan

BACKGROUND The prevalence of non-alcoholic fatty liver(NAFLD)has increased *** with NAFLD are known to have higher chance for renal function *** past studies used traditional multiple linear regression(MLR)to identify risk factors for decreased estimated glomerular filtration rate(eGFR).However,medical research is increasingly relying on emerging machine learning(Mach-L)*** present study enrolled healthy women to identify factors affecting eGFR in subjects with and without NAFLD(NAFLD+,NAFLD-)and to rank their *** To uses three different Mach-L methods to identify key impact factors for eGFR in healthy women with and without *** A total of 65535 healthy female study participants were enrolled from the Taiwan MJ cohort,accounting for 32 independent variables including demographic,biochemistry and lifestyle parameters(independent variables),while eGFR was used as the dependent *** from MLR,three Mach-L methods were applied,including stochastic gradient boosting,eXtreme gradient boosting and elastic *** of estimation were used to define method accuracy,where smaller degree of error indicated better model *** Income,albumin,eGFR,High density lipoprotein-Cholesterol,phosphorus,forced expiratory volume in one second(FEV1),and sleep time were all lower in the NAFLD+group,while other factors were all significantly higher except for smoking ***-L had lower estimation errors,thus outperforming *** Model 1,age,uric acid(UA),FEV1,plasma calcium level(Ca),plasma albumin level(Alb)and T-bilirubin were the most important factors in the NAFLD+group,as opposed to age,UA,FEV1,Alb,lactic dehydrogenase(LDH)and Ca for the *** the importance percentage was much higher than the 2nd important factor,we built Model 2 by removing *** The eGFR were lower in the NAFLD+group compared to the NAFLD-group,with age being was the most important impact factor in both groups of he

关键词： Non-alcoholic fatty liver Estimated glomerular filtration rate Machine learning Chinese women

Return to Dialysis after Kidney Graft Failure

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Open Journal of Nephrology 2024年第2期14卷 240-252页

作者： Ikram Ftaimi Soukaina Sakab Manal Chattahi Tarik Bouattar Loubna Benamar Rabia Bayahia Naima Ouzeddoun service de Nphrologie-Dialyse-transplantationrnale CHU Ibn Sina Rabat Universit Mohammed V Rabat Morocco

Introduction: The transition period from renal transplantation to dialysis is associated with high morbidity and mortality. The aim of this study is to describe the clinical and paraclinical characteristics, therapeutic management and evolutionary profile of patients returning to dialysis after kidney graft failure. Material and Methods: This was a retrospective, descriptive study conducted in the Nephrology-Dialysis-Renal Transplant Department at university hospital IbnSina between January 1998 and December 2021. We included all renal transplant recipients who had experienced kidney graft dysfunction and returned to dialysis. Patients with a follow-up after return to dialysis of less than 1 year were excluded. Results: Among 166 renal transplant recipients, 20 returned to dialysis after a median renal graft life of 85.5 months [42 - 186], corresponding to a prevalence of 12%. The mean age of our patients was 38.7 ± 11.9 years, with a M/F sex ratio of 2.3. Dialysis was initiated urgently in 10 patients (50%). Hemodialysis was the most commonly used modality (75%). Central venous catheterization was used in 35% of cases, including tunneled catheters. General condition is impaired in all patients, with persistent hypertension in 70% of cases. Mean uremia was 2.35 ± 0.8 g/l, mean creatinine 116 ± 48.3 mg/l, giving a mean GFR of 5.1 ± 2.2 ml/min. Mean albuminemia was 32.9 ± 6 g/l and mean hemoglobinemia 8.6 ± 1.9 g/dl. During the first year of follow-up, none of the patients died. However, 13 patients required hospitalization, with a mean length of stay of 15 days. Eight patients were hospitalized for infections and 5 for renal graft intolerance syndrome. After a mean follow-up of 22 months, 6 patients were detransplanted following graft necrosis. Conclusion: Return to dialysis after RT is fraught with a high rate of complications. The management of these patients must be optimized to improve their vital prognosis and quality of life.

关键词： Kidney Graft Failure Dialysis Detransplantation Immunosuppression

Role of Noncoding RNAs in the Tumor Immune Microenvironment of Hepatocellular Carcinoma

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Journal of Clinical and Translational Hepatology 2023年第3期11卷 682-694页

作者： Yue Lv Zhen Wang Kefei Yuan Department of liver Surgery&liver transplantation State Key Laboratory of Biotherapy and Cancer CenterWest China HospitalSichuan Universityand Collaborative Innovation Center of BiotherapyChengduSichuanChina Laboratory of liver Surgery West China HospitalSichuan UniversityChengduSichuanChina

Hepatocellular carcinoma (HCC) is one of the most preva-lent malignancies. It has high mortality and poor clinical out-comes, but the molecular mechanisms in the pathogenesis of HCC are not understood. The tumor immune microenviron-ment (TIME) is a highly intricate system with distinct popula-tions of innate and adaptive immune cells, as well as other stromal cells. They interact and evolve with tumor cells to influence tumor growth, migration, invasion, immune eva-sion, and response to therapy. Emerging evidence has shown noncoding RNAs (ncRNAs) are prominent regulators of TIME in HCC. In this review, we elaborate on the functions and molecular mechanisms of ncRNAs in remodeling TIME of HCC and discuss their diagnostic and therapeutic potential for HCC treatment.

关键词： ncRNAs TIME HCC Biomarker Therapeutic strategy.

Pros and cons of live kidney donation in prediabetics: A critical review and way forward

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World Journal of transplantation 2024年第1期14卷 12-31页

作者： Muhammad Abdul Mabood Khalil Nihal Mohammed Sadagah Jackson Tan Furrukh Omair Syed Vui Heng Chong Salem H Al-Qurashi Center of Renal Diseases and transplantation King Fahad Armed Forces Hospital JeddahJeddah 23311Saudi Arabia Department of Nephrology RIPAS Hospital Brunei DarussalamBrunei Muara BA1710Brunei Darussalam Division of Gastroenterology and Hepatology Department of MedicineRaja Isteri Pengiran Anak Saleha HospitalBandar Seri Begawan BA1710Brunei Darussalam

There is shortage of organs,including kidneys,*** with deceased kidney transplantation,there is a significant rise in live kidney *** prevalence of prediabetes(PD),including impaired fasting glucose and impaired glucose tolerance,is on the rise across the *** teams frequently come across prediabetic kidney donors for *** are at risk of diabetes,chronic kidney disease,cardiovascular events,stroke,neuropathy,retinopathy,dementia,depression and nonalcoholic liver disease along with increased risk of all-cause ***,most of the studies done in prediabetic kidney donors are retrospective in nature and have a short follow up *** is lack of prospective long-term studies to know about the real risk of complications after ***,there are variations in recommendations from various guidelines across the globe for donations in prediabetics,leading to more confusion among *** increases the responsibility of transplant teams to take appropriate decisions in the best interest of both donors and *** review focuses on pathophysiological changes of PD in kidneys,potential complications of PD,other risk factors for development of type 2 diabetes,a review of guidelines for kidney donation,the potential role of diabetes risk score and calculator in kidney donors and the way forward for the evaluation and selection of prediabetic kidney donors.

关键词： Live kidney donation Prediabetes Impaired fasting glucose Impaired glucose tolerance Review

Angiogenesis and immune checkpoint dual blockade:Opportunities and challenges for hepatocellular carcinoma therapy

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World Journal of Gastroenterology 2022年第42期28卷 6034-6044页

作者： Si-Qi Li Yang Yang Lin-Sen Ye Department of Hepatic Surgery and liver transplantation Center The Third Affiliated Hospital of Sun Yat-sen UniversityGuangzhou 510630Guangdong ProvinceChina

The disease burden related to hepatocellular carcinoma(HCC) is increasing. Most HCC patients are diagnosed at the advanced stage and multikinase inhibitors have been the only treatment choice for them. Recently, the approval of immune checkpoint inhibitors(ICIs) has provided a new therapeutic strategy for HCC. It is noteworthy that the positive outcomes of the phase Ⅲ clinical trial IMBrave150 [atezolizumab(anti-programmed cell death ligand 1 antibody) combined with bevacizumab(anti-vascular endothelial growth factor monoclonal antibody)],showed that overall survival and progression-free survival were significantly better with sorafenib. This combination therapy has become the new standard therapy for advanced HCC and has also attracted more attention in the treatment of HCC with anti-angiogenesis-immune combination therapy. Currently, the synergistic antitumor efficacy of this combination has been shown in many preclinical and clinical studies. In this review, we discuss the mechanism and clinical application of anti-angiogenics and immunotherapy in HCC, outline the relevant mechanism and rationality of the combined application of antiangiogenics and ICIs, and point out the existing challenges of the combination therapy.

关键词： Anti-angiogenesis Immunotherapy Combination therapy Vascular endothelial growth factor Immune checkpoint blockade Hepatocellular carcinoma