Skip directly to content

PubMed Liver Transplant

Subscribe to PubMed Liver Transplant feed PubMed Liver Transplant
NCBI: db=pubmed; Term=liver transplant
Updated: 7 min 20 sec ago

Testing feasibility of an accurate microscopic assessment of macrovesicular steatosis in liver allograft biopsies by smartphone add-on lenses.

Thu, 10/19/2017 - 12:45

Testing feasibility of an accurate microscopic assessment of macrovesicular steatosis in liver allograft biopsies by smartphone add-on lenses.

Microsc Res Tech. 2017 Oct 17;:

Authors: Cesaretti M, Poté N, Dondero F, Cauchy F, Schneck AS, Soubrane O, Paradis V, Diaspro A, Antonini A

Abstract
Light microscopy is an essential tool in histological examination of tissue samples. However, the required equipment for a correct and rapid diagnosis is sometimes unavailable. Smartphones and mobile phone networks are widespread, and could be used for diagnostic imaging and telemedicine. Macrovesicular steatosis (MS) is a major risk factor for liver graft failure, and is only assessable by microscopic examination of a frozen tissue section. The aim of this study was to compare the microscopic assessment of MS in liver allograft biopsies by a smartphone with eyepiece adaptor (BLIPS device) to standard light microscopy. Forty liver graft biopsies were evaluated in transmitted light, using an Iphone 5s and 4 different mini-objective, add-on lenses. A significant correlation was reported between the two different approaches for graft MS assessment (Spearman's correlation coefficient: rs  = 0.946; p < .001). Smartphone with eyepiece adaptor had similar discriminatory power to identify MS in liver grafts than standard light microscopy. Based on these findings, a smartphone integrated with a low-cost eyepiece adaptor can achieve adequate accuracy in the assessment of MS in liver graft, and could be used as an alternative to standard light microscope when unavailable.

PMID: 29044859 [PubMed - as supplied by publisher]

Liver Transplant Length of Stay (LOS) Index: A Novel Predictive Score for Hospital Length of Stay following Liver Transplantation.

Thu, 10/19/2017 - 12:45

Liver Transplant Length of Stay (LOS) Index: A Novel Predictive Score for Hospital Length of Stay following Liver Transplantation.

Clin Transplant. 2017 Oct 17;:

Authors: Rana A, Witte ED, Halazun KJ, Sood GK, Mindikoglu AL, Sussman N, Vierling JM, Kueht ML, Galvan NTN, Cotton RT, O'Mahony CA, Goss JA

Abstract
An index to predict hospital length of stay after liver transplantation could address unmet clinical needs. Length of stay is an important surrogate for hospital costs and efforts to limit stays can preserve our healthcare resources. Here, we devised a scoring system that predicts hospital length of stay following liver transplantation. We used univariate and multivariate analyses on 73,635 adult liver transplant recipient data and identified independent recipient and donor risk factors for prolonged hospital stay (> 30 days). Multiple imputation was used to account for missing variables. We identified 22 factors as significant predictors of prolonged hospital stay, including the most significant risk factors: Intensive Care Unit (ICU) admission (OR 1.75, CI 1.58-1.95) and previous transplant (OR 1.60, CI 1.47-1.75). The Length of Stay (LOS) index assigns weighted risk points to each significant factors in a scoring system to predict prolonged hospital stay after liver transplantation with a c-statistic of 0.75. The LOS index demonstrated good discrimination across the entire population, dividing the cohort into tertiles, which had odds ratios of 2.25 (CI 2.06-2.46) and 7.90 (7.29-8.56) for prolonged hospital stay (> 30 days). The LOS index utilizes 22 significant donor and recipient factors to accurately predict hospital length of stay following liver transplantation. The index further demonstrates the basis for a clear clinical recommendation to mitigate risk of long hospitalization by minimizing cold ischemia time. This article is protected by copyright. All rights reserved.

PMID: 29044759 [PubMed - as supplied by publisher]

Outcome Comparison of Liver Transplantation for Hepatitis-A-related Versus Hepatitis-B-related Acute Liver Failure in Adult Recipients.

Thu, 10/19/2017 - 12:45

Outcome Comparison of Liver Transplantation for Hepatitis-A-related Versus Hepatitis-B-related Acute Liver Failure in Adult Recipients.

Clin Transplant. 2017 Oct 17;:

Authors: Jung DH, Hwang S, Lim YS, Kim KH, Ahn CS, Moon DB, Ha TY, Song GW, Park GC, Lee SG

Abstract
Hepatitis A virus (HAV) can cause acute liver failure (ALF). This study compares outcomes between liver transplantation (LT) for HAV-related ALF (HAV-ALF) and LT for Hepatitis B virus (HBV)-related ALF (HBV-ALF). Of 3,616 adult LTs performed between January 2005 and December 2014, we performed LT for HAV-ALF recipients (n = 29) and LT for HBV-ALF recipients (n = 34). HAV-ALF group included 18 males and 11 females with mean age of 33.1 years. Graft survival rates in HAV-ALF and HBV-ALF were 65.5% and 88.0% (1 year) and 65.5% and 84.0% (5 years) (P = 0.048). Patient survival rates in HAV-ALF and HBV-ALF were 69.0% and 88.0% (1 year) and 69.0% and 84.0% (5 years) (P = 0.09). Multivariate analyses demonstrated that acute pancreatitis and HAV recurrence were independent risk factors of graft and patient survival. Posttransplant outcome was poorer in patients with HAV-ALF than in those with HBV-ALF. This weakens LT's appropriateness in HAV-ALF patients with pancreatitis. HAV recurrence after LT for HAV-ALF is common and often fatal, thus HAV recurrence should be monitored vigilantly, beginning early post-transplant. This article is protected by copyright. All rights reserved.

PMID: 29044729 [PubMed - as supplied by publisher]

Systematic Review and Meta-analysis of Liver Transplantation Using Grafts from Deceased Donors aged over 70-years.

Thu, 10/19/2017 - 12:45

Systematic Review and Meta-analysis of Liver Transplantation Using Grafts from Deceased Donors aged over 70-years.

Clin Transplant. 2017 Oct 17;:

Authors: Dasari BV, Mergental H, Isaac JR, Muiesan P, Mirza DF, Perera MTPR

Abstract
INTRODUCTION: Due to the current organ shortage, nearly 20% of patients die waiting for a liver transplant (LT). The average donor age is on the rise, and grafts from elderly donors are offered as extended criteria grafts.
METHODS: This is a meta-analysis comparing the outcome differences of adult patients undergoing LT using grafts from <70-year-old donors versus >70-year-old donors. The primary end-points were graft and patient survival. Secondary outcomes were biliary and vascular complications as well as graft function. The odds ratio (OR) is a summary statistic with the corresponding 95% confidence interval; p < 0.05 was considered to be statistically significant.
RESULTS: Eight non-randomized comparative studies with 4376 LT recipients were included. 79.9% and 20.1% of the grafts were from <70-year-old and >70-year-old donors, respectively. Graft survival at 1-year was similar between the two groups [p=0.11], but there was better 3-year and 5-year graft survival in the >70-year-old group [p=0.006 and p<0.0001, respectively]. Patient survival was also similar between the groups at 1 year [p=0.54], but with better survival at 3-year and 5-year follow-ups [p=0.007 and p<0.0001, respectively] in the >70-year-old group. There were no statistically significant differences in the incidence of biliary, vascular, and graft functional related complications.
CONCLUSION: Liver grafts from selected >70-year-old donors do not pose added organ specific risks and thus have comparable transplantation outcomes. This article is protected by copyright. All rights reserved.

PMID: 29044682 [PubMed - as supplied by publisher]

Severe Thrombocytopenia in a Patient Following Liver Transplantation Caused by HPA-1a Antibodies Produced by the Liver Donor.

Thu, 10/19/2017 - 12:45

Severe Thrombocytopenia in a Patient Following Liver Transplantation Caused by HPA-1a Antibodies Produced by the Liver Donor.

Am J Hematol. 2017 Oct 16;:

Authors: Lindholm PF, Kwaan HC, Ramsey G, Curtis BR, Fryer J

PMID: 29044602 [PubMed - as supplied by publisher]

Pancreaticojejunostomy: Does the technique matter? A randomized trial.

Thu, 10/19/2017 - 12:45

Pancreaticojejunostomy: Does the technique matter? A randomized trial.

J Surg Oncol. 2017 Oct 16;:

Authors: Singh AN, Pal S, Mangla V, Kilambi R, George J, Dash NR, Chattopadhyay TK, Sahni P

Abstract
BACKGROUND: Despite a large number of studies, the ideal technique of pancreaticojejunostomy (PJ) after pancreaticoduodenectomy (PD) remains debatable. We compared the two most common techniques of PJ (duct-to-mucosa and dunking) in a randomized trial.
METHODS: This open-label randomized trial was done at a tertiary care center from January 2009 to October 2015. Patients with resectable periampullary tumours with a pancreatic duct diameter ≥2 mm, requiring PD were randomly assigned to one of the two techniques using computer generated random numbers. The primary outcome was postoperative pancreatic fistula (POPF) rate and secondary outcomes were frequency of other postoperative complications.
RESULTS: A total of 193 patients were randomized and analyzed (intention-to-treat analysis), 97 in duct-to-mucosa and 96 in dunking group. Both groups were comparable for baseline demographic and clinical profiles. The incidence of POPF in the entire study group was 23.8%. There was no statistically significant difference between the two groups (24.7% vs 22.9%, P = 0.71). Similarly, the incidence of grades B and C (clinically significant) POPF was comparable (16.5% vs 13.5%, P = 0.57). Both groups were comparable with respect to the secondary outcomes.
DISCUSSION: The duct-to-mucosa technique of PJ after PD is not superior to the dunking technique with respect to POPF rate. (CTRI/2010/091/000531).

PMID: 29044532 [PubMed - as supplied by publisher]

Hepatic morphology abnormalities: beyond cirrhosis.

Thu, 10/19/2017 - 12:45

Hepatic morphology abnormalities: beyond cirrhosis.

Abdom Radiol (NY). 2017 Oct 17;:

Authors: Mamone G, Cortis K, Sarah A, Caruso S, Miraglia R

Abstract
The diagnosis of cirrhosis can be reached on the basis of established hepatic morphological changes. However, some other conditions can mimic cirrhosis. The aim of this pictorial essay is to review the CT and MRI appearances of hepatic morphology abnormalities in the cirrhotic liver and other diseases, describing pathologic conditions that can mimic cirrhosis, with useful tips for the differential diagnosis. Mimickers of cirrhosis include congenital hepatic fibrosis, Caroli disease, Budd-Chiari Syndrome, hepatoportal sclerosis, cavernous transformation of the portal vein, pseudocirrhosis from metastatic disease, acute liver failure, post-therapeutic morphologic changes in the liver, and infective conditions including schistosomiasis and oriental cholangiohepatitis. Recognizing the hepatic morphological changes in images can help radiologists to diagnose cirrhosis and other diseases in early stages.

PMID: 29043403 [PubMed - as supplied by publisher]

Risk of cancer after lung transplantation for COPD.

Thu, 10/19/2017 - 12:45

Risk of cancer after lung transplantation for COPD.

Int J Chron Obstruct Pulmon Dis. 2017;12:2841-2847

Authors: Ekström M, Riise GC, Tanash HA

Abstract
BACKGROUND: The risk of cancer is increased and affects survival after lung transplantation (LTx), but has not been well characterized in COPD. We aimed to evaluate the incidence and prognosis of cancer following LTx for COPD.
METHODS: A prospective, population-based study of patients undergoing LTx for end-stage COPD at the two transplantation centers in Sweden between 1990-2013, with follow-up for incident cancer and death, using national registers. The excess risk of cancer was calculated as standardized incidence ratios compared with the general population matched for age, sex, and calendar year. Risk factors for cancer were analyzed using Fine-Gray regression, and survival after cancer diagnosis with Kaplan-Meier.
RESULTS: In total, 331 patients (mean age 55.4 years; 64% women; 97% former smokers) were included. At a median follow-up of 2.8 years, 35% of patients had developed cancer and the risk was increased more than 10-fold ([95% CI] 8.1-11.8). The highest excess risks were for non-Hodgkin lymphoma (20.8-66.7), skin cancer (20.3-35.2), lung (11.7-31.2), liver (3.6-51.6), and colorectal cancer (6.1-19.5). Median survival was longer for skin cancer (8 years; 95% CI, 3-15) compared with non-skin cancer (4 years; 95% CI, 2.8-4.8; p<0.001).
CONCLUSION: The cancer risk is markedly increased after LTx for COPD. It could not be predicted by the factors evaluated, but contributed significantly to a negative prognosis.

PMID: 29042765 [PubMed - in process]

Living Donor Liver Transplantation for Acute Liver Failure : Comparing Guidelines on the Prediction of Liver Transplantation.

Thu, 10/19/2017 - 12:45

Living Donor Liver Transplantation for Acute Liver Failure : Comparing Guidelines on the Prediction of Liver Transplantation.

Acta Med Okayama. 2017 Oct;71(5):381-390

Authors: Yoshida K, Umeda Y, Takaki A, Nagasaka T, Yoshida R, Nobuoka D, Kuise T, Takagi K, Yasunaka T, Okada H, Yagi T, Fujiwara T

Abstract
Determining the indications for and timing of liver transplantation (LT) for acute liver failure (ALF) is essential. The King's College Hospital (KCH) guidelines and Japanese guidelines are used to predict the need for LT and the outcomes in ALF. These guidelines' accuracy when applied to ALF in different regional and etiological backgrounds may differ. Here we compared the accuracy of new (2010) Japanese guidelines that use a simple scoring system with the 1996 Japanese guidelines and the KCH criteria for living donor liver transplantation (LDLT). We retrospectively analyzed 24 adult ALF patients (18 acute type, 6 sub-acute type) who underwent LDLT in 1998-2009 at our institution. We assessed the accuracies of the 3 guidelines' criteria for ALF. The overall 1-year survival rate was 87.5%. The new and previous Japanese guidelines were superior to the KCH criteria for accurately predicting LT for acute-type ALF (72% vs. 17%). The new Japanese guidelines could identify 13 acute-type ALF patients for LT, based on the timing of encephalopathy onset. Using the previous Japanese guidelines, although the same 13 acute-type ALF patients (72%) had indications for LT, only 4 patients were indicated at the 1st step, and it took an additional 5 days to decide the indication at the 2nd step in the other 9 cases. Our findings showed that the new Japanese guidelines can predict the indications for LT and provide a reliable alternative to the previous Japanese and KCH guidelines.

PMID: 29042695 [PubMed - in process]

Value of Preoperative Indocyanine Green Clearance Test for Predicting Post-Hepatectomy Liver Failure in Noncirrhotic Patients.

Thu, 10/19/2017 - 12:45

Value of Preoperative Indocyanine Green Clearance Test for Predicting Post-Hepatectomy Liver Failure in Noncirrhotic Patients.

Med Sci Monit. 2017 Oct 18;23:4973-4980

Authors: Ibis C, Albayrak D, Sahiner T, Soytas Y, Gurtekin B, Sivrikoz N

Abstract
BACKGROUND Liver failure is the most feared complication following hepatectomy. Post-hepatectomy liver failure (PHLF) is closely related to the remnant liver volume, and functional reserve. There are several methods for predicting PHLF prior to liver resection. The indocyanine green (ICG) clearance test was popularized in patients with hepatocellular cancer (HCC). We aim to demonstrate the value of preoperative ICG clearance measurement via pulse spectrophotometer (LIMON®) in prediction of PHLF in noncirrhotic patients prior to liver resection. MATERIAL AND METHODS Fifty-three noncirrhotic patients who underwent liver resection due to different pathologies were included. Retrospectively collected clinical data, including the preoperative ICG clearance measurements and remnant liver volumes of the patients, were statistically evaluated according to the PHLF criteria of the International Study Group of Liver Surgery. RESULTS Four (7.5%) patients with PHLF were observed. There was no significant difference between PHLF and non-PHLF groups regarding ICG clearance measurements with cut-off values of 5% and 9.5%. CONCLUSIONS The ICG clearance test does not satisfy our expectations in noncirrhotic patients in predicting PHLF. We believe that the ICG clearance test should be reserved for patients with cirrhosis and/or HCC. This test could be an option for noncirrhotic patients with chronic active hepatitis, advanced-grade fatty livers, or for patients who received long-term preoperative chemotherapy, and also for patients who underwent single or multiple sessions of TACE or TARE prior to liver resection. If the routine selection criteria have been fulfilled, there is no further need to perform the ICG clearance test for living liver donors.

PMID: 29042529 [PubMed - in process]

MicroRNAs as biomarkers for liver injury: Current knowledge, challenges and future prospects.

Thu, 10/19/2017 - 12:45

MicroRNAs as biomarkers for liver injury: Current knowledge, challenges and future prospects.

Food Chem Toxicol. 2017 Oct 14;:

Authors: Lin H, Ewing LE, Koturbash I, Gurley BJ, Miousse IR

Abstract
MicroRNAs (miRNAs) are short regulatory RNAs that are involved in various biological processes that regulate gene expression posttranscriptionally. Changes in miRNA expression can be detected in many physiological and pathological events, such as liver injury. Drug induced liver injury is a life threatening condition that frequently requires organ transplantation. Hepatotoxicity is also one of the major causes of drug failure in clinical trials and of drug withdrawal from the market. The profiling of miRNA expression shows great promise in monitoring liver injury, in the prediction of outcome in patients, and in the identification of liver-reactive compounds in toxicological assessment. Recent studies have demonstrated organ-specificity of some miRNAs (i.e., miR-122), which are released into biological fluids as a result of hepatocyte damage. This attests to the potential of miRNAs as noninvasive biomarkers to detect liver toxicity. This review presents information on miRNA signatures of hepatotoxicity and on the application of promising miRNA biomarkers in preclinical safety assessment. We further discuss the technical challenges associated with these emerging biomarkers for early diagnosis and detection of hepatotoxicity.

PMID: 29042291 [PubMed - as supplied by publisher]

Human umbilical cord Wharton jelly cells promote extra-pancreatic insulin formation and repair of renal damage in STZ-induced diabetic mice.

Thu, 10/19/2017 - 12:45

Human umbilical cord Wharton jelly cells promote extra-pancreatic insulin formation and repair of renal damage in STZ-induced diabetic mice.

Cell Commun Signal. 2017 Oct 17;15(1):43

Authors: Maldonado M, Huang T, Yang L, Xu L, Ma L

Abstract
BACKGROUND: We evaluated the therapeutic effect and fate of high doses of human umbilical cord Wharton jelly cells (hUCWJCs) after IP administration to streptozotocin (STZ)-induced diabetic mice.
METHODS: Type 1 diabetes (T1D) was induced in Kunming mice via IP injection of STZ. hUCWJCs were labeled with 1,1'-dioctadecyl-3,3,3',3'-tetramethylindocarbocyanine perchlorate (DiI). Diabetic animals with sustained hyperglycemia for at least 2 weeks were administered 1 × 10(7) Dil-hUCWJCs via intraperitoneal injection. Insulin, glucagon and PDX-1 were detected by immunofluorescence with confocal microscopy. Serum mouse and human C-peptide was assayed in blood collected via intracardiac puncture. Specific β-cell differentiation markers and human DNA were assessed using qPCR performed with 200 ng of target DNA.
RESULTS: hUCWJCs migrated to the STZ-damaged organs and contributed to lower blood glucose levels in 30% of the treated mice. Confocal microscopy revealed the presence of resident insulin-positive cells in the liver and kidneys. hUCWJC-treated mice with restored hyperglycemia also showed increased serum mouse C-peptide levels. The qPCR results, particularly in the liver, revealed that after transplantation hUCWJCs upregulated genes of endocrine precursors but failed to express endocrine stage markers. Mice with restored hyperglycemia had reduced urinary volume and lacked glomerular hypertrophy, exhibiting a morphology resembling that of normal glomeruli. Moreover, we also verified that one of the possible mechanisms by which hUCWJCs exert immunosuppressive effects is through down-regulation of the cell surface receptor HLA-1.
CONCLUSIONS: We confirmed the potential of IP administration of hUCWJCs and the capability of these cells to migrate to damaged tissues and promote insulin secretion from non-pancreatic local cells and to improve renal damage. These findings confer unique therapeutic properties to hUCWJCs, suggesting a promising future in the treatment of diabetes mellitus.

PMID: 29041943 [PubMed - in process]

Assessment of liver perfusion and function by indocyanine green in the perioperative setting and in critically ill patients.

Thu, 10/19/2017 - 12:45
Related Articles

Assessment of liver perfusion and function by indocyanine green in the perioperative setting and in critically ill patients.

J Clin Monit Comput. 2017 Oct 16;:

Authors: Sakka SG

Abstract
Indocyanine green (ICG) is a water-soluble dye that is bound to plasma proteins when administered intravenously and nearly completely eliminated from the blood by the liver. ICG elimination depends on hepatic blood flow, hepatocellular function and biliary excretion. ICG elimination is considered as a useful dynamic test describing liver function and perfusion in the perioperative setting, i.e., in liver surgery and transplantation, as well as in critically ill patients. ICG plasma disappearance rate (ICG-PDR) which can be measured today by transcutaneous systems at the bedside is a valuable method for dynamic assessment of liver function and perfusion, and is regarded as a valuable prognostic tool in predicting survival of critically ill patients, presenting with sepsis, ARDS or acute liver failure.

PMID: 29039062 [PubMed - as supplied by publisher]

Japanese Biliary Atresia Registry.

Thu, 10/19/2017 - 12:45
Related Articles

Japanese Biliary Atresia Registry.

Pediatr Surg Int. 2017 Oct 16;:

Authors: Nio M

Abstract
The Japanese Biliary Atresia Registry (JBAR) was launched in 1989 by the Japanese Biliary Atresia Society (JBAS). JBAR employed an initial questionnaire, a questionnaire for liver transplantation, and a follow-up questionnaire. The questionnaire has been sent to the pediatric surgeons of JBAS member institutions and the hospitals in which council members of the Japanese Society of Pediatric Surgeons are working. One hundred and twenty-three hospitals have been included in JBAR between 1989 and 2015. Each patient is to be followed up for 30 years. Between 1989 and 2015, 3160 patients have been registered in JBAR. Among them, 1236 patients underwent liver transplantation. Follow-up questionnaire is also going on. 20-year overall and native-liver survival rates were 89 and 49%, respectively. The surgical outcome of BA has markedly improved owing to the co-operation of Kasai portoenterostomy and liver transplantation. Japanese big database of BA is now available.

PMID: 29039049 [PubMed - as supplied by publisher]

Is Routine Intraoperative Contrast-Enhanced Ultrasonography Useful During Whole Liver Transplantation?

Thu, 10/19/2017 - 12:45
Related Articles

Is Routine Intraoperative Contrast-Enhanced Ultrasonography Useful During Whole Liver Transplantation?

World J Surg. 2017 Oct 16;:

Authors: Golse N, Santoni S, Karam V, Ciacio O, Pittau G, Allard MA, Cherqui D, Sa Cunha A, Adam R, Castaing D, Vibert E

Abstract
BACKGROUND: Vascular complications following liver transplantation (LT) may result from technical deficiencies. Intraoperative diagnosis remains challenging but can prevent serious delayed complications. Intraoperative Doppler ultrasonography (IOUS) represents the gold standard for imaging, although it requires radiological skills. Contrast-enhanced ultrasonography has been reported during postoperative assessments, but never intraoperatively (CE-IOUS). The aim of this study was to assess the feasibility of routine CE-IOUS, to evaluate its impact on surgical strategy and its usefulness.
METHODS: All 553 whole LTs performed in our tertiary centre between 01/2010 and 12/2014 were reviewed. We compared perioperative outcomes and long-term survival in IOUS (n = 370) versus CE-IOUS (n = 103) groups. Secondarily, the seven cases where the two imaging findings conflicted (CE+ Group) were matched 1:2 and compared with an exclusively IOUS procedure (CE- Group, n = 14) to assess the consequences of a specific CE-guided strategy.
RESULTS: CE-IOUS assessments were successful in 100% of cases, without any adverse effects. Vascular complications and patient/graft survival rates were identical in the IOUS and CE-IOUS groups (p = 0.65, 0.95 and 0.86, respectively). CE-IOUS confirmed IOUS findings in 93% of cases (n = 96) and led to the realization of an additional procedure (median arcuate ligament lysis) and six conservative strategies despite poor arterial (n = 5) or venous flow (n = 1) under Doppler analysis. The CE+ and CE- groups presented statistically identical perioperative and long-term outcomes.
CONCLUSION: This study demonstrated the feasibility of CE-IOUS during whole LT. However, we failed to demonstrate any advantages of CE-IOUS over IOUS. Therefore, IOUS currently remains the gold-standard imaging technique for the intraoperative assessment of vascular patency.

PMID: 29038827 [PubMed - as supplied by publisher]

Naturalizing activity and safety of human monoclonal antibodies against of hepatitis C virus.

Thu, 10/19/2017 - 12:45
Related Articles

Naturalizing activity and safety of human monoclonal antibodies against of hepatitis C virus.

Hum Antibodies. 2017 Sep 29;:

Authors: Abelhafez TH, Tabll AA, El-Awady MK, Mashaly MM, El Shenawy R, El-Abd YS, Shaker MH, Abdel Malak CA

Abstract
AIM: Assessment of neutralizing activity of the human monoclonal antibodies against HCV and also study its safety in experimental small animals (Swiss mice).
MATERIALS AND METHODS: Assessment of neutralizing activity of the human monoclonal antibodies against HCV envelope regions (E1, E2) by two methods (by HCV cc infectious system and by using positive HCV positive serum as source of HCV particles (neutralizing assay 2). Dot ELISA were used to study the activity of the generated antibodies. We tested the safety and toxicity of the generated human antibodies by assessment the changes in biochemistry of liver function tests and changes in kidney function test, Complete blood counts (CBC) and study the pathological changes with different concentration of purified human antibodies.
RESULTS: Human Abs # 5 & 11 showed neutralizing activity by (neutralizing assay 2) but were not neutralizing by HCV cc assay. Human Abs # 12 & 15 showed neutralizing activity by two methods i.e our generated human antibodies Abs# 5 &11 & 12 & 15 were neutralizing for HCV genotype 4a and Abs # 12 & 15 were neutralizing for HCV genotypes 4a and 2a. Liver and kidney functions and CBC results indicated that doses of 10 μg, 100 μg were safe. The histopathological results indicated that the dose of 10 μg of purified human monoclonal antibodies per mouse body weight was safe.
CONCLUSION: The generated human monoclonal antibodies can be used to develop a potent immunotherapy that can be administrated for the post-transplantation patients to prevent the recurrence of HCV infection. Also, the monoclonal antibodies can be used to develop a vaccine against HCV.

PMID: 29036810 [PubMed - as supplied by publisher]

Liver Function in Patients With Nonalcoholic Fatty Liver Disease Randomized to Roux-en-Y Gastric Bypass Versus Sleeve Gastrectomy: A Secondary Analysis of a Randomized Clinical Trial.

Thu, 10/19/2017 - 12:45
Related Articles

Liver Function in Patients With Nonalcoholic Fatty Liver Disease Randomized to Roux-en-Y Gastric Bypass Versus Sleeve Gastrectomy: A Secondary Analysis of a Randomized Clinical Trial.

Ann Surg. 2017 Nov;266(5):738-745

Authors: Kalinowski P, Paluszkiewicz R, Ziarkiewicz-Wróblewska B, Wróblewski T, Remiszewski P, Grodzicki M, Krawczyk M

Abstract
OBJECTIVES: The aim of the study was to compare the influence of sleeve gastrectomy (SG) versus Roux-en-Y gastric bypass (RYGB) on liver function in bariatric patients with non-alcoholic fatty liver disease (NAFLD) in a randomized clinical trial (NCT01806506).
BACKGROUND: Rapid weight loss and malabsorption after bariatric surgery in patients with NAFLD or steatohepatitis (NASH) may impair liver function.
METHODS: Sixty-six morbidly obese patients randomized to SG or RYGB were included in a secondary outcome analysis. Intraoperative liver biopsies were categorized with NAFLD Activity Score (NAS) and liver function tests were done before surgery and after 1, 6 and 12 months.
RESULTS: NASH was present in 54.5% RYGB and 51.5% SG patients (P > 0.05). At 12 months excess weight loss was 68.7 ± 19.7% after SG and 62.8 ± 18.5% after RYGB (P > 0.05). At 1 month international normalized ratio (INR) increased after RYGB (0.98 ± 0.05 vs 1.14 ± 0.11; P < 0.05) and SG (0.99 ± 0.06 vs 1.04 ± 0.06; P < 0.05), RYGB induced significantly greater increase in INR in the whole group and NASH patients than SG. After RYGB albumin decreased at 1 month (41.2 ± 2.7 vs 39.0 ± 3.2 g/L; P < 0.05). At 12 months, INR and albumin returned to baseline. At 12 months in NASH group, SG induced significant improvement in aspartate aminotransferase (32.4 ± 17.4 vs 21.5 ± 6.9U/L), alanine aminotransferase (39.9 ± 28.6U/L vs 23.8 ± 14.1U/L), gamma-glutamyl transpeptidase (34.3 ± 16.6 vs 24.5 ± 16.8U/L), and lactate dehydrogenase (510.8 ± 33 vs 292.4 ± 29). Variables predictive of INR change after 1 month included operation type, NAS ≥ 5, bilirubin, body mass index, hemoglobin A1C, and dyslipidemia.
CONCLUSIONS: Patients with NASH undergoing RYGB are more susceptible to early transient deterioration of liver function than after SG.

PMID: 28767558 [PubMed - indexed for MEDLINE]

The Allosteric Hemoglobin Effector ITPP Inhibits Metastatic Colon Cancer in Mice.

Thu, 10/19/2017 - 12:45
Related Articles

The Allosteric Hemoglobin Effector ITPP Inhibits Metastatic Colon Cancer in Mice.

Ann Surg. 2017 Nov;266(5):746-753

Authors: Limani P, Linecker M, Schneider MA, Kron P, Tschuor C, Kachaylo E, Ungethuem U, Nicolau C, Lehn JM, Graf R, Humar B, Clavien PA

Abstract
OBJECTIVE: To test the effects of enhanced intracellular oxygen contents on the metastatic potential of colon cancer.
BACKGROUND: Colorectal cancer is the commonest gastrointestinal carcinoma. Distant metastases occur in half of patients and are responsible for most cancer-related deaths. Tumor hypoxia is central to the pathogenesis of metastases. Myo-Inositoltrispyrophosphate (ITPP), a nontoxic, antihypoxic compound, has recently shown significant benefits in experimental cancer, particularly when combined with standard chemotherapy. Whether ITPP protects from distant metastases in primary colon cancer is unknown.
METHODS: ITPP alone or combined with FOLFOX was tested in a mouse model with cecal implantation of green fluorescent protein-labeled syngeneic colorectal cancer cells. Tumor development was monitored through longitudinal magnetic resonance imaging-based morphometric analysis and survival. Established serum markers of tumor spread were measured serially and circulating tumor cells were detected via fluorescence measurements.
RESULTS: ITPP significantly reduced the occurrence of metastases as well as other indicators of tumor aggressiveness. Less circulating tumor cells along with reduction in malignant serum markers (osteopontin, Cxcl12) were noted. The ITPP benefits also affected the primary cancer site. Importantly, animals treated with ITPP had a significant survival benefit compared with respective controls, while a combination of FOLFOX with ITPP conferred the maximum benefits, including dramatic improvements in survival (mean 86 vs 188 d).
CONCLUSIONS: Restoring oxygen in metastatic colon cancer through ITPP inhibits tumor spread and markedly improves animal survival; an effect that is enhanced through the application of subsequent chemotherapy. These promising novel findings call for a clinical trial on ITPP in patients with colorectal cancer, which is under way.

PMID: 28742687 [PubMed - indexed for MEDLINE]

Distribution of human umbilical cord blood-derived mesenchymal stem cells (hUCB-MSCs) in canines after intracerebroventricular injection.

Thu, 10/19/2017 - 12:45
Related Articles

Distribution of human umbilical cord blood-derived mesenchymal stem cells (hUCB-MSCs) in canines after intracerebroventricular injection.

Neurobiol Aging. 2016 Nov;47:192-200

Authors: Park SE, Jung NY, Lee NK, Lee J, Hyung B, Myeong SH, Kim HS, Suh YL, Lee JI, Cho KR, Kim DH, Choi SJ, Chang JW, Na DL

Abstract
In this study, we investigated the distribution of human umbilical cord blood-derived mesenchymal stem cells (hUCB-MSCs) administered via intracerebroventricular (ICV) injection in a canine model. Ten beagles (11-13 kg per beagle) each received an injection of 1 × 10(6) cells into the right lateral ventricle and were sacrificed 7 days after administration. Based on immunohistochemical analysis, hUCB-MSCs were observed in the brain parenchyma, especially along the lateral ventricular walls. Detected as far as 3.5 mm from the cortical surface, these cells migrated from the lateral ventricle toward the cortex. We also observed hUCB-MSCs in the hippocampus and the cervical spinal cord. According to real-time polymerase chain reaction results, most of the hUCB-MSCs were found distributed in the brain and the cervical spinal cord but not in the lungs, heart, kidneys, spleen, and liver. ICV administered hUCB-MSCs also enhanced the endogenous neural stem cell population in the subventricular zone. These results highlighted the ICV delivery route as an optimal route to be performed in stem cell-based clinical therapies for neurodegenerative diseases.

PMID: 27614113 [PubMed - indexed for MEDLINE]

Radiological evaluation of response to neoadjuvant treatment in pancreatic cancer.

Thu, 10/19/2017 - 12:45
Related Articles

Radiological evaluation of response to neoadjuvant treatment in pancreatic cancer.

Diagn Interv Imaging. 2016 Dec;97(12):1225-1232

Authors: Cassinotto C, Sa-Cunha A, Trillaud H

Abstract
Neoadjuvant chemotherapy has become common practice in the management of patients with non-metastatic pancreatic adenocarcinoma. This strategy helps better select patients who would benefit from surgical resection and also increase the number of patients amenable to surgical resection whose tumor seemed too locally advanced on initial imaging. However, several studies have shown that the radiological evaluation of the response after neoadjuvant therapy is difficult for pancreatic carcinoma. This article reviews the scientific basis of neoadjuvant therapy for non-metastatic pancreatic cancer and provides an update on tumor response evaluation with imaging after neoadjuvant treatment.

PMID: 27692675 [PubMed - indexed for MEDLINE]

Pages