Clinical course of cirrhosis in young adults and therapeutic potential of liver transplantation.

AbstractTumor recurrence is the major obstacle for pushing the envelope of liver transplantation for hepatocellular carcinoma (HCC) patients. The inflammatory cascades activated by acute liver graft injury promote tumor recurrence. We aimed to explore the role and mechanism of myeloid-derived suppressor cell (MDSC) mobilization induced by liver graft injury on tumor recurrence. By analyzing 331 HCC patients who received liver transplantation, the patients with graft weight ratio (GWR, the weight of liver graft divided by the estimated standard liver weight of recipient) <60% had higher tumor recurrence than GWR ≥60% ones. MDSCs and CXCL10/TLR4 levels were significantly increased in patients with GWR <60% or tumor recurrence. These findings were further validated in our rat orthotopic liver transplantation model. In CXCL10−/− and TLR4−/− mice of hepatic ischemia/reperfusion injury plus major hepatectomy (IRH) model, monocytic MDSCs, instead of granulocytic MDSCs, were significantly decreased. Importantly, CXCL10 deficiency reduced the accumulation of TLR4+ monocytic MDSCs, and CXCL10 increased MDSC mobilization in the presence of TLR4. Moreover, MMP14 was identified as the key molecule bridging CXCL10/TLR4 signaling and MDSC mobilization. Knockout or inhibition of CXCL10/TLR4 signaling significantly reduced the tumor growth with decreased monocytic MDSCs and MMP14 in the mouse tumor recurrent model. Our data indicated that monocytic MDSCs were mobilized and recruited to liver graft during acute phase injury, and to promote HCC recurrence after transplantation. Targeting MDSC mobilization via CXCL10/TLR4/MMP14 signaling may represent the therapeutic potential in decreasing post-transplant liver tumor recurrence.

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Natural course of HCV viremia following liver transplantation and clinical course of reinfection

Transplantation Proceedings ◽

10.1016/s0041-1345(97)00537-x ◽

1997 ◽

Vol 29 (6) ◽

pp. 2635-2639

Author(s):

R. Safadi ◽

D. Shouval ◽

Y. Ashur ◽

A. Eid ◽

O. Jurim ◽

...

Keyword(s):

Liver Transplantation ◽

Clinical Course ◽

Natural Course

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Incidence, prevalence, and clinical course of hepatitis C following liver transplantation

Gastroenterology ◽

10.1016/0016-5085(92)91130-v ◽

1992 ◽

Vol 103 (1) ◽

pp. 323-329 ◽

Cited By ~ 77

Author(s):

Gunjan Shah ◽

A.Jake Demetris ◽

Judith S. Gavaler ◽

Jessica H. Lewis ◽

Saturo Todo ◽

...

Keyword(s):

Liver Transplantation ◽

Hepatitis C ◽

Clinical Course ◽

Incidence Prevalence

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Evaluation of Procalcitonin (PCT) As a Marker of Infection in Early Post Living Donated Liver Transplant Period.

10.21203/rs.3.rs-287578/v1 ◽

2021 ◽

Author(s):

Eman Ibrahim El-Desoki Mahmoud ◽

Mohammad A. Algendy ◽

Adel M. Al-Ansary ◽

Maissa K. Noaman

Keyword(s):

Liver Transplantation ◽

Clinical Course ◽

Leukocyte Count ◽

Demographic Data ◽

Positive Culture ◽

Infectious Complications ◽

Total Leukocyte Count ◽

Solid Organ ◽

Single Center ◽

Cutoff Value

Abstract Background: Procalcitonin (PCT) has been increasingly used as a biomarker of bacterial infection and as a tool to guide antimicrobial therapy. Despite its increased use, data in patients with solid organ transplants are limited. The study aim is to assess the frequency of rising procalcitonin associated with infectious complications in immunosuppressed living donated liver transplantation.Methods: A single center, retrospective observational study. Preoperative patients' demographic data, operative, anesthetic data and postoperative clinical course are analyzed till discharge from intensive care unit.Results: Sixty patients were classified according to the culture results' into a positive culture group & a negative one, then following up sepsis variables in each group. Total leukocyte count (TLC) and procalcitonin (PCT) were high in the positive culture group in the first 4 and 5 days respectively and was statistically significant (P-value < 0.05).PCT at a cutoff value ≥ 9ng/ml had higher specificity, especially on day three postoperative (90.7%). The TLC cutoff value of ≥ 17.3/mm3on day one; had the specificity of > 90%. Conclusions: following up PCT level on day one with TLC is essential and will help to detect sepsis and guide early antimicrobial initiation post liver transplantation.Trial registration: NHTMRI, NCT03389360. Registered 7 February, 2018,https://register.clinicaltrials.gov/prs/app/action/SelectProtocol?sid=S0007O6F&selectaction=Edit&uid=U0003W0U&ts=2&cx=fwyacz

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Epidemiology and clinics of mushroom poisoning in Northern Italy: A 21-year retrospective analysis

Human & Experimental Toxicology ◽

10.1177/0960327117730882 ◽

2017 ◽

Vol 37 (7) ◽

pp. 697-703 ◽

Cited By ~ 12

Author(s):

G Cervellin ◽

I Comelli ◽

G Rastelli ◽

F Sanchis-Gomar ◽

F Negri ◽

...

Keyword(s):

Liver Transplantation ◽

Early Identification ◽

Clinical Presentation ◽

Clinical Course ◽

Clinical Information ◽

Northern Italy ◽

Gastrointestinal Toxicity ◽

Mushroom Poisoning ◽

Limited Information ◽

Life Threatening

Background: Limited information exists about epidemiology and management of mushroom poisoning. We analyzed and described epidemiology, clinical presentation, and clinical course of mushroom-poisoned patients admitted to emergency departments (EDs) of the Province of Parma, Italy. Methods: Data from the database of mycological service were matched with clinical information retrieved from hospitals’ database, from January 1, 1996 to December 31, 2016. Results: Mycologist consultation was obtained in 379/443 identified mushroom poisonings. A remarkable seasonality was found, with significant peak in autumn. Thanks to the collaboration, the implicated species could be identified in 397 cases (89.6%); 108 cases (24.4%) were due to edible mushrooms, Boletus edulis being the most represented (63 cases). Overall, 408 (92%) cases presented with gastrointestinal toxicity. Twenty cases of amatoxin poisoning were recorded (11 Amanita phalloides and 9 Lepiota brunneoincarnata). One liver transplantation was needed. We observed 13 cases of cholinergic toxicity and 2 cases of hallucinogenic toxicity. Finally, 46 cases were due to “mixed” toxicities, and a total of 69 needed hospitalization. Conclusions: Early identification and management of potentially life-threatening cases is challenging in the ED, so that a mycologist service on call is highly advisable, especially during periods characterized by the highest incidence of poisoning.

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