Review
Immunology
Martin Tepel, Subagini Nagarajah, Qais Saleh, Olivier Thaunat, Stephan J. L. Bakker, Jacob van den Born, Morten A. Karsdal, Federica Genovese, Daniel G. K. Rasmussen
Summary: The characterization of potential kidney transplant recipients using novel biomarkers can lead to improved outcomes after transplantation. This mini-review focuses on the current understanding of pretransplant recipients' characteristics, biomarkers, and immunology. Clinical characteristics and immunological risk assessment, such as histocompatibility leukocyte antigens (HLAs) and non-HLA antibodies, have been used to predict recipient and allograft survival. Recent studies have shown that pretransplant markers, such as plasma endotrophin levels and non-synonymous single-nucleotide polymorphism mismatch, are associated with posttransplant complications and allograft loss. Integrating clinical characteristics and novel markers is important for making better diagnostic decisions tailored to individual patients.
FRONTIERS IN IMMUNOLOGY
(2022)
Article
Nutrition & Dietetics
Lena Berchtold, Anja Filzer, Rita Achermann, Vasileios Devetzis, Suzan Dahdal, Marco Bonani, Aurelia Schnyder, Dela Golshayan, Patrizia Amico, Uyen Huynh-Do, Sophie de Seigneux, Spyridon Arampatzis
Summary: Hyponatremia 6 months after transplantation is not associated with mortality in kidney allograft patients, nor with rapid decline in renal function, graft loss, or mortality. The presence of hyponatremia at 6 months post-transplantation does not have negative effects in this population.
Article
Immunology
Sandesh Parajuli, Natalie M. Bath, Luis Hidalgo, Glen Leverson, Neetika Garg, Robert R. Redfield, Didier A. Mandelbrot
Summary: Low-level pretransplant donor-specific antibodies may increase the risk of antibody-mediated rejection and lead to higher rates of BK viremia post kidney transplantation. It is important to closely monitor the impact of low-level DSAs during kidney transplantation.
IMMUNITY INFLAMMATION AND DISEASE
(2021)
Article
Immunology
Allison J. Kwong, W. Ray Kim, John Lake, Peter G. Stock, Connie J. Wang, James B. Wetmore, Marc L. Melcher, Andrew Wey, Nicholas Salkowski, Jon J. Snyder, Ajay K. Israni
Summary: A study found that livers with macrovesicular steatosis are less likely to be transplanted due to their higher risk of graft failure. To facilitate the use of these higher-risk organs, the SRTR now includes the variable of macrovesicular steatosis in their risk-adjustment models.
Review
Oncology
Kohei Ogawa, Yasutsugu Takada
Summary: Hepatocellular carcinoma (HCC) is a common cancer in men and a leading cause of cancer death. Liver transplantation (LT) is a treatment option for HCC patients. Locoregional therapy, such as transarterial chemoembolization and radiofrequency ablation, has been used as a pretreatment before LT. In Western countries, locoregional therapy is used to bridge until transplantation or for downstaging. Recent reports have clarified the effects of bridging and downstaging locoregional therapy before LT.
Article
Health Care Sciences & Services
Laura Ioana Mazilescu, Isabel Bernheim, Juergen Treckmann, Sonia Radunz
Summary: This study found that female recipients and female surgeons are underrepresented in liver transplant surgery, and the survival rate of female recipients may be affected. Further research is needed to examine the societal factors influencing the outcome of female patients and take measures to possibly improve the prognosis of female liver transplant recipients.
JOURNAL OF PERSONALIZED MEDICINE
(2023)
Article
Endocrinology & Metabolism
Diego Martinelli, Giulio Catesini, Benedetta Greco, Alessia Guarnera, Chiara Parrillo, Evelina Maines, Daniela Longo, Antonio Napolitano, Francesca De Nictolis, Sara Cairoli, Daniela Liccardo, Stefania Caviglia, Anna Sidorina, Giorgia Olivieri, Barbara Siri, Roberto Bianchi, Gionata Spagnoletti, Luca Dello Strologo, Marco Spada, Carlo Dionisi-Vici
Summary: Liver and liver/kidney transplantation have positive effects on the neurological outcome of patients with methylmalonic aciduria. Improved biomarkers were observed in plasma, while biomarkers of mitochondrial dysfunction decreased in cerebrospinal fluid. Neurocognitive evaluation showed significant cognitive improvement and brain changes at MRI. Early transplantation is recommended due to long-term complications and low quality of life.
JOURNAL OF INHERITED METABOLIC DISEASE
(2023)
Article
Surgery
Marion Patras, Evelyne Decullier, Celeste Lebbe, Julie Delyon, Jacques Dantal, Christophe Legendre, Manal Mazloum, Aurelie Du Thanh, Feriel Boukari, Emmanuel Morelon, Denis Jullien, Jean Kanitakis, Emilie Ducroux
Summary: This study assessed melanoma recurrence-free survival after pretransplant melanoma (PTM), showing reassuring results for in situ and stage IA PTM. Waiting time for transplantation is not mandatory for these patients, but caution is needed for those with higher stage melanomas.
TRANSPLANT INTERNATIONAL
(2021)
Article
Biochemistry & Molecular Biology
Sebastian O. Decker, Albert Krueger, Henryk Wilk, Florian Uhle, Thomas Bruckner, Stefan Hofer, Markus A. Weigand, Thorsten Brenner, Aleksandar R. Zivkovic
Summary: Plasmatic markers, specifically BChE and MR-proADM, can be used as predictive indicators for 90-day outcomes and early bacterial infections in liver transplant patients.
Article
Immunology
Arpit Amin, Alfonso Molina, Lisa Quach, Takahiro Ito, Robert McMillan, Joseph DiNorcia, Vatche G. Agopian, Fady M. Kaldas, Douglas G. Farmer, Ronald W. Busuttil, Drew J. Winston
Summary: A retrospective study of liver transplant recipients with pretransplant Aspergillus colonization at Ronald Reagan UCLA Medical Center showed that these patients can still undergo successful liver transplantation with appropriate antifungal prophylaxis, and posttransplant outcome is mainly determined by noninfectious complications rather than fungal infection. Pretransplant Aspergillus colonization alone should not necessarily preclude or delay liver transplantation.
Review
Gastroenterology & Hepatology
Alexandre Pimentel Ferreira, Mariana Verdelho Machado
Summary: Frailty and sarcopenia have a negative impact on post-transplant outcomes in patients with liver cirrhosis, with severe cases leading to reduced survival rates and increased complications. The reversibility of frailty and sarcopenia depends on the severity of the conditions and comorbidities.
EUROPEAN JOURNAL OF GASTROENTEROLOGY & HEPATOLOGY
(2021)
Article
Pediatrics
Angelo Di Giorgio, Silvia Gamba, Naire Sansotta, Emanuele Nicastro, Michele Colledan, Lorenzo D'Antiga
Summary: This retrospective study compared the diagnosis and management of pediatric patients with acute liver failure (ALF) in two time periods. The study found that there was a lower need for liver transplantation (LT) in recent years compared to the past, indicating improvements in the diagnosis and management of children with ALF.
Article
Oncology
Matteo Serenari, Enrico Prosperi, Marc-Antoine Allard, Michele Paterno, Nicolas Golse, Andrea Laurenzi, Rene Adam, Matteo Ravaioli, Daniel Cherqui, Matteo Cescon
Summary: This study demonstrates that the time interval between hepatic resection (HR) and secondary liver transplantation (SLT) is a key factor in predicting complications after liver transplantation (LT), without affecting hepatocellular carcinoma (HCC)-related death.
Article
Surgery
Jeng-Wei Chen, Nai-Kuan Chou, Chih-Hsien Wang, Nai-Hsin Chi, Shu-Chien Huang, Hsi-Yu Yu, Yih-Sharng Chen, Ron-Bin Hsu
Summary: End stage renal disease (ESRD) is a contraindication to isolated heart transplantation (HT), but heart failure patients may require HT and renal replacement therapy (RRT) due to acute kidney injury. In this study, patients requiring RRT had lower survival rates, and pre-transplant hyperbilirubinemia, post-transplant RRT, and post-transplant early bloodstream infection were identified as independent risk factors for 1-year mortality. The majority of operative survivors experienced renal recovery after HT, but patients with persistent RRT had a higher incidence of dialysis-dependent ESRD within 10 years.
TRANSPLANT INTERNATIONAL
(2022)
Article
Pediatrics
Marek Stefanowicz, Piotr Kalicinski, Grzegorz Kowalewski, Adam Kowalski, Mateusz Ciopinski, Marek Szymczak, Agnieszka Kwiecinska, Waldemar Patkowski, Krzysztof Zieniewicz, Ireneusz Grzelak, Diana Kaminska, Hor Ismail
Summary: The aim of this study was to analyze the risk factors for hepatic artery thrombosis (HAT) and its impact on long-term outcomes in pediatric living donor liver transplantation (LDLT). The study included 400 patients who underwent primary LDLT between 1999 and 2020. The results showed that acute liver failure, a hepatic artery anastomosis diameter below 2 mm, and intraoperative hepatic artery flow dysfunction were associated with a higher risk of HAT. Patients in the HAT group had worse survival rates and higher rates of biliary stenosis and retransplantation compared to the non-HAT group. Close monitoring of hepatic artery flow and immediate surgical revascularization can help mitigate the risks associated with HAT.
Editorial Material
Gastroenterology & Hepatology
Bo kyung Koo, Hyunsuk Lee, Soo-heon Kwak, Dong hyeon Lee, Jeong hwan Park, Won Kim
CLINICAL GASTROENTEROLOGY AND HEPATOLOGY
(2023)
Article
Gastroenterology & Hepatology
Pimsiri Sripongpun, W. Ray Kim, Ajitha Mannalithara, Vivek Charu, Anna Vidovszky, Steven Asch, Manisha Desai, Sun H. Kim, Allison J. Kwong
Summary: This study developed and validated a score to assess liver fibrosis in patients with NAFLD using widely available variables. The score, known as SAFE, showed higher accuracy in distinguishing low-risk NAFLD compared to other methods.
Article
Gastroenterology & Hepatology
Marlyn J. Mayo, Elizabeth Carey, Helen T. Smith, Andrea R. Mospan, Megan McLaughlin, April Thompson, Heather L. Morris, Robert Sandefur, W. Ray Kim, Christopher Bowlus, Cynthia Levy
Summary: This study investigated the impact of pruritus on quality of life and its management in patients with PBC. The prevalence of pruritus was found to be high and it had a negative impact on patients' quality of life. However, the study also found that pruritus in PBC is often undertreated.
DIGESTIVE DISEASES AND SCIENCES
(2023)
Article
Gastroenterology & Hepatology
Branden D. Tarlow, W. Ray Kim, Ajitha Mannalithara, Paul Y. Kwo, C. Andrew Bonham, Allison Kwong
Summary: This study found that MELD 3.0 scores beyond 40 are associated with increasing waitlist mortality without adversely affecting posttransplant outcomes. Uncapping the MELD score for waitlist candidates may lead to greater survival benefits from liver transplantation.
Article
Gastroenterology & Hepatology
Man-Fung Yuen, Chi-Yi Chen, Chun-Jen Liu, Wen-Juei Jeng, Magdy Elkhashab, Carla S. Coffin, Won Kim, Susan Greenbloom, Alnoor Ramji, Young S. Lim, Yoon J. Kim, Scott K. Fung, Dong J. Kim, Jeong-Won Jang, Kwan Sik Lee, Radhakrishnan P. Iyer, Chelsea Macfarlane, Kathy Jackson, Stephen A. Locarnini, Henry L. Y. Chan, Nezam H. Afdhal
Summary: Treatment with Inarigivir for HBV infection showed a trend of reducing viral load and antigen levels. A greater reduction in HBsAg was observed in patients pre-treated with Inarigivir after switching to tenofovir.
LIVER INTERNATIONAL
(2023)
Article
Immunology
Allison J. Kwong, W. Ray Kim, John Lake, Peter G. Stock, Connie J. Wang, James B. Wetmore, Marc L. Melcher, Andrew Wey, Nicholas Salkowski, Jon J. Snyder, Ajay K. Israni
Summary: A study found that livers with macrovesicular steatosis are less likely to be transplanted due to their higher risk of graft failure. To facilitate the use of these higher-risk organs, the SRTR now includes the variable of macrovesicular steatosis in their risk-adjustment models.
Article
Nutrition & Dietetics
Heejun Son, Bo Kyung Koo, Sae Kyung Joo, Dong Hyeon Lee, Heejoon Jang, Jeong Hwan Park, Mee Soo Chang, Won Kim
Summary: This study aimed to investigate the effects of diet on the development of nonalcoholic steatohepatitis (NASH) and fibrosis progression in patients with nonalcoholic fatty liver disease (NAFLD). The total energy intake had no impact on fibrosis progression but was associated with high-risk NASH. The effect of total energy intake on high-risk NASH was more pronounced in patients without the PNPLA3 risk allele.
AMERICAN JOURNAL OF CLINICAL NUTRITION
(2023)
Article
Gastroenterology & Hepatology
Allison J. Kwong, Ke-You Zhang, Noelle Ebel, Ajitha Mannalithara, W. Ray Kim
Summary: We evaluated the predictive performance of MELD-Sodium, MELD 3.0, and Pediatric End-stage Liver Disease for 90-day waitlist mortality risk among adolescent liver transplant registrants. The results showed that MELD 3.0 can effectively rank adolescents to predict their risk of death within 90 days and better represent their urgency for liver transplants.
Editorial Material
Gastroenterology & Hepatology
W. Ray Kim, Yasuko Iwakiri, Anna S. F. Lok
Editorial Material
Gastroenterology & Hepatology
Yun Kyu Lee, Bo Kyung Koo, Won Kim
ALIMENTARY PHARMACOLOGY & THERAPEUTICS
(2023)
Article
Gastroenterology & Hepatology
Guanlin Li, Huapeng Lin, Pimsiri Sripongpun, Lilian Y. Liang, Xinrong Zhang, Vincent W. S. Wong, Grace L. H. Wong, W. Ray Kim, Terry C. F. Yip
Summary: The study compared the SAFE score with other non-invasive tests in diagnosing liver fibrosis and predicting liver-related events in Asian patients with NAFLD. The results showed that transient elastography had the highest AUROC for detecting significant fibrosis, followed by the SAFE score. The SAFE score also outperformed other blood-based algorithms in predicting liver-related events.
LIVER INTERNATIONAL
(2023)
Article
Medicine, General & Internal
Pimsiri Sripongpun, Prowpanga Udompap, Ajitha Mannalithara, N. Lance Downing, Anna A. Vidovszky, Allison J. Kwong, Aparna Goel, Paul Y. Kwo, W. Ray Kim
Summary: The study aims to analyze the impact of health insurance coverage on HCV infection prevalence in US adults born after 1965 and formulate strategies for population screening. The results show higher HVC prevalence in uninsured individuals, and alanine aminotransferase prescreening can effectively reduce the number of screenings.
MAYO CLINIC PROCEEDINGS
(2023)