Health Care Science最新文献

{"title":"Management of Radiodermatitis in Patients With Head and Neck Cancer Undergoing Radiotherapy: A Scoping Review","authors":"Tâmara Taynah Medeiros da Silva,&nbsp;Louise Constancia de Melo Alves Silva,&nbsp;Thatiane Evelyn de Lima Fernandes,&nbsp;Karena Cristina da Silva Leal,&nbsp;Thaís Brunna Maurício Pinheiro,&nbsp;Guilherme Moises Alves Fernandes,&nbsp;Kátia Regina Barros Ribeiro,&nbsp;Daniele Vieira Dantas,&nbsp;Rodrigo Assis Neves Dantas","doi":"10.1002/hcs2.70062","DOIUrl":"10.1002/hcs2.70062","url":null,"abstract":"<p>Given the worldwide prevalence of head and neck cancer and the importance of scientifically based treatment, current studies are discussing innovative strategies for the treatment of radiodermatitis. This review adhered to the Joanna Briggs Institute's nine-step methodological framework for scoping reviews and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews checklist. We searched eight databases: Web of Science, Science Direct, Scientific Electronic Library Online, CAPES Catalog of Theses and Dissertations, Elsevier's Scopus, Wiley Online Library, PubMed Central, and Cochrane Library. Data collection occurred in March 2024. A final sample of 21 articles was selected. The research question was formulated using the “Population, Concept and Context” framework. This led to the specific question: “What are the strategies identified in the literature used in the management of radiodermatitis in patients with head and neck cancer undergoing radiotherapy?” The included studies were published between 2011 and 2024, with China being the leading producer of articles. Clinical trials were the predominant study design. Scales were frequently used to assess various aspects of radiodermatitis. The Radiation Therapy Oncology Group criteria were commonly used. Several topical agents for preventing radiodermatitis were evaluated, including pharmacological therapies, phototherapy/photobiomodulation, and dressings. Numerous topical agents have been clinically tested for the treatment and prevention of radiodermatitis in patients with head and neck cancer. However, the current body of research is insufficient in both quantity and quality to conclusively support or refute the widespread approval of any specific product.</p>","PeriodicalId":100601,"journal":{"name":"Health Care Science","volume":"5 4","pages":"364-375"},"PeriodicalIF":6.0,"publicationDate":"2026-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13398964/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148586608","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diabetic Retinopathy in Primary Healthcare in a Brazilian Municipality: A Cross-Sectional Study Using Teleophthalmology","authors":"Lorrana Luysse dos Anjos Assis,&nbsp;Fernando Korn Malerbi,&nbsp;Rosiane Chiaroti,&nbsp;Lívia Maria Ferrante Vizzotto Consoli,&nbsp;Vanessa Patrícia Pereira Motozo,&nbsp;Francisco Barbosa-Junior,&nbsp;Rinaldo Eduardo Machado de Oliveira","doi":"10.1002/hcs2.70076","DOIUrl":"10.1002/hcs2.70076","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Diabetic retinopathy is a complication of diabetes and the leading cause of irreversible blindness in people of working age. This study aims to estimate the prevalence of diabetic retinopathy among individuals taking insulin who attend the primary healthcare in the municipality of Jardinópolis, state of São Paulo, Brazil.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This is a cross-sectional study with a sample of 152 participants, in which data collection occurred in March 2023 by means of interviews, laboratory exams and fundoscopy with a portable retinal camera mounted onto a device attached to a smartphone. The captured images were automatically analysed by means of deep learning algorithms for grading retinal alterations, as well as diabetic retinopathy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The prevalence of diabetic retinopathy was estimated to be 28.3% (95% CI 21.1–35.4), with most of the cases corresponding to mild non-proliferative diabetic retinopathy (65.1%). No association was found between diabetic retinopathy and the variables investigated. Concordance test between self-reported and diagnosed diabetic retinopathy showed a Kappa coefficient of 0.30 (95% CI, 0.13–0.47), in which 16.5% of the participants reported having no diabetic retinopathy despite being diagnosed as having it. However, 9.9% of the participants self-reporting having diabetic retinopathy were not diagnosed with it.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The prevalence of diabetic retinopathy is within the national range. The lack of knowledge on the diagnosis of diabetic retinopathy and aspects related to such a complication of diabetes was found to be worrying. Therefore, one highlights the importance of primary healthcare programmes in promoting integral care to people with diabetes, including ocular health.</p>\u0000 </section>\u0000 </div>","PeriodicalId":100601,"journal":{"name":"Health Care Science","volume":"5 4","pages":"310-319"},"PeriodicalIF":6.0,"publicationDate":"2026-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13398352/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148586614","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"From Evidence to Delivery: Building Readiness for Maternal Respiratory Syncytial Virus Vaccination in Bangladesh.","authors":"Ridwana Maher Manna, Siobhan L Johnstone, Pradip Chandra, Michelle J Groome, Shams El Arifeen, Aniqa Tasnim Hossain","doi":"10.1002/hcs2.70091","DOIUrl":"10.1002/hcs2.70091","url":null,"abstract":"","PeriodicalId":100601,"journal":{"name":"Health Care Science","volume":" ","pages":""},"PeriodicalIF":6.0,"publicationDate":"2026-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13418492/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148623605","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring the Value Realization and Management of Healthcare Data Elements in the Context of New Quality Productive Forces.","authors":"Zhixuan Yu, Jiaxuan Wei, Jianlin Wang, Jie Lu, Pengfei Cao","doi":"10.1002/hcs2.70086","DOIUrl":"10.1002/hcs2.70086","url":null,"abstract":"<p><p>This review centers on the core role of medical data in new quality productive forces. It systematically examines the current landscape of the rapid expansion of these data and explores their value in depth. Drawing on value chain theory, the paper proposes a \"value flow\" analytical framework, and conducts an in-depth exploration of the full dynamic process through which medical data are converted into data assets. We defined \"value flow\" as a process in which data value undergoes directional transmission, integration, amplification, and ultimate release along a chain-like pathway spanning data collection, governance, analysis, application, and circulation. We argue that a focus solely on the static components of the \"value chain\" cannot fully capture the holistic landscape of the transformation. Instead, it is essential to integrate dynamic value flow to systematically resolve the core challenges inherent in this transformation. The tracking and optimization of value flow direction supports objectives including: (1) Eliminating data silos and process breakpoints, and guaranteeing the seamless flow of value across clinical practice, scientific research, administrative management and other application scenarios; (2) Defining the contributions and rights allocation of stakeholders at each stage, providing a robust basis for the development of a compliant and sustainable profit-sharing mechanism; (3) Charting the operational orientation of data as assets, facilitating the precise allocation of data assets to high-demand scenarios and maximizing the realization of their inherent value. This paper therefore focuses on the assetization of medical data, and incorporates value flow to suggest a sustainable value release mechanism and core components of asset management after assetization. It therefore establishes a factor-oriented management framework for data assets rooted in value chain theory and guided by value flow direction. This framework offers medical institutions practical guidance for integrating theoretical underpinnings and operational feasibility of data assetization, supporting the management of data across its full life-cycle, including value monetization and strategic planning of data assets.</p>","PeriodicalId":100601,"journal":{"name":"Health Care Science","volume":" ","pages":""},"PeriodicalIF":6.0,"publicationDate":"2026-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13398552/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148586635","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Artificial Intelligence in Ophthalmology: Current Status, Challenges, and Future Perspectives","authors":"She Chongyang,&nbsp;Tao Yong","doi":"10.1002/hcs2.70052","DOIUrl":"https://doi.org/10.1002/hcs2.70052","url":null,"abstract":"<p>Artificial intelligence (AI) is revolutionizing ophthalmology by providing innovative solutions for disease screening, diagnosis, personalized treatment, and the delivery of global healthcare services. This review explores the current state of AI research and applications in the field of ophthalmology, and the applications of telemedicine as well as clinical trials demonstrating AI's utility in reducing diagnostic time and improving treatment outcomes. It also analyzes the challenges faced in practical applications, including economic constraints, data privacy issues, and regulatory hurdles. The review highlights the future directions of AI integration, including highly accurate AI diagnosis, the formulation of personalized treatment plans, AI-assisted surgical treatment, wearable medical devices, and telemedicine connectivity technologies. In addition, collaborative efforts among academia, the industry, and policymakers are crucial for overcoming these obstacles and fully unleashing the potential of AI in achieving equitable, efficient, and personalized ophthalmic healthcare services.</p>","PeriodicalId":100601,"journal":{"name":"Health Care Science","volume":"5 3","pages":"249-259"},"PeriodicalIF":3.3,"publicationDate":"2026-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/hcs2.70052","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148174344","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Combined Detection of Preoperative Serum Calcitonin and Carcinoembryonic Antigen in Medullary Thyroid Carcinoma: A Retrospective Multicenter Cohort Study","authors":"Yu Yang,&nbsp;Yufei He,&nbsp;Bo Lin,&nbsp;Yuanyuan Zheng,&nbsp;Xinyi Deng,&nbsp;Wenxin Chen,&nbsp;Zhenbang Ke,&nbsp;Yue Qiu,&nbsp;Yuting Hong,&nbsp;Jiayuan Zhang,&nbsp;Guojie Dong,&nbsp;Siqi Qiao,&nbsp;Ziyi Xin,&nbsp;Xuyang Li,&nbsp;Tianyi Xu,&nbsp;Wenke Chen,&nbsp;Xinwen Chen,&nbsp;Yingtong Hou,&nbsp;Fenghua Lai,&nbsp;Jianyan Long,&nbsp;Zhanqiang Zhang,&nbsp;Xiangdong Xu,&nbsp;Yihao Liu","doi":"10.1002/hcs2.70074","DOIUrl":"https://doi.org/10.1002/hcs2.70074","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The aim of this study was to investigate the clinical value of combined detection of preoperative serum calcitonin (Ctn) and carcinoembryonic antigen (CEA) for diagnosing medullary thyroid carcinoma (MTC), as well as predicting lymph node metastases and prognosis, compared with the value of detection of either marker alone.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This retrospective multicenter cohort study included patients with thyroid nodules who underwent preoperative measurements of serum Ctn and CEA at six medical centers between 2012 and 2024. Receiver operating characteristic (ROC) curves were analyzed to compare the diagnostic performances of Ctn, CEA, and their combination.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 13,272 patients were included in the study, comprising 115 with MTC, 10,845 with papillary thyroid carcinoma, and 2312 with benign nodules. For diagnosing MTC, the area under the ROC curve (AUC) values for Ctn and CEA alone were 0.992 and 0.983, respectively, while the combination of the two markers achieved the highest AUC of 0.999. Ctn had a higher positive predictive value (PPV) for MTC diagnosis than CEA (51% vs. 31%), and the combination did not improve the PPV (46%) compared with Ctn alone. For predicting cervical and lateral neck lymph node metastases in MTC, the combination had a higher AUC than Ctn or CEA alone (0.735 vs. 0.708 vs. 0.655 and 0.769 vs. 0.707 vs. 0.675). The combination also had a higher AUC for predicting recurrence than Ctn or CEA alone (0.734 vs. 0.642 vs. 0.611).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Compared with the detection of either marker alone, the combined detection of Ctn and CEA improved the diagnostic accuracy for MTC but did not enhance the PPV. The combined detection also improved the predictive accuracy for cervical and lateral lymph node metastases and disease recurrence.</p>\u0000 </section>\u0000 </div>","PeriodicalId":100601,"journal":{"name":"Health Care Science","volume":"5 3","pages":"223-230"},"PeriodicalIF":3.3,"publicationDate":"2026-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/hcs2.70074","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148174438","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Analysis of Research Trends and Output Effectiveness in the Medical Field Based on the National Natural Science Foundation of China","authors":"Hu Jin,&nbsp;Huang Hui,&nbsp;Bao Xinjie,&nbsp;Bai Hua","doi":"10.1002/hcs2.70075","DOIUrl":"https://doi.org/10.1002/hcs2.70075","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>This study aims to analyze the trends in research focus and output effectiveness in the medical field supported by the National Natural Science Foundation of China (NSFC) over the past 15 years, providing a basis for the optimal allocation of scientific research resources.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Based on the NSFC Big Data Knowledge Management Service Database, a retrospective approach was adopted to retrieve data on completed projects and output achievements from 2009 to 2023. Indicators, including compound annual growth rate (CAGR) and output-to-project ratio, were used to evaluate the growth of project completion and research productivity across 35 secondary medical categories.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Over the 15-year period, a total of 439,637 NSFC projects were completed, with the Division of Medical Science ranking first in both scale (23%) and growth rate (CAGR 11%). The 35 secondary categories (H01–H35) under the Division of Medical Science showed differentiated development characteristics, namely “a few growing rapidly, most growing steadily, and a small number lagging behind”: six directions including biomedical engineering had a CAGR of ≥ 15%; oncology and traditional chinese medicine contributed large output volumes but showed low output-to-project ratios, whereas neuroscience, imaging medicine, and biomedical engineering achieved high efficiency. Key Programs achieved the highest output-to-project ratios, followed by the General Program and then the Young Scientists Fund.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The completion and output of NSFC-funded medical projects reflect national strategic orientations and disciplinary development laws, but imbalance remains between project scale and output efficiency across subfields. It is suggested to establish a dynamic evaluation mechanism, promote the “basic research-application-transformation” collaborative model, support small-scale yet high-efficiency fields, and conduct long-term tracking of output achievements. These measures are expected to optimize the allocation of NSFC funding resources.</p>\u0000 </section>\u0000 </div>","PeriodicalId":100601,"journal":{"name":"Health Care Science","volume":"5 3","pages":"231-239"},"PeriodicalIF":3.3,"publicationDate":"2026-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/hcs2.70075","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148174454","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors Affecting the Appropriate Angiography Prescription in Iranian Hospitals","authors":"Atieh Sadat Bigdeli,&nbsp;Leila Riahi,&nbsp;Fakhreddin Hejazi,&nbsp;Aniseh Nik Ravan","doi":"10.1002/hcs2.70059","DOIUrl":"https://doi.org/10.1002/hcs2.70059","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Inappropriate angiography prescriptions impose substantial financial and clinical burdens on healthcare systems. This study aimed to develop a comprehensive model for appropriate angiography prescription by examining supply-and demand-side factors in public and private hospitals in Iran.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Data were collected from domestic and international databases covering the period from 1998 to 2023 and analyzed through exploratory and confirmatory factor analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Results indicated that physician density and information asymmetry were the most influential factors in the public sector, while physician income and patient insistence dominated in the private sector. Patient preferences and intolerance of uncertainty were key demand-side determinants.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The findings support policy interventions targeting behavioral and structural drivers of inappropriate prescriptions.</p>\u0000 </section>\u0000 </div>","PeriodicalId":100601,"journal":{"name":"Health Care Science","volume":"5 3","pages":"240-248"},"PeriodicalIF":3.3,"publicationDate":"2026-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/hcs2.70059","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148174805","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Construction and Practice of an Efficient Classroom for Surgical Procedures in a Digital Environment","authors":"Jiao Wang,&nbsp;Chunyu Zhou","doi":"10.1002/hcs2.70053","DOIUrl":"https://doi.org/10.1002/hcs2.70053","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Higher medical education has undergone profound changes arising from the digitalization of education. However, teaching efficiency needs to be further improved, and medical and surgical teaching still faces problems such as insufficient integration of theory and practice. This study focuses on digital technology-enabled medical and surgical teaching to maximize teaching efficiency and explore innovative paths for improved teaching quality and cultivation of practice-oriented medical skills.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We used a questionnaire survey method to investigate medical students' (<i>n</i> = 278) practical experiences of digitalized surgical courses. Data from the survey questionnaire were quantitatively analyzed to understand students' demographic backgrounds, learning outcomes using digital technology, mastery of surgical techniques, and satisfaction with new teaching methods.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Excellent student learning outcomes were reported following the technology-enabled medical and surgical teaching. Ninety-five students (34.17%) demonstrated significant improvement in their mastery of surgical theory, and 120 students (43.16%) showed improvement. The mean score (maximum score of 5) for laparoscopic surgical skills was 3.85, and the mean score for anatomical structure recognition was 4.02, both indicating a high level of proficiency. In terms of teaching satisfaction, 235 students (84.53%) expressed satisfaction or strong satisfaction with the digital teaching methods, reflecting widespread acceptance of this educational model.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Digital technology was associated with greater efficacy and skill mastery for medical students learning surgical procedures in our study. Students' teaching satisfaction also improved. This study demonstrates the value of digital technology use in medical education and suggests some new lines of research and practice in medical education.</p>\u0000 </section>\u0000 </div>","PeriodicalId":100601,"journal":{"name":"Health Care Science","volume":"5 3","pages":"174-179"},"PeriodicalIF":3.3,"publicationDate":"2026-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/hcs2.70053","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148173963","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Standardized Management Pathway to Prevent Acute Rejection After Liver Transplantation Following ICI Therapy for Downstaging HCC","authors":"Ning Wang,&nbsp;Zebin Zhu,&nbsp;Hao Zheng,&nbsp;Can Qi,&nbsp;Xiaodong Yuan,&nbsp;Xuefeng Li,&nbsp;Zhijun Xu,&nbsp;Jiwei Qin,&nbsp;Wei Wu,&nbsp;Jizhou Wang,&nbsp;Ruipeng Song,&nbsp;Zhiyong Guo,&nbsp;Lianxin Liu,&nbsp;Shu-Geng Zhang,&nbsp;Björn Nashan","doi":"10.1002/hcs2.70071","DOIUrl":"https://doi.org/10.1002/hcs2.70071","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Immune checkpoint inhibitors (ICIs) have shown promise in downstaging hepatocellular carcinoma (HCC) for liver transplantation (LT), enabling previously ineligible patients to meet transplant criteria. However, their use raises concerns about post-transplant acute rejection (AR) based on data lacking information regarding standardized management pathways and notably perioperative protocols, including immunosuppression protocols and monitoring.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This study evaluated 59 LT recipients divided into three groups (two control groups), including 13 ICI-exposed patients (third group). All groups followed a standardized immunosuppression protocol and monitoring embedded into an enhanced recovery after surgery (ERAS) protocol, featuring basiliximab and steroid induction, early mammalian target of rapamycin inhibitor (mTOR) use, and reduced tacrolimus dosing.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Despite varied ICI washout intervals (median 36 days), no AR episodes were observed in any group. One-year overall survival and recurrence-free survival were 93%/85% and 100%/85% in standard patients, and 77%/69% in ICI-exposed patients, respectively. The most frequent complications were biliary and infectious, with no significant intergroup differences.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>These findings suggest that in a standardized clinical pathway with structured immunosuppressive protocols, therapeutic drug monitoring, and early complication surveillance, LT can be safely performed after ICI exposure without increasing rejection risk. The study underscores the need for standardized clinical pathways and consistent reporting of immunosuppressive regimens to optimize outcomes in this emerging patient population.</p>\u0000 </section>\u0000 </div>","PeriodicalId":100601,"journal":{"name":"Health Care Science","volume":"5 3","pages":"196-206"},"PeriodicalIF":3.3,"publicationDate":"2026-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/hcs2.70071","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148174729","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}