Current Opinion in Organ Transplantation最新文献_第2页

Artificial intelligence-enhanced interpretation of kidney transplant biopsy: focus on rejection. 人工智能增强的肾移植活检解释：关注排斥反应。

IF 1.8 4区医学

Current Opinion in Organ Transplantation Pub Date : 2025-06-01 Epub Date: 2025-04-01 DOI: 10.1097/MOT.0000000000001213

Alton B Farris, Jeroen van der Laak, Dominique van Midden

{"title":"Artificial intelligence-enhanced interpretation of kidney transplant biopsy: focus on rejection.","authors":"Alton B Farris, Jeroen van der Laak, Dominique van Midden","doi":"10.1097/MOT.0000000000001213","DOIUrl":"10.1097/MOT.0000000000001213","url":null,"abstract":"Purpose of review: The objective of this review is to provide an update on the application of artificial intelligence (AI) for the histological interpretation of kidney transplant biopsies.Recent findings: AI, particularly convolutional neural networks (CNNs), has demonstrated great potential in accurately identifying kidney structures, detecting abnormalities, and diagnosing rejection with improved objectivity and reproducibility. Key advancements include the segmentation of kidney compartments for accurate assessment and the detection of inflammatory cells to aid in rejection classification. Development of decision support tools like the Banff Automation System and iBox for predicting long-term allograft failure have also been made possible through AI techniques. Challenges in AI implementation include the need for rigorous evaluation and validation studies, computational resource requirements and energy consumption concerns, and regulatory hurdles. Data protection regulations and Food and Drug Administration (FDA) approval represent such entry barriers. Future directions involve the integration of AI of histopathology with other modalities, such as clinical laboratory and molecular data. Development of more efficient CNN architectures could be possible through the exploration of self-supervised and graph neural network approaches.Summary: The field is progressing towards an automated Banff Classification system, with potential for significant improvements in diagnostic processes and patient care.","PeriodicalId":10900,"journal":{"name":"Current Opinion in Organ Transplantation","volume":" ","pages":"201-207"},"PeriodicalIF":1.8,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12052063/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143763291","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Polygenic risk scores in kidney transplantation. 肾移植的多基因风险评分。

IF 1.8 4区医学

Current Opinion in Organ Transplantation Pub Date : 2025-06-01 Epub Date: 2025-04-01 DOI: 10.1097/MOT.0000000000001212

Kira Jelencsics, Rainer Oberbauer

{"title":"Polygenic risk scores in kidney transplantation.","authors":"Kira Jelencsics, Rainer Oberbauer","doi":"10.1097/MOT.0000000000001212","DOIUrl":"10.1097/MOT.0000000000001212","url":null,"abstract":"Purpose of review: Estimation of genetic risk is crucial for understanding heritable diseases but also transplant outcomes. Polygenic risk scores (PRSs) are constructed from genome-wide association studies (GWAS) summing an individual's risk alleles weighted by their effect size. Introducing PRSs into transplant medicine may improve predictions of outcomes such as rejection, graft loss or death. This review of recent publications highlights the additional variability in outcomes explained by PRSs beyond established clinical models.Recent findings: Four studies on PRSs in transplantation have examined outcomes such as acute rejection, changes in posttransplant estimated glomerular filtration rate (eGFR) and posttransplant diabetes mellitus (PTDM) and explored the role of donor polygenic burden for cerebrovascular traits. PRSs have been showing utility in predicting PTDM [adjusted odds ratio (OR):1.48 (95% confidence interval (CI): 1.06, 2.08]. A PRS based on a non-HLA alloimmunity GWAS explained additional variability for acute rejection [adjusted hazard ratio (HR): 1.54, 95% CI: 1.07, 2.22]. Donor PRSs for hypertension and cerebrovascular traits correlated with lower recipient eGFR (HR: 1.44, 95% CI: 1.07, 1.93). Genetic variation was also linked to long-term kidney function, though clinical variables explained a greater proportion of the variability (0.3% vs. 32%).Summary: Currently, PRSs modestly enhance outcome prediction in transplantation when added to clinical models. With a more biologically based selection of variants, PRSs may gain greater value in transplant risk assessment.","PeriodicalId":10900,"journal":{"name":"Current Opinion in Organ Transplantation","volume":" ","pages":"208-214"},"PeriodicalIF":1.8,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143763297","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Banff 2022 pancreas pathology update: how to make the right diagnosis and decrease inconclusive pathology results. Banff 2022胰腺病理学更新：如何做出正确的诊断并减少不确定的病理结果。

IF 1.8 4区医学

Current Opinion in Organ Transplantation Pub Date : 2025-05-21 DOI: 10.1097/MOT.0000000000001231

Cinthia B Drachenberg, Surya V Seshan, John C Papadimitriou

{"title":"Banff 2022 pancreas pathology update: how to make the right diagnosis and decrease inconclusive pathology results.","authors":"Cinthia B Drachenberg, Surya V Seshan, John C Papadimitriou","doi":"10.1097/MOT.0000000000001231","DOIUrl":"https://doi.org/10.1097/MOT.0000000000001231","url":null,"abstract":"Purpose of review: The Banff 2022 pancreas transplant pathology update is the most comprehensive to date. It has improved the criteria for T-cell and antibody mediated rejection, recognized other clinicopathological differential diagnoses, and addressed the critically important islet failures. Nevertheless, multidisciplinary discussions during and after the meeting showed a need to enhance the real and perceived value of pancreas transplant biopsies. In particular, the occurrence of clinicopathological discrepancies and/or inconclusive biopsy findings, result in considerable uncertainty in clinical and pathology decision making.Recent findings: The current review expands on the 2022 report by presenting the most common situations leading to an inconclusive diagnosis (Banff \"indeterminate\" category), a major issue of discussion. The entities discussed herein are: nonspecific infiltrates versus active rejection; residual inflammation after treatment of active rejection; ischemic pancreatitis and peripancreatic reactions in the early posttransplant period; biopsy findings associated with exocrine drainage impairment, and other unusual or nonspecific findings. An algorithm for the evaluation of pancreas allograft biopsies is also presented, that should facilitate the interpretation of morphological findings.Summary: Systematic integration of essential clinical information with the pathology findings can improve the diagnostic yield of pancreas allograft biopsies and reduce the cases with and \"indeterminate\" diagnoses.","PeriodicalId":10900,"journal":{"name":"Current Opinion in Organ Transplantation","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144109947","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Normothermic regional perfusion and liver transplant: expanding the donation after circulatory death donor pool. 常温区域灌注与肝移植：扩大循环死亡后供体池。

IF 1.8 4区医学

Current Opinion in Organ Transplantation Pub Date : 2025-05-15 DOI: 10.1097/MOT.0000000000001230

Christopher C Stahl, David D Aufhauser

{"title":"Normothermic regional perfusion and liver transplant: expanding the donation after circulatory death donor pool.","authors":"Christopher C Stahl, David D Aufhauser","doi":"10.1097/MOT.0000000000001230","DOIUrl":"https://doi.org/10.1097/MOT.0000000000001230","url":null,"abstract":"Purpose of review: Normothermic regional perfusion (NRP) is a novel technique developed to improve organ utilization and recipient outcomes following donation after circulatory death (DCD). NRP has revolutionized DCD liver transplant by extending donor criteria and reducing the incidence of ischemic cholangiopathy (IC) and other complications in recipients. However, there is significant geographic and center-specific variation in NRP use and practices. This review collates practices from pioneering NRP centers across the globe regarding donor selection criteria, NRP techniques, organ viability monitoring, and other key areas to help guide the continued growth of NRP liver transplantation.Recent findings: DCD livers recovered using NRP have consistently demonstrated excellent outcomes, with IC and patient and graft survival rates approaching those seen with grafts from donation after brain death donors. Recently, transplant centers have been working to increase the DCD donor pool by relaxing limits on donor quality, reconsidering organ viability markers, and combining NRP with ex situ machine perfusion technologies.Summary: NRP is a powerful organ recovery technology transforming the practice of DCD liver transplantation. Current evidence suggests that organ utilization could be further expanded using NRP recovery, with excellent clinical outcomes reported by centers using less stringent donor and organ viability criteria.","PeriodicalId":10900,"journal":{"name":"Current Opinion in Organ Transplantation","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143982792","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Liver transplantation for hepatocellular carcinoma following immunotherapy. 肝细胞癌免疫治疗后的肝移植。

IF 1.8 4区医学

Current Opinion in Organ Transplantation Pub Date : 2025-05-06 DOI: 10.1097/MOT.0000000000001228

Rebecca Marino, Ahmed Talaat Hassan, Alexander Fagenson, Parissa Tabrizian

{"title":"Liver transplantation for hepatocellular carcinoma following immunotherapy.","authors":"Rebecca Marino, Ahmed Talaat Hassan, Alexander Fagenson, Parissa Tabrizian","doi":"10.1097/MOT.0000000000001228","DOIUrl":"https://doi.org/10.1097/MOT.0000000000001228","url":null,"abstract":"Purpose of review: To explore the emerging use of immune checkpoint inhibitors (ICIs) in hepatocellular carcinoma (HCC) patients eligible for liver transplantation (LT), particularly as bridging and downstaging therapies. This review also addresses the clinical challenges of integrating ICIs into transplant protocols, including graft rejection, immune-related toxicities, and gaps in evidence.Recent findings: ICIs have shown potential as bridging and downstaging therapies before LT, with multicentric studies reporting 75.6% successful downstaging, 85% 3-year post-LT survival, and 7.2% rejection-related mortality. A washout interval >94 days and older age have been identified as protective factors against allograft rejection. Combining locoregional therapies with ICIs has proven effective in the EMERALD-1 and LEAP-012 trials, which demonstrated improved progression-free survival (15.0 and 14.6 months, respectively) with ICI-TACE combinations. Similarly, the STAR-FIT phase II trial, combining TACE, SBRT, and avelumab, showed a 42% complete response rate and 12% conversion to curative therapy. Toxicity and rejection risk remain major challenges.Summary: ICIs represent a promising tool for expanding transplant eligibility in HCC, but their integration into LT pathways remains complex. Safety concerns, particularly regarding timing and immune modulation, require careful evaluation. Prospective studies and biomarker development are needed to guide clinical decision-making. Novel therapies such as CAR-T cells may offer more targeted approaches in the future.","PeriodicalId":10900,"journal":{"name":"Current Opinion in Organ Transplantation","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143957293","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Simultaneous pancreas and kidney transplant vs. pancreas after kidney transplantation: is one better? 胰肾同时移植vs肾移植后胰：哪个更好？

IF 1.8 4区医学

Current Opinion in Organ Transplantation Pub Date : 2025-05-05 DOI: 10.1097/MOT.0000000000001229

Sarah Huber, Jonathan A Fridell

{"title":"Simultaneous pancreas and kidney transplant vs. pancreas after kidney transplantation: is one better?","authors":"Sarah Huber, Jonathan A Fridell","doi":"10.1097/MOT.0000000000001229","DOIUrl":"https://doi.org/10.1097/MOT.0000000000001229","url":null,"abstract":"Purpose of review: For those with insulin dependent diabetes mellitus and renal failure, both simultaneous pancreas and kidney (SPK) and pancreas after kidney (PAK) transplant can free the recipient of renal replacement and insulin therapies and provide survival advantage over ongoing dialysis and diabetes. Yet, pancreas transplants are notably declining in the United States, particularly for PAK.Recent findings: Pancreas transplant continues to provide better glycemic control than all present medical therapies. Outcomes for both SPK and PAK also continue to improve, and overall patient survival for both SPK and PAK are similar, excellent, and superior to all other transplant or medical options. SPK is associated with better pancreas allograft survival, but this gap is narrowing for PAK, and the best kidney allograft survival is achieved with living donor renal transplant (LDRTx) and PAK.Summary: PAK remains a viable and successful treatment for uremia and insulin dependent diabetes, and, particularly when following a LDRTx, can confer the additional benefits associated with LDRTx and preemptive transplant. To achieve insulin and dialysis independence, either LDRTx followed by PAK (if a living donor is available) or SPK should be offered to candidates with appropriate indications.","PeriodicalId":10900,"journal":{"name":"Current Opinion in Organ Transplantation","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143982796","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

New methods for improving pancreas preservation. 改善胰腺保存的新方法。

IF 1.8 4区医学

Current Opinion in Organ Transplantation Pub Date : 2025-05-05 DOI: 10.1097/MOT.0000000000001224

Mohamed A Elzawahry, Trevor Reichman, Andrew Sutherland

{"title":"New methods for improving pancreas preservation.","authors":"Mohamed A Elzawahry, Trevor Reichman, Andrew Sutherland","doi":"10.1097/MOT.0000000000001224","DOIUrl":"https://doi.org/10.1097/MOT.0000000000001224","url":null,"abstract":"Purpose of review: Pancreas and islet transplantation face critical organ shortage challenges, with many potential grafts discarded due to concerns about consequences of ischemia-reperfusion injury, particularly from donation after circulatory death (DCD) donors. Static cold storage remains standard practice but has significant limitations. Novel preservation technologies may improve transplant outcomes, donor selection and even expand the donor pool.Recent findings: Normothermic regional perfusion in DCD donors has increased pancreas utilization with promising one-year graft survival comparable to donation after brain-death (DBD) donors. Hypothermic machine perfusion maintains tissue integrity and shows promising preclinical results. Oxygenated hypothermic machine perfusion successfully restores tissue adenosine triphosphate (ATP) levels without notable tissue injury. Normothermic machine perfusion, despite challenges, offers potential for viability assessment and resuscitation.Summary: Advanced preservation technologies provide platforms for assessment, reconditioning, and therapeutic interventions for pancreas grafts. Clinical translation requires consensus on perfusion parameters and perfusate composition optimized for pancreatic preservation. Future developments should focus on implementing sensitive and specific assessment methods, including beta-cell specific biomarkers, to confidently select and utilize marginal pancreas grafts for transplantation.","PeriodicalId":10900,"journal":{"name":"Current Opinion in Organ Transplantation","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143972475","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Obesity management before and after pancreas transplantation. 胰腺移植前后的肥胖管理。

IF 1.8 4区医学

Current Opinion in Organ Transplantation Pub Date : 2025-05-05 DOI: 10.1097/MOT.0000000000001226

Ali B Abbasi, Andrew Posselt, Babak J Orandi, Jon S Odorico, Peter G Stock

{"title":"Obesity management before and after pancreas transplantation.","authors":"Ali B Abbasi, Andrew Posselt, Babak J Orandi, Jon S Odorico, Peter G Stock","doi":"10.1097/MOT.0000000000001226","DOIUrl":"https://doi.org/10.1097/MOT.0000000000001226","url":null,"abstract":"Purpose of review: We provide a review on the incidence, consequences, and management of obesity in patients before and after pancreas transplant.Recent findings: Obesity is common in patients with both type 1 and type 2 diabetes. Obesity at the time of pancreas transplant is associated with worse graft and patient survival, while weight gain after transplant is associated with insulin resistance and posttransplant diabetes. Currently, lifestyle interventions are the backbone of obesity management and can improve insulin sensitivity, but result in only modest weight loss. Metabolic and bariatric surgery (MBS) offers the potential for substantial and durable weight loss. Laparoscopic sleeve gastrectomy is the procedure of choice and can be performed safely both before and after pancreas transplant. Antiobesity medications (AOMs) may also be effective, but concerns remain regarding determine the safety and efficacy when used in pancreas transplant recipients. More evidence is needed to guide the use of AOMs and MBS in pancreas transplant recipients.Summary: Lifestyle interventions, MBS, and AOMs each have a role in managing obesity after pancreas transplantation. In light of limited evidence and unique challenges in pancreas transplant patients, obesity management in pancreas transplant patients requires an individualized approach that leverages multidisciplinary expertise.","PeriodicalId":10900,"journal":{"name":"Current Opinion in Organ Transplantation","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143980854","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Donation after circulatory death; cholangiopathy in the machine age. 循环性死亡后捐赠；机器时代的胆管病。

IF 1.8 4区医学

Current Opinion in Organ Transplantation Pub Date : 2025-05-02 DOI: 10.1097/MOT.0000000000001222

Ian S Currie, Fiona M Hunt

{"title":"Donation after circulatory death; cholangiopathy in the machine age.","authors":"Ian S Currie, Fiona M Hunt","doi":"10.1097/MOT.0000000000001222","DOIUrl":"10.1097/MOT.0000000000001222","url":null,"abstract":"Purpose of review: Published work evaluating machine perfusion of DCD (donation after circulatory death) liver grafts in situ and ex situ is rapidly evolving, with several landmark studies published in the last 6 months. The central question in DCD liver transplant remains; which strategies most effectively reduce cholangiopathy? This condition, which results in repeated hospital admissions, interventions, re-transplantation and death, is a major deterrent to DCD utilization. This review considers current evidence in the mitigation of transplant cholangiopathy by machine perfusion in DCD liver grafts.Recent findings: Studies which directly address DCD cholangiopathy as a primary outcome are few in number, despite their critical importance. In systematic reviews, Normothermic Regional Perfusion and Hypothermic Machine Perfusion consistently and significantly reduce transplant cholangiopathy rates. By contrast, the efficacy of Normothermic Machine Perfusion performed at donor or recipient centres is less well described and cautious interpretation is required. The most recent development, namely hypothermic followed by normothermic perfusion, has only now appeared in the literature but appears to offer advantages compared to either technology alone.Summary: To reduce DCD cholangiopathy, current data best support the use of donor centre NRP or recipient centre HMP. However, utilization is also improved when warm perfusion is involved.","PeriodicalId":10900,"journal":{"name":"Current Opinion in Organ Transplantation","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143989684","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Pancreas retransplantation. 胰腺再移植。

IF 1.8 4区医学

Current Opinion in Organ Transplantation Pub Date : 2025-05-02 DOI: 10.1097/MOT.0000000000001225

Marcelo Perosa, Tiago G Miranda, Fernanda R Danziere

{"title":"Pancreas retransplantation.","authors":"Marcelo Perosa, Tiago G Miranda, Fernanda R Danziere","doi":"10.1097/MOT.0000000000001225","DOIUrl":"https://doi.org/10.1097/MOT.0000000000001225","url":null,"abstract":"Purpose of review: Pancreas retransplantation (PRT) remains a topic of debate due to the increased risks involved and advancements in diabetes mellitus management.Recent findings: The majority of PRT are pancreas after kidney (PAK) transplants, typically performed when a primary simultaneous pancreas-kidney (SPK) transplant results in pancreas graft failure while the kidney graft remains functioning. Over the past few decades, the number of PRT procedures has declined, mirroring the decrease in PAK transplant activity. Technical or late immunological loss of the initial pancreas is associated with better PRT outcomes, whereas early immunological failure and sensitization predict poor post-PRT outcome.Summary: Several critical factors must be considered when evaluating PRT, including the cause and timing of primary pancreas graft failure, as well as the recipient's surgical and immunological profile. PRT outcomes should be interpreted with caution, as most primary pancreas transplants (PT) are SPK, whereas the majority of PRT are solitary PT. When comparing only primary solitary PT to PRT, the outcomes are similar, particularly when performed in high-volume centers.","PeriodicalId":10900,"journal":{"name":"Current Opinion in Organ Transplantation","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143985338","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0