Annals of surgery最新文献

{"title":"Three Molecular Developmental Pathways of Remnant Pancreatic Cancer After Resection: A Nationwide Project Study of Japan Pancreas Society.","authors":"Shuji Suzuki, Yuko Omori, Yusuke Ono, Katsuya Hirose, Taito Itoh, Hidenori Karasaki, Mitsugi Shimoda, Yuichi Nagakawa, Ryota Higuchi, Itaru Endo, Toshiki Rikiyama, Michiaki Unno, Tsutomu Fujii, Yuki Sunagawa, Hidetoshi Eguchi, Hideki Sasanuma, Takahiro Akahori, Keiichi Okano, Masaji Tani, Satoshi Hirano, Yasuhiro Shimizu, Minoru Kitago, Shugo Mizuno, Tomohisa Yamamoto, Masayuki Furukawa, Masayuki Ohtsuka, Motokazu Sugimoto, Akira Matsushita, Kenichi Hakamada, Hisato Igarashi, Tamotsu Kuroki, Satoshi Tanno, Yoshihisa Tsuji, Atsushi Masamune, Kazuhiro Mizumoto, Yoshiki Hirooka, Hiroki Yamaue, Kazuichi Okazaki, Sohei Satoi, Yoshifumi Takeyama, Yusuke Mizukami, Toru Furukawa","doi":"10.1097/SLA.0000000000006444","DOIUrl":"10.1097/SLA.0000000000006444","url":null,"abstract":"<p><strong>Objective: </strong>To clarify the molecular mechanism of remnant pancreatic cancer (PC) development after primary PC resection.</p><p><strong>Background: </strong>Molecular mechanisms of the development of remnant PCs after primary PC resection are largely unknown.</p><p><strong>Methods: </strong>Forty-three patients undergoing remnant PC resection after primary PC resection between 2001 and 2017 at 26 institutes were retrospectively analyzed. Clinicopathologic features and molecular alterations detected by targeted amplicon sequencing of 36 PC-associated genes were evaluated.</p><p><strong>Results: </strong>These patients showed significantly lower body mass indices and higher hemoglobin A1c values at remnant PC resection than at primary PC resection. A comparison of the molecular features between primary and remnant PCs indicated that remnant PCs were likely to develop through 3 different molecular pathways: successional, showing identical and accumulated alterations (n = 14); phylogenic, showing identical and distinct alterations (n = 26); and distinct, showing independent distinctive alterations (n = 3). The similarity of gene alterations was associated with time to the remnant PC development ( r = 0.384, P = 0.0173). Phylogenic pathways were significantly associated with the intraductal spread of carcinoma ( P = 0.007). Patient survival did not differ significantly depending on these molecular pathways.</p><p><strong>Conclusions: </strong>Molecular profiling uncovered 3 pathways for the development of remnant PCs, namely, successional, phylogenic, and distinct pathways. The vast majority of remnant PCs are likely to be molecularly associated with primary PCs either in the successional or phylogenic way. This information could impact the design of a strategy for monitoring and treating remnant PCs.</p>","PeriodicalId":8017,"journal":{"name":"Annals of surgery","volume":" ","pages":"1015-1025"},"PeriodicalIF":7.5,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141625804","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Dwindling Matter: An Analysis of Medicare Reimbursement for Endocrine Surgery Procedures From 2000 to 2023.","authors":"Anthony T Saxton, Alberto J Monreal, Michael T Stang, Hadiza S Kazaure, Randall P Scheri","doi":"10.1097/SLA.0000000000006423","DOIUrl":"10.1097/SLA.0000000000006423","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate Medicare reimbursement trends for endocrine surgeries from 2000 to 2023.</p><p><strong>Background: </strong>As the population ages, demand for endocrine surgeries is expected to increase. Understanding reimbursement trends is essential to ensure the financial sustainability of endocrine surgery.</p><p><strong>Methods: </strong>Data were extracted from Medicare Inpatient and Outpatient Hospital data sets, National Summary, and Physician Fee Look-up Files for nine common thyroid, parathyroid, and adrenal surgeries. Data were adjusted for inflation. Descriptive statistics, compound annual growth rate (CAGR), and linear regression models were built to evaluate practice and reimbursement trends.</p><p><strong>Results: </strong>From 2000 to 2023, there was a 63.8% increase in endocrine surgery volume. However, inflation-adjusted average procedure reimbursements decreased by 43.2% from $1709 to $972 (CAGR-2.4%), which is the largest decrease for any surgical subspecialty reported in the published literature. At the current CAGR, the average estimated reimbursement is projected to decrease to $868 by 2030 ( P <0.001). Average facility reimbursements for inpatient and outpatient hospitalizations increased. However, substantial practice pattern shifts in the study period led to decreased overall facility reimbursements, with a $17.9 million decrease in total inpatient reimbursements between 2016 and 2021 that was only partially offset by a $3.2 million increase in outpatient hospital reimbursements.</p><p><strong>Conclusion: </strong>Medicare procedure reimbursements for endocrine surgeries have been outpaced by inflation, with large decreases since 2000. Concurrent changes in practice patterns have also resulted in markedly fewer inpatient stays, leading to lower total facility reimbursements. Our data raise concern over the financial sustainability of the endocrine surgery field as the demand for endocrine surgery procedures increases.</p>","PeriodicalId":8017,"journal":{"name":"Annals of surgery","volume":" ","pages":"891-900"},"PeriodicalIF":7.5,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141445331","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Multicenter Randomised Controlled Trial of Single Versus Double Venous Outflow Reconstruction in Right Lobe Living Donor Liver Transplantation: Venous Outflow in Liver Transplantation Trial.","authors":"Mettu Srinivas Reddy, Akshadhar J Koneti, Abhideep Chaudhary, Ashwin Rammohan, Raghavendra Babu Yalakanti, Shweta Mallick, Rajanikanth Patcha, Vipin Pal Singh, Satish Kumar Krishnan, Niteen Kumar, Prasanna Gopal, Mohamed Rela, Surendran Sudhindran","doi":"10.1097/SLA.0000000000006601","DOIUrl":"10.1097/SLA.0000000000006601","url":null,"abstract":"<p><strong>Objective: </strong>To compare early patency and outcomes of single outflow [single outflow technique (SOT)] and double outflow [double outflow technique (DOT)] reconstruction in right lobe living donor liver transplantation (RtLDLT) in a multicenter open-labeled randomized controlled trial.</p><p><strong>Background: </strong>Optimum graft venous outflow is a key factor in determining outcomes of RtLDLT. There are no data directly comparing SOT and DOT techniques of graft outflow reconstruction.</p><p><strong>Methods: </strong>Adult patients undergoing RtLDLT needing anterior sector vein reconstruction were enrolled. A prosthetic graft was used to create a neo-middle hepatic vein (neoMHV). Web-based permuted block randomization was used to allocate patients to SOT or DOT (1:1) before graft implantation. The primary endpoint was neoMHV patency for up to 6 weeks. Secondary endpoints were postoperative morbidity and survival. Intention-to-treat and as-treated analyses are reported.</p><p><strong>Results: </strong>Five centers randomized 219 patients to SOT (n = 110) or DOT (n = 109). Both groups were similar in baseline characteristics. SOT had better neoMHV patency at 2 weeks (92.5% vs 82.9%, P = 0.032), 4 weeks (84% vs 69%, P = 0.011) but not at 6 weeks (69.5% vs 59.2%, P = 0.124). Cox proportional hazards analysis revealed DOT [hazard ratio: 1.56 (95% CI = 1.02, 2.4); P = 0.041] and use of Dacron graft [hazard ratio: 2.83 (95% CI = 1.16, 6.94), P = 0.023] as independent risk factors for neoMHV thrombosis. SOT was associated with better in-hospital survival (97.3% vs 90.8%; P = 0.044) but similar 1-year survival (89% vs 85%, P = 0.340). SOT was associated with improved survival in patients who developed early allograft dysfunction or needed reoperation.</p><p><strong>Conclusions: </strong>SOT has better early neoMHV patency than DOT and may be associated with better early survival.</p>","PeriodicalId":8017,"journal":{"name":"Annals of surgery","volume":" ","pages":"911-920"},"PeriodicalIF":7.5,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142806102","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Burns and Mental Health: A Matched Cohort Study.","authors":"Gabrielle Kang-Auger, Daniel E Borsuk, Nancy Low, Aimina Ayoub, Nathalie Auger, Stéphane Buteau","doi":"10.1097/SLA.0000000000006270","DOIUrl":"10.1097/SLA.0000000000006270","url":null,"abstract":"<p><strong>Objective: </strong>To determine the association between burns and hospitalization for mental health disorders up to 3 decades later.</p><p><strong>Background: </strong>Burns are associated with pain, disability, and scarring, but the long-term impact on mental health is unclear.</p><p><strong>Methods: </strong>We analyzed a cohort of 23,726 patients with burns aged ≥10 years who were matched to 223,626 controls from Quebec, Canada, between 1989 and 2022. The main exposure was admission for a burn. We followed patients during 3,642,206 person-years of follow-up to identify future hospitalizations for psychiatric disorders, substance use disorders, and suicide attempts. We estimated adjusted hazard ratios (HRs) with 95% CIs for the association between burns and subsequent mental health hospitalization using Cox proportional hazards regression.</p><p><strong>Results: </strong>Patients with burns had a 1.76 times greater risk of mental health hospitalization over time (95% CI: 1.72-1.81), compared with controls. Associations were present regardless of burn site, but were greatest for burns covering ≥50% of the body (HR: 3.29, 95% CI: 2.61-4.15), third-degree burns (HR: 2.04, 95% CI: 1.94-2.14), and burns requiring skin grafts (HR: 2.00, 95% CI: 1.90-2.10). Compared with controls, patients with burns had more than two times the risk of hospitalization for eating disorders (HR: 3.14, 95% CI: 2.50-3.95), psychoactive substance use disorders (HR: 2.27, 95% CI: 2.17-2.39), and suicide attempts (HR: 2.42, 95% CI: 2.23-2.62). Risks were particularly elevated within 5 years of the burn but persisted throughout follow-up.</p><p><strong>Conclusions: </strong>Burns are associated with an increased risk of hospitalization for mental health disorders up to 30 years later.</p>","PeriodicalId":8017,"journal":{"name":"Annals of surgery","volume":" ","pages":"982-988"},"PeriodicalIF":7.5,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12061376/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140179240","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Remote Symptom Monitoring in Thoracic Surgery Patients After Discharge.","authors":"Marisa Sewell, Thomas Boerner, Caitlin Harrington, Meier Hsu, Kay See Tan, Rebecca A Carr, Susan Jones, Daniel Zocco, Prasad S Adusumilli, Manjit S Bains, Matthew J Bott, Robert J Downey, James Huang, James M Isbell, Bernard J Park, Gaetano Rocco, Valerie W Rusch, Smita Sihag, David R Jones, Jennifer Cracchiolo, Daniela Molena","doi":"10.1097/SLA.0000000000006619","DOIUrl":"10.1097/SLA.0000000000006619","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate an electronic platform for remote symptom monitoring to enhance postdischarge care in thoracic surgery using patient reporting of symptoms.</p><p><strong>Background: </strong>Owing to the increased use of enhanced recovery after surgery protocols, patients are spending a larger portion of their postoperative course at home. For patients undergoing complex operations, this represents an opportunity for early identification of abnormal symptoms at home before deterioration.</p><p><strong>Methods: </strong>An online symptom-tracking platform for thoracic surgery patients was created on the basis of opinions from stakeholders and a review of the literature. Starting in February 2021, patients were educated about the symptom tracker in preoperative clinics. After discharge, patients received a series of electronic surveys covering 23 symptom domains assessed using a Likert Scale for severity. Moderate symptoms prompted a \"yellow alert,\" and severe symptoms prompted a \"red alert,\" both notifying the nursing team and prompting appropriate action. Patients were considered responders if they completed at least 1 survey.</p><p><strong>Results: </strong>In total, 1997 patients were enrolled; 76% (n = 1520) were responders. Responders were younger, more likely to be White, less likely to have medical comorbidities, and less likely to be readmitted [odds ratio: 0.53 (95% CI: 0.37-0.76); P < 0.001]. Responders who were readmitted had a higher percentage of red alerts (47% vs 24%; P < 0.001) and yellow alerts (74% vs 61%; P = 0.016) compared with responders who were not readmitted.</p><p><strong>Conclusions: </strong>Electronic reporting adds an additional mechanism of communication between the patient and the clinical team, with the potential to lower the odds of readmission.</p>","PeriodicalId":8017,"journal":{"name":"Annals of surgery","volume":" ","pages":"1063-1069"},"PeriodicalIF":7.5,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142943171","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Charting the Course: Insights into Neuroendocrine Tumor Dynamics in the United States.","authors":"Christopher Wu, Zhixing Song, Sanjana Balachandra, Sophie Dream, Herbert Chen, J Bart Rose, Smita Bhatia, Andrea Gillis","doi":"10.1097/SLA.0000000000006331","DOIUrl":"10.1097/SLA.0000000000006331","url":null,"abstract":"<p><strong>Objective: </strong>To explore changing trends and characteristics in neuroendocrine tumors (NETs) epidemiology, focusing on demographics, clinical aspects, and survival, including the impact of social determinants of health (SDOH) on outcomes.</p><p><strong>Background: </strong>The escalating incidence and prevalence of NETs underscore the pressing need for updated epidemiologic data to reveal the evolving landscape of this condition. Access to current information is imperative for informing clinical strategies and public health initiatives targeting NETs.</p><p><strong>Methods: </strong>A retrospective, population-based study analyzed NET patient data from 1975 to 2020, using the Surveillance, Epidemiology, and End Results (SEER 8, 12, 18) program. We calculated annual age-adjusted incidence, prevalence, and 5-year overall survival (OS) rates. Survival trends from 2000 to 2019 were examined, employing the Fine-Gray model to evaluate cancer-specific mortality.</p><p><strong>Results: </strong>NETs' age-adjusted incidence rate quadrupled from 1.5 per 100,000 in 1975 to 6.0 per 100,000 in 2020. A decline in incidence occurred from 6.8 per 100,000 in 2019 to 6.0 per 100,000 in 2020. All-cause survival multivariable analysis demonstrated high grade (HR: 2.95, 95% CI: 2.63-3.09, P <0.001), single patients (HR: 1.49, 95% CI: 1.45-1.54, P <0.001), and Black patients (HR: 1.17, 95% CI:1.13-1.22, P <0.001) all had worse survival than their controls.</p><p><strong>Conclusions: </strong>Our study shows a steady increase in NETs incidence until 2019, with a decline in 2020. Understanding the reasons behind this trend is vital for improved management and public health planning. Further research should focus on the factors driving these changes to enhance our understanding of NET epidemiology.</p>","PeriodicalId":8017,"journal":{"name":"Annals of surgery","volume":" ","pages":"968-975"},"PeriodicalIF":7.5,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11538379/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140848752","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Postoperative Complications and Mobilization Following Major Abdominal Surgery With Versus Without Fitness Tracker-based Feedback (EXPELLIARMUS); A Student-led Multicenter Randomized Controlled Clinical Trial of the CHIR-Net SIGMA Study Group: Erratum.","authors":"Andre L Mihaljevic","doi":"10.1097/SLA.0000000000006727","DOIUrl":"10.1097/SLA.0000000000006727","url":null,"abstract":"","PeriodicalId":8017,"journal":{"name":"Annals of surgery","volume":"281 6","pages":"e6"},"PeriodicalIF":7.5,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143963496","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Impact of Psychological Prehabilitation on Surgical Outcomes: A Meta-analysis and Meta-regression.","authors":"Anne E Hall, Nghiem H Nguyen, Catherine T Cascavita, Kaavian Shariati, Archi K Patel, Wei Chen, Youngnam Kang, Xiaoyan Ren, Chi-Hong Tseng, Marco A Hidalgo, Justine C Lee","doi":"10.1097/SLA.0000000000006677","DOIUrl":"10.1097/SLA.0000000000006677","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the efficacy of psychological prehabilitation in improving surgical outcomes.</p><p><strong>Background: </strong>Prehabilitation aims to improve surgical outcomes through prevention. While most prehabilitation protocols have focused on improving patient knowledge and physical function, mental health has started to receive greater attention due to its effects on postoperative recovery, including persistent opioid use. However, the efficacy of psychological prehabilitation remains unclear due to the heterogeneity of psychological modalities, intervention characteristics, and surgical contexts.</p><p><strong>Methods: </strong>A systematic review, meta-analysis, and meta-regression of randomized controlled trials from 2004 to 2024 were conducted per \"Preferred Reporting Items for Systematic Reviews and Meta-Analyses\" guidelines to assess the effect of psychotherapy on 4 postoperative outcomes: length of stay (LOS), pain, anxiety, and depression. Randomized controlled trials were retrieved from MEDLINE, EMBASE, CENTRAL, and Google Scholar databases (March 2024). Studies with >50 adult surgical patients were included. Random effect meta-analyses estimated pooled effect sizes, with meta-regression analyzing intervention and surgery types.</p><p><strong>Results: </strong>Twenty articles comprising 2376 patients were included. Psychological prehabilitation interventions included cognitive behavioral therapy (70%), supportive psychotherapy (25%), and acceptance and commitment therapy (5%). Pooled analysis revealed greater reductions in LOS [mean difference (MD) = -1.62 days; 95% CI: -2.899, -0.349; P = 0.012], pain (MD = -3.52; 95% CI: -2.642, -4.401; P < 0.001), anxiety (standard MD = -1.51; 95% CI: -0.634, -2.385; P < 0.001), and depression (standard MD = -1.48; 95% CI: -0.578, -2.382; P = 0.001). Psychotherapy modality and surgery type showed no significant effects, except for anxiety.</p><p><strong>Conclusions: </strong>Psychological prehabilitation reduces LOS, pain, anxiety, and depression after surgery. Further studies are necessary to compare different types, durations, and delivery methods of psychotherapy for specific postoperative outcomes of interest.</p>","PeriodicalId":8017,"journal":{"name":"Annals of surgery","volume":" ","pages":"928-941"},"PeriodicalIF":7.5,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143447726","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Homelessness Research Has a Data Problem.","authors":"Hannah Decker, Elizabeth Wick","doi":"10.1097/SLA.0000000000006620","DOIUrl":"10.1097/SLA.0000000000006620","url":null,"abstract":"","PeriodicalId":8017,"journal":{"name":"Annals of surgery","volume":" ","pages":"906-908"},"PeriodicalIF":7.5,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142943261","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mitochondrial Transplantation: A Novel Therapy for Liver Ischemia/Reperfusion Injury.","authors":"Avinash Naraiah Mukkala, Bruna Araujo David, Menachem Ailenberg, Jady Liang, Chirag Manoj Vaswani, Danielle Karakas, Rachel Goldfarb, William Barbour, Avishai Gasner, Ruoxian Scarlet Wu, Raluca Petrut, Mirjana Jerkic, Ana Cristina Andreazza, Claudia Dos Santos, Heyu Ni, Haibo Zhang, Andras Kapus, Paul Kubes, Ori David Rotstein","doi":"10.1097/SLA.0000000000006655","DOIUrl":"10.1097/SLA.0000000000006655","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the hepatoprotective effects of mitochondrial transplantation (MTx) in a murine liver ischemia/reperfusion (I/R) model.</p><p><strong>Background: </strong>Sequential liver ischemia, followed by reperfusion (I/R), is a pathophysiological process underlying hepatocellular injury in a number of clinical contexts, such as hemorrhagic shock/resuscitation, major elective liver surgery, and organ transplantation. A unifying pathogenic consequence of I/R is mitochondrial dysfunction. Restoration of mitochondria through transplantation (MTx) has emerged as a potential therapeutic in I/R. However, its role in liver I/R and its mechanisms of action remain poorly defined.</p><p><strong>Methods: </strong>We investigated the hepatoprotective effects of MTx in an in vivo mouse model of liver I/R and used in vivo imaging and various knockout and transgenic mouse models to determine the mechanism of protection.</p><p><strong>Results: </strong>We found that I/R-induced hepatocellular injury was prevented by MTx, as measured by plasma ALT, AST, and liver histology. In addition, I/R-induced pro-inflammatory cytokine release (IL-6, TNFα) was dampened by MTx, and anti-inflammatory IL-10 was enhanced. Moreover, MTx lowered neutrophil infiltration into both the liver sinusoids and lung bronchoalveolar lavage fluid, suggesting a local and distant reduction in inflammation. Using in vivo intravital imaging, we found that I/R-subjected Kupffer cells (KCs), rapidly sequestered transplanted mitochondria, and acidified mitochondria within lysosomal compartments. To specifically interrogate the role of KCs, we depleted KCs using the diphtheria toxin-inducible Clec4f/iDTR transgenic mouse, then induced I/R, and discovered that KCs are necessary for the beneficial effects of MTx. Finally, we induced I/R in the complement receptor of the immunoglobulin (CRIg) superfamily knockout mice and found that CRIg was required for mitochondria capture by KCs and mitochondria-mediated hepatoprotection.</p><p><strong>Conclusions: </strong>In this study, we demonstrated that CRIg-dependent capture of mitochondria by I/R-subjected KCs is a hepatoprotective mechanism in vivo . These data progress knowledge on the mechanisms of MTx and open new avenues for clinical translation.</p>","PeriodicalId":8017,"journal":{"name":"Annals of surgery","volume":" ","pages":"1032-1047"},"PeriodicalIF":7.5,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143254357","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}