Journal of Liver Transplantation最新文献_第7页

Antibody-mediated rejection in liver transplantation- An unresolved puzzle 肝移植中抗体介导的排斥反应--一个未解之谜

Journal of Liver Transplantation Pub Date : 2024-02-01 DOI: 10.1016/j.liver.2024.100200

Lakshmi V U , Dinesh Balakrishnan , Narmadha M P , S Sudhindran

{"title":"Antibody-mediated rejection in liver transplantation- An unresolved puzzle","authors":"Lakshmi V U , Dinesh Balakrishnan , Narmadha M P , S Sudhindran","doi":"10.1016/j.liver.2024.100200","DOIUrl":"10.1016/j.liver.2024.100200","url":null,"abstract":"<div><p>Antibody-mediated rejection (AMR) in liver transplantation is a frequently underestimated contributor to allograft injury. Despite advancements in defining acute and chronic AMR, challenges persist in timely identification and effective management. The complexities arise from the intricate nature of diagnosis, the absence of standardized treatment protocols, and uncertainties regarding long-term outcomes.</p><p>Understanding the specific antibodies involved, their target antigens on liver cells, and the mechanisms of complement activation is crucial for developing targeted therapies. This knowledge gap, coupled with the absence of clear diagnostic criteria and standardized treatments, adds to the intricacy of addressing AMR in liver transplantation.</p><p>Heightened clinical awareness and prompt identification of AMR post-liver transplantation are crucial. These efforts not only refine our understanding but also drive future research initiatives and the formulation of effective diagnostic and treatment protocols. Ongoing research aims to unravel AMR complexities through diagnostic tool advancements and refined histopathologic assessments, especially during acute and chronic rejection episodes.</p><p>This review delves into recent progress in clinically diagnosing and treating AMR in liver transplantation. It underscores the importance of recognizing specific histopathologic features in liver biopsy tissue during both acute and chronic phases of AMR. By shedding light on these complexities, the review aims to contribute to evolving research, fostering a deeper understanding, and paving the way for more effective management strategies in liver transplantation.</p></div>","PeriodicalId":100799,"journal":{"name":"Journal of Liver Transplantation","volume":"13 ","pages":"Article 100200"},"PeriodicalIF":0.0,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666967624000011/pdfft?md5=d5a6dbd34272980401e155df10f2ea95&pid=1-s2.0-S2666967624000011-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139634842","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}

引用次数: 0

Social science perspectives on liver transplantation - The author's reply to the rebuttal 作者对反驳的答复--肝移植的社会科学视角

Journal of Liver Transplantation Pub Date : 2024-01-10 DOI: 10.1016/j.liver.2023.100198

Julia Rehsmann

引用次数: 0

Rebuttal to the author's reply - The German Transplantation Scandal 对提交人答复的反驳

Journal of Liver Transplantation Pub Date : 2024-01-04 DOI: 10.1016/j.liver.2023.100197

Björn Nashan

引用次数: 0

High discordance rate between explant and listing diagnosis among liver transplant recipients for alcoholic liver disease 酒精性肝病肝移植受者的移植诊断与列表诊断不一致率很高

Journal of Liver Transplantation Pub Date : 2023-12-31 DOI: 10.1016/j.liver.2023.100199

Aditya Gandhi , Kenji Okumura , Kevin Wolfe , Seigo Nishida , Roxana Bodin , Abhay Dhand

引用次数: 0

Predictors of early and long-term readmissions and their association with survival after liver transplantation 肝移植术后早期和长期再入院的预测因素及其与存活率的关系

Journal of Liver Transplantation Pub Date : 2023-12-17 DOI: 10.1016/j.liver.2023.100195

N Simonian , M Brahmania , M Bhat , A Kim , HLA Janssen , BE Hansen , K Patel

{"title":"Predictors of early and long-term readmissions and their association with survival after liver transplantation","authors":"N Simonian , M Brahmania , M Bhat , A Kim , HLA Janssen , BE Hansen , K Patel","doi":"10.1016/j.liver.2023.100195","DOIUrl":"10.1016/j.liver.2023.100195","url":null,"abstract":"<div><h3>Background</h3><p>The impact of post liver transplantation (LT) readmissions on mortality has not been well described. Thus, the primary objective of our study was to determine predictors of readmissions post-LT and assess impact on survival.</p></div><div><h3>Methods</h3><p>Single center retrospective observational study investigating adult patients who underwent LT between January 1, 2010 – December 31, 2019 at Toronto General Hospital (TGH). Time-dependent cox regression model was used to investigate risk factors for 30-day, 30–90-day, and >90-day readmissions to hospital. The effect of readmission on survival was assessed with the Kaplan–Meier estimator.</p></div><div><h3>Results</h3><p>987 patients fulfilled inclusion criteria. Significant predictors of 30-day readmissions were BMI > 30 kg/m<sup>2</sup> (HR=0.64; CI 0.42–0.98; p-value 0.04) and autoimmune/cholestatic liver disease (HR=1.86; CI 1.01–3.42; <em>p</em> = 0.046) at 30-days. Post-LT length of stay (HR=1.05; CI 1.02–1.08; <em>p</em><0.001) at 30–90 days. Meanwhile, living donor LT (HR=1.41; CI 1.06–1.89; <em>p</em> = 0.02) and distance from LT center (HR=1.05; CI 1.01–1.09; <em>p</em> = 0.011) after 90 days. Infection was the main reason for readmission across three time periods. An inpatient readmission across any time period was found to be significantly associated with mortality (HR=2.4; 1.6–3.6; <em>p</em><0.0001).</p></div><div><h3>Conclusion</h3><p>Hospital readmissions post-LT are associated with increased mortality. Although infection is a common risk factor for readmission other modifiable risk factors may be an area for target of interventions to reduce post-LT readmission.</p></div>","PeriodicalId":100799,"journal":{"name":"Journal of Liver Transplantation","volume":"13 ","pages":"Article 100195"},"PeriodicalIF":0.0,"publicationDate":"2023-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666967623000570/pdfft?md5=72f7492705b270a2ea4c2ccbf8e5b27e&pid=1-s2.0-S2666967623000570-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139025155","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}

引用次数: 0

Perioperative management of glucose and lactate homeostasis in paediatric glycogen storage disease type 1a coming for living donor liver transplant 儿童糖原贮积症 1a 型活体肝移植围手术期的葡萄糖和乳酸平衡管理

Journal of Liver Transplantation Pub Date : 2023-12-17 DOI: 10.1016/j.liver.2023.100196

Annu Sarin Jolly , Vidyadhar Metri , Sanjay K. Goja , Manoj K. Singh , Varun Mahabaleshwar , Sahana Shankar

{"title":"Perioperative management of glucose and lactate homeostasis in paediatric glycogen storage disease type 1a coming for living donor liver transplant","authors":"Annu Sarin Jolly , Vidyadhar Metri , Sanjay K. Goja , Manoj K. Singh , Varun Mahabaleshwar , Sahana Shankar","doi":"10.1016/j.liver.2023.100196","DOIUrl":"10.1016/j.liver.2023.100196","url":null,"abstract":"<div><p>Glycogen storage disease (GSD) is a rare inborn autosomal recessive inherited disorder of carbohydrate metabolism. There are multiple types of GSD, out of which GSD type I, III, IV, VI, and IX show liver involvement. Due to a deficiency of glucose-6-phosphatase enzyme in this disorder, glycogen stored in the liver cannot be metabolised, leading to poor tolerance to fasting and increased risk of hypoglycaemia and lactate acidosis. Inability to metabolise glycogen leads to progressive accumulation of glycogen in liver leading to hepatic adenoma (HA) and/or hepatocellular carcinoma (HCC). Liver transplantation (LT) has been proposed as the preferred therapy for these types of GSD, as it helps in correcting the primary hepatic enzyme defect, thereby improving the quality of life and reducing the risk of HCC. Herein we report our experience of perioperative management of paediatric GSD type 1a (Von Gierke's disease) patient undergoing living donor liver transplant (LDLT).</p></div>","PeriodicalId":100799,"journal":{"name":"Journal of Liver Transplantation","volume":"13 ","pages":"Article 100196"},"PeriodicalIF":0.0,"publicationDate":"2023-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666967623000582/pdfft?md5=e9597817f053818f38e92a1a7f9b7ac9&pid=1-s2.0-S2666967623000582-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139018686","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}

引用次数: 0

Increase of circulating IgA levels after pediatric liver transplantation. A retrospective cohort study 儿童肝移植后循环IgA水平升高。回顾性队列研究

Journal of Liver Transplantation Pub Date : 2023-11-22 DOI: 10.1016/j.liver.2023.100194

Guillermo Costaguta , Stéphanie Dion , Marie-Ève Chartier , Massimiliano Paganelli , Fernando Álvarez

{"title":"Increase of circulating IgA levels after pediatric liver transplantation. A retrospective cohort study","authors":"Guillermo Costaguta , Stéphanie Dion , Marie-Ève Chartier , Massimiliano Paganelli , Fernando Álvarez","doi":"10.1016/j.liver.2023.100194","DOIUrl":"https://doi.org/10.1016/j.liver.2023.100194","url":null,"abstract":"<div><h3>Introduction</h3><p>Elevation of IgA levels has not been studied in the post-transplant setting. We present a series of pediatric liver recipients with elevated IgA during follow-up and relate them to changes in renal function.</p></div><div><h3>Materials and methods</h3><p>We conducted a retrospective study of patients that underwent a liver transplantation at our institution between 2002 and 2022 and excluded those with less than two years of follow-up.</p></div><div><h3>Results</h3><p>Eighty-five patients were identified, 56% with elevated IgA. They were younger at transplantation (<em>p</em> 0.006) and had persistent splenomegaly (<em>p</em> 0.02). They were also more likely to have allergies (<em>p</em> < 0.001). Furthermore, 93% of those with eczema (<em>p</em> < 0.001) and 90% of those with food allergy had elevated IgA (<em>p</em> < 0.001). Glomerular filtration rate decreased over time in both groups, although it wasn't significant. However, the rate was different between the two (<em>p</em> < 0.001), especially after the sixth year of follow-up (<em>p</em> 0.02). Furthermore, of the 14 patients with values below 90 mL/min/1.73 m<sup>2</sup>, 12 belonged to the group with elevated IgA (<em>p</em> 0.02).</p></div><div><h3>Conclusion</h3><p>We believe that intestinal permeability secondary to portal hypertension combined with tacrolimus exposure may facilitate the development of immune reactions increasing IgA levels, causing its deposition in kidneys, and leading to renal injury over time.</p></div>","PeriodicalId":100799,"journal":{"name":"Journal of Liver Transplantation","volume":"13 ","pages":"Article 100194"},"PeriodicalIF":0.0,"publicationDate":"2023-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666967623000569/pdfft?md5=3369760c40c54c92fe76a8eb6870e3e0&pid=1-s2.0-S2666967623000569-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138448979","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}

引用次数: 0

Liver transplantation for liver hemangioma: The Paul Brousse Hospital experience and a systematic review of the literature 肝血管瘤的肝移植:保罗·布鲁斯医院的经验和文献的系统回顾

Journal of Liver Transplantation Pub Date : 2023-11-10 DOI: 10.1016/j.liver.2023.100193

Ainhoa Andres Imaz, Maria Conticchio, Chady Salloum, Daniel Cherqui, René Adam, Daniel Azoulay

{"title":"Liver transplantation for liver hemangioma: The Paul Brousse Hospital experience and a systematic review of the literature","authors":"Ainhoa Andres Imaz, Maria Conticchio, Chady Salloum, Daniel Cherqui, René Adam, Daniel Azoulay","doi":"10.1016/j.liver.2023.100193","DOIUrl":"https://doi.org/10.1016/j.liver.2023.100193","url":null,"abstract":"<div><h3>Background</h3><p>Liver hemangiomas are the most common type of benign liver tumor in adults, often asymptomatic and non amenable to treatment. Liver transplantation has been suggested to be an effective treatment option in highly selected patients with non-resectable giant liver hemangiomas causing severe symptoms when other treatment options have failed or are deemed inappropriate</p></div><div><h3>Methods</h3><p>We report our experience at Paul Brousse Hospital with liver transplantation for giant hepatic hemangioma and a systematic review of the literature on the indication of liver transplantation, to clarify feasibility and short- and long-term outcomes.</p></div><div><h3>Results</h3><p>The literature search yielded 525 articles. After screening titles and abstracts, 19 articles were finally included in this review. Regarding our experience during the study period, three out of 3593 liver transplantations were carried out for giant symptomatic hemangioma. In the literature 23 cases were described, of which 5 associated to a Kasabach-Merritt syndrome, with an acceptable follow up.</p></div><div><h3>Conclusions</h3><p>Giant liver hemangiomas represent a rare indication for liver transplantation. Exceptionally when other treatment options have failed or are not suitable, liver transplantation is a safe and effective option.</p></div>","PeriodicalId":100799,"journal":{"name":"Journal of Liver Transplantation","volume":"13 ","pages":"Article 100193"},"PeriodicalIF":0.0,"publicationDate":"2023-11-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666967623000557/pdfft?md5=b12973f4f32766159ae153277f0e565a&pid=1-s2.0-S2666967623000557-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134689142","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}

引用次数: 0

Treatment of pulmonary hypertension with inhaled nitric oxide during orthotopic liver transplantation 原位肝移植术中吸入一氧化氮治疗肺动脉高压

Journal of Liver Transplantation Pub Date : 2023-11-06 DOI: 10.1016/j.liver.2023.100192

Sonya Soh , Ahmed Al Gharrash , Ian Kaufman , Peter Metrakos , Jennifer Kalil , Thomas Schricker

{"title":"Treatment of pulmonary hypertension with inhaled nitric oxide during orthotopic liver transplantation","authors":"Sonya Soh , Ahmed Al Gharrash , Ian Kaufman , Peter Metrakos , Jennifer Kalil , Thomas Schricker","doi":"10.1016/j.liver.2023.100192","DOIUrl":"https://doi.org/10.1016/j.liver.2023.100192","url":null,"abstract":"<div><p>Despite pre-transplant screening, patients with chronic liver disease may present with previously undiagnosed pulmonary hypertension (PH) at the time of liver transplantation. While severe portopulmonary hypertension (PoPH) at the time of surgery is considered a contraindication to transplantation, the current evidence guiding perioperative management of newly diagnosed PH is limited.</p><p>We present a case of a 65-year-old male with previously undiagnosed severe PH secondary to cirrhosis-related hyperdynamic circulation, successfully managed with intra- and postoperative inhaled nitric oxide (iNO) therapy during orthotopic liver transplantation. Rapid stabilization of elevated mean pulmonary pressures (mPAP) allowed an uncomplicated perioperative transplant course.</p><p>This case highlights the importance of recognizing and addressing newly diagnosed PH at the time of liver transplantation. Whereas severe PoPH presents significant perioperative risk, PH in cirrhosis is more commonly due to alternative etiologies of venous congestion or hyperdynamic circulation. Our case suggests that elevated mPAP of alternative etiologies may not immediately compromise postoperative transplant outcomes. Intraoperative vasodilator therapy, including iNO, may be a useful therapeutic and diagnostic tool in these cases. Further investigation into perioperative management of new PH in liver transplantation is warranted to refine surgical decision-making and improve patient outcomes.</p></div>","PeriodicalId":100799,"journal":{"name":"Journal of Liver Transplantation","volume":"13 ","pages":"Article 100192"},"PeriodicalIF":0.0,"publicationDate":"2023-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666967623000545/pdfft?md5=eda302a6b088525ba2bc33fe2cd4b474&pid=1-s2.0-S2666967623000545-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"92134261","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}

引用次数: 0

Vascular thrombosis after pediatric liver transplantation: Is prevention achievable? 儿童肝移植后血管血栓:预防是否可行?

Journal of Liver Transplantation Pub Date : 2023-11-01 DOI: 10.1016/j.liver.2023.100185

Mercedes Martinez , Elise Kang , Fernando Beltramo , Michael Nares , Asumthia Jeyapalan , Alicia Alcamo , Alexandra Monde , Leslie Ridall , Sameer Kamath , Kristina Betters , Courtney Rowan , Richard Shane Mangus , Shubhi Kaushik , Matt Zinter , Joseph Resch , Danielle Maue

{"title":"Vascular thrombosis after pediatric liver transplantation: Is prevention achievable?","authors":"Mercedes Martinez , Elise Kang , Fernando Beltramo , Michael Nares , Asumthia Jeyapalan , Alicia Alcamo , Alexandra Monde , Leslie Ridall , Sameer Kamath , Kristina Betters , Courtney Rowan , Richard Shane Mangus , Shubhi Kaushik , Matt Zinter , Joseph Resch , Danielle Maue","doi":"10.1016/j.liver.2023.100185","DOIUrl":"https://doi.org/10.1016/j.liver.2023.100185","url":null,"abstract":"<div><h3>Background</h3><p>Vascular thromboses (VT) are life-threatening events after pediatric liver transplantation (LT). Single-center studies have identified risk factors for intra-abdominal VT, but large-scale pediatric studies are lacking.</p></div><div><h3>Methods</h3><p>This multicenter retrospective cohort study of isolated pediatric LT recipients assessed pre- and perioperative variables to determine VT risk factors and anticoagulation-associated bleeding complications.</p></div><div><h3>Results</h3><p>Within seven postoperative days, 31/331 (9.37%) patients developed intra-abdominal VT. Open fascia occurred more commonly in patients with VT (51.61 vs 23.33%) and remained the only independent risk factor in multivariable analysis (OR = 2.84, <em>p</em> = 0.012). Patients with VT received more blood products (83.87 vs 50.00%), had significantly higher rates of graft loss (22.58 vs 1.33%), infection (50.00 vs 20.60%), and unplanned return to the operating room (70.97 vs 16.44%) compared to those without VT. The risk of bleeding was similar (<em>p</em> = 0.2) between patients on and off anticoagulation.</p></div><div><h3>Conclusions</h3><p>Prophylactic anticoagulation did not increase bleeding complications in this cohort. The only independent factor associated with VT was open fascia, likely a graft/recipient size mismatch surrogate, supporting the need to improve surgical techniques to prevent VT that may not be modifiable with anticoagulation.</p></div>","PeriodicalId":100799,"journal":{"name":"Journal of Liver Transplantation","volume":"12 ","pages":"Article 100185"},"PeriodicalIF":0.0,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666967623000478/pdfft?md5=f77e1481231946b4888e853dcbfad732&pid=1-s2.0-S2666967623000478-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"92045591","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}

引用次数: 0