Pub Date : 2026-03-01Epub Date: 2026-01-09DOI: 10.1016/j.dld.2025.12.014
Alexandra Argyrou , Stavros P. Papadakos , Ioannis Karniadakis , Elisavet Michailidou , Stamatina Vogli , Jannis Vlachogiannakos
Background
Gastroesophageal reflux disease (GERD) is a prevalent gastrointestinal disorder with multifactorial etiology, including genetic components. Despite numerous genetic association studies (GAS), the role of specific gene polymorphisms in GERD susceptibility remains unclear due to inconsistent findings.
Aims
To systematically review GAS on GERD and conduct a meta-analysis to evaluate the association between specific gene polymorphisms and GERD risk.
Methods
A systematic review of PubMed, Cochrane, ScienceDirect, Scopus, DisGENET, GWASCatalog, and HuGE Phenopedia databases (2012–2024) was conducted to identify GAS for GERD. Meta-analytical methods were used to synthesize the results.
Results
21 GAS, including 27,783 GERD patients and 83,857 controls, were analyzed, focusing on 132 polymorphisms across 105 genes. Meta-analysis of seven studies revealed a significant association between GNB3 rs5443 C > T and increased GERD-like symptom phenotypes (ORp = 2.24, 95 % CI: 1.56–3.21), suggesting a dominant genetic model. No significant associations were found for TNF, IL1B, or CYP2C19. Heterogeneity and potential bias were observed in some analyses, necessitating cautious interpretation of the findings.
Conclusion
The findings support a robust association between GNB3 rs5443 C > T and susceptibility to GERD-like symptom phenotypes, suggesting a potential genetic predisposition. Additional large, well-characterized studies using standardized GERD definitions are needed to validate these results and elucidate the broader genetic landscape of the disease.
背景：胃食管反流病（GERD）是一种常见的多因素胃肠道疾病，其病因包括遗传因素。尽管有大量的遗传关联研究（GAS），但由于研究结果不一致，特定基因多态性在GERD易感性中的作用仍不清楚。目的：系统回顾GAS对GERD的影响，并进行荟萃分析，评估特定基因多态性与GERD风险之间的关系。方法：对PubMed、Cochrane、ScienceDirect、Scopus、DisGENET、GWASCatalog和HuGE Phenopedia数据库（2012-2024）进行系统评价，以确定GERD的GAS。采用元分析方法对结果进行综合分析。结果：共分析了21例GAS，包括27,783例GERD患者和83,857例对照，重点分析了105个基因的132个多态性。7项研究的荟萃分析显示，GNB3 rs5443 C > T与增加的gerd样症状表型之间存在显著相关性（ORp = 2.24, 95% CI: 1.56-3.21），提示存在显性遗传模型。TNF、IL1B或CYP2C19未发现显著相关性。在一些分析中观察到异质性和潜在偏倚，需要谨慎解释研究结果。结论：研究结果支持GNB3 rs5443 C > T与对gerd样症状表型的易感性之间的强相关性，提示潜在的遗传易感性。需要使用标准化GERD定义的其他大型、特征明确的研究来验证这些结果并阐明该疾病更广泛的遗传格局。
{"title":"The role of gene polymorphisms in the occurrence of gastroesophageal reflux disease: A systematic review and meta-analysis of genetic association studies","authors":"Alexandra Argyrou , Stavros P. Papadakos , Ioannis Karniadakis , Elisavet Michailidou , Stamatina Vogli , Jannis Vlachogiannakos","doi":"10.1016/j.dld.2025.12.014","DOIUrl":"10.1016/j.dld.2025.12.014","url":null,"abstract":"<div><h3>Background</h3><div>Gastroesophageal reflux disease (GERD) is a prevalent gastrointestinal disorder with multifactorial etiology, including genetic components. Despite numerous genetic association studies (GAS), the role of specific gene polymorphisms in GERD susceptibility remains unclear due to inconsistent findings.</div></div><div><h3>Aims</h3><div>To systematically review GAS on GERD and conduct a meta-analysis to evaluate the association between specific gene polymorphisms and GERD risk.</div></div><div><h3>Methods</h3><div>A systematic review of PubMed, Cochrane, ScienceDirect, Scopus, DisGENET, GWASCatalog, and HuGE Phenopedia databases (2012–2024) was conducted to identify GAS for GERD. Meta-analytical methods were used to synthesize the results.</div></div><div><h3>Results</h3><div>21 GAS, including 27,783 GERD patients and 83,857 controls, were analyzed, focusing on 132 polymorphisms across 105 genes. Meta-analysis of seven studies revealed a significant association between GNB3 rs5443 <em>C</em> > <em>T</em> and increased GERD-like symptom phenotypes (ORp = 2.24, 95 % CI: 1.56–3.21), suggesting a dominant genetic model. No significant associations were found for TNF, IL1B, or CYP2C19. Heterogeneity and potential bias were observed in some analyses, necessitating cautious interpretation of the findings.</div></div><div><h3>Conclusion</h3><div>The findings support a robust association between GNB3 rs5443 <em>C</em> > <em>T</em> and susceptibility to GERD-like symptom phenotypes, suggesting a potential genetic predisposition. Additional large, well-characterized studies using standardized GERD definitions are needed to validate these results and elucidate the broader genetic landscape of the disease.</div></div>","PeriodicalId":11268,"journal":{"name":"Digestive and Liver Disease","volume":"58 3","pages":"Pages 315-322"},"PeriodicalIF":3.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145943022","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD) encompasses a spectrum of liver conditions, primarily driven by metabolic factors and characterized by steatosis. Extracellular vesicles and particles (EVPs) are emerging as biomarkers for liver diseases as they reflect the state of their cells of origin and carry molecular cargo that can influence disease progression. We aimed to explore the role of EVPs with MASLD progression, smoking impact and EVPs effect on macrophages.
Methods
We analyzed EVPs using nanoparticle tracking analysis, transmission electron microscopy and flow cytometry. Cytokine expressions were quantified in EVPs-exposed macrophages.
Results
We showed that EVP number is higher in patients with steatohepatitis and they were correlated with the severity of liver inflammation and steatosis, as well as with biological markers. In particular CD63+-ASGR1+-EVPs were notably more prevalent in blood of patients with steatohepatitis. Active smoking further increased EVP numbers and CD63+-ASGR1+-EVPs in MASLD patients. Functionally, exposure of macrophages to CD63+-EVPs from MASLD patients induced TGF-β and TIMP-1 secretion.
Conclusion
This study highlights the potential of EVs as biomarkers for MASLD progression and their role in mediating disease mechanisms via intercellular communication, notably by their potential to contribute to fibrogenic signaling. Although exploratory, the study also highlights the potential impact of the exposome, particularly smoking, on MASLD pathogenesis.
{"title":"Circulating hepatocyte-derived extracellular particles as potential biomarker of steatohepatitis progression to fibrogenesis: Exploring the impact of smoking","authors":"Oumnia Masrour , Justine Morvan , Alison Rapin , Alexis Aimé , Agnès Burel , Valentine Genêt , Stéphanie Brisset , Dominique Lagadic-Gossmann , Edouard Bardou-Jacquet , Corinne Martin-Chouly","doi":"10.1016/j.dld.2025.12.003","DOIUrl":"10.1016/j.dld.2025.12.003","url":null,"abstract":"<div><h3>Background</h3><div>Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD) encompasses a spectrum of liver conditions, primarily driven by metabolic factors and characterized by steatosis. Extracellular vesicles and particles (EVPs) are emerging as biomarkers for liver diseases as they reflect the state of their cells of origin and carry molecular cargo that can influence disease progression. We aimed to explore the role of EVPs with MASLD progression, smoking impact and EVPs effect on macrophages.</div></div><div><h3>Methods</h3><div>We analyzed EVPs using nanoparticle tracking analysis, transmission electron microscopy and flow cytometry. Cytokine expressions were quantified in EVPs-exposed macrophages.</div></div><div><h3>Results</h3><div>We showed that EVP number is higher in patients with steatohepatitis and they were correlated with the severity of liver inflammation and steatosis, as well as with biological markers. In particular CD63<sup>+</sup>-ASGR1<sup>+</sup>-EVPs were notably more prevalent in blood of patients with steatohepatitis. Active smoking further increased EVP numbers and CD63<sup>+</sup>-ASGR1<sup>+</sup>-EVPs in MASLD patients. Functionally, exposure of macrophages to CD63<sup>+</sup>-EVPs from MASLD patients induced TGF-β and TIMP-1 secretion.</div></div><div><h3>Conclusion</h3><div>This study highlights the potential of EVs as biomarkers for MASLD progression and their role in mediating disease mechanisms <em>via</em> intercellular communication, notably by their potential to contribute to fibrogenic signaling. Although exploratory, the study also highlights the potential impact of the exposome, particularly smoking, on MASLD pathogenesis.</div></div>","PeriodicalId":11268,"journal":{"name":"Digestive and Liver Disease","volume":"58 3","pages":"Pages 355-364"},"PeriodicalIF":3.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145951271","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-03-01Epub Date: 2026-01-19DOI: 10.1016/j.dld.2025.12.022
M. Maida , A. Facciorusso , G.E.M. Rizzo , D. Ligresti , G. Marchegiani , A. Vitello , F. Bonomo , C. Fabbri , A. Anderloni , I. Tarantino , I-EUS group
Background and Aims
Gastric outlet obstruction (GOO) is a late complication of several malignancies, markedly impairing quality of life. Surgical gastroenterostomy (S-GE) has long been the palliative standard, but outcomes are variable and morbidity remains considerable. Endoscopic ultrasound-guided gastroenterostomy (EUS-GE) has emerged as a minimally invasive alternative. We conducted a systematic review and meta-analysis comparing EUS-GE and S-GE, with a specific focus on malignant GOO.
Methods
MEDLINE, Embase, Scopus, and the Cochrane Library were searched through September 2025. Eligible studies directly compared EUS-GE and S-GE and reported clinical success (CS), adverse events (AEs), severe AEs, and recurrence/reintervention. Pooled odds ratios (OR) with 95% confidence intervals (CI) were calculated using random-effects models.
Results
Thirteen studies (2 RCTs, 11 retrospective; 1,611 patients) were analyzed. Overall, EUS-GE achieved higher CS (OR 2.69; p=0.007), fewer AEs (OR 0.21; p<0.001) and severe AEs (OR 0.54; p=0.05) versus S-GE, with no significant difference in recurrence/reintervention rate (OR 0.54; p=0.22). In malignant GOO, CS (OR 1.90; p=0.12) and recurrence/reintervention rate (OR 0.68; p=0.50) were comparable, while overall AEs remained lower with EUS-GE (OR 0.26; p<0.01).
Conclusions
In malignant GOO, EUS-GE provides comparable clinical efficacy to S-GE with fewer overall AEs. These data support EUS-GE as a preferred minimally invasive option in selected patients.
{"title":"EUS-guided versus surgical gastroenterostomy for the management of malignant gastric outlet obstruction: A systematic review and meta-analysis","authors":"M. Maida , A. Facciorusso , G.E.M. Rizzo , D. Ligresti , G. Marchegiani , A. Vitello , F. Bonomo , C. Fabbri , A. Anderloni , I. Tarantino , I-EUS group","doi":"10.1016/j.dld.2025.12.022","DOIUrl":"10.1016/j.dld.2025.12.022","url":null,"abstract":"<div><h3>Background and Aims</h3><div>Gastric outlet obstruction (GOO) is a late complication of several malignancies, markedly impairing quality of life. Surgical gastroenterostomy (S-GE) has long been the palliative standard, but outcomes are variable and morbidity remains considerable. Endoscopic ultrasound-guided gastroenterostomy (EUS-GE) has emerged as a minimally invasive alternative. We conducted a systematic review and meta-analysis comparing EUS-GE and S-GE, with a specific focus on malignant GOO.</div></div><div><h3>Methods</h3><div>MEDLINE, Embase, Scopus, and the Cochrane Library were searched through September 2025. Eligible studies directly compared EUS-GE and S-GE and reported clinical success (CS), adverse events (AEs), severe AEs, and recurrence/reintervention. Pooled odds ratios (OR) with 95% confidence intervals (CI) were calculated using random-effects models.</div></div><div><h3>Results</h3><div>Thirteen studies (2 RCTs, 11 retrospective; 1,611 patients) were analyzed. Overall, EUS-GE achieved higher CS (OR 2.69; p=0.007), fewer AEs (OR 0.21; p<0.001) and severe AEs (OR 0.54; p=0.05) versus S-GE, with no significant difference in recurrence/reintervention rate (OR 0.54; p=0.22). In malignant GOO, CS (OR 1.90; p=0.12) and recurrence/reintervention rate (OR 0.68; p=0.50) were comparable, while overall AEs remained lower with EUS-GE (OR 0.26; p<0.01).</div></div><div><h3>Conclusions</h3><div>In malignant GOO, EUS-GE provides comparable clinical efficacy to S-GE with fewer overall AEs. These data support EUS-GE as a preferred minimally invasive option in selected patients.</div></div>","PeriodicalId":11268,"journal":{"name":"Digestive and Liver Disease","volume":"58 3","pages":"Pages 323-330"},"PeriodicalIF":3.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146009236","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Author’s Reply: “Comment on ``Impact of oral butyrate on clinical and biochemical parameters in IBD: A randomized placebo-controlled study targeting gut microbiota''","authors":"Sonia Facchin , Matteo Calgaro , Mattia Pandolfo , Nicola Vitulo , Luisa Bertin , Edoardo Vincenzo Savarino","doi":"10.1016/j.dld.2026.01.008","DOIUrl":"10.1016/j.dld.2026.01.008","url":null,"abstract":"","PeriodicalId":11268,"journal":{"name":"Digestive and Liver Disease","volume":"58 3","pages":"Pages 414-415"},"PeriodicalIF":3.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146046026","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-03-01Epub Date: 2026-01-31DOI: 10.1016/j.dld.2025.12.032
Pedro Mesquita , Rolando Pinho , Adélia Rodrigues , Catarina Costa , Pedro Teixeira , Rita Ferreira , Ana Ponte , Teresa Freitas
Background
Small bowel capsule endoscopy (SBCE) is central to Crohn’s Disease (CD) care but limited by lengthy review and reader variability. We tested whether an artificial-intelligence (AI)–triaged, human-reviewed workflow - SmartScan, SS - can serve as a first-line alternative to full-video (FV) review, reducing reading time while maintaining safety and score fidelity.
Methods
Single-center, randomized, assessor-blinded, dual-reader, 2 × 2 crossover non-inferiority reading study of OMOM® HD SBCE videos in adults with established CD. Each study underwent paired FV and SS reads. The primary endpoint was non-inferiority of the agreement on Lewis Score (LS) activity category plus stricture status. Secondary endpoints included LS category agreement, equivalence of continuous LS/CECDAI, within-tolerance agreement, stricture sensitivity, performance with short transit and low Brotz quality, and reading-time superiority.
Results
We analyzed 153 paired studies. SS and FV agreed on both LS category and stricture in 96.1 % (147/153), surpassing the non-inferiority (NI) margin (p = 0.005). LS category exact match was 96.7 %. Continuous scores were equivalent, and stricture sensitivity 100 % (11/11). Within-tolerance agreement was 91.5 % (140/153) but failed to meet the prespecified NI criteria. Results were similar with short transit and low Brotz quality. Mean reading time fell from 41.5 to 12.8 min (p < 0.001).
Conclusions
SS achieved NI for the primary composite endpoint and preserved equivalence of continuous LS/CECDAI, while markedly reduced reading time. These data support an AI-triaged, human-reviewed workflow with selective escalation to FV when uncertainty arises.
{"title":"OMOM SmartScan provides noninferior assessment of Lewis score and CECDAI in Crohn’s disease vs full-video review","authors":"Pedro Mesquita , Rolando Pinho , Adélia Rodrigues , Catarina Costa , Pedro Teixeira , Rita Ferreira , Ana Ponte , Teresa Freitas","doi":"10.1016/j.dld.2025.12.032","DOIUrl":"10.1016/j.dld.2025.12.032","url":null,"abstract":"<div><h3>Background</h3><div>Small bowel capsule endoscopy (SBCE) is central to Crohn’s Disease (CD) care but limited by lengthy review and reader variability. We tested whether an artificial-intelligence (AI)–triaged, human-reviewed workflow - SmartScan, SS - can serve as a first-line alternative to full-video (FV) review, reducing reading time while maintaining safety and score fidelity.</div></div><div><h3>Methods</h3><div>Single-center, randomized, assessor-blinded, dual-reader, 2 × 2 crossover non-inferiority reading study of OMOM® HD SBCE videos in adults with established CD. Each study underwent paired FV and SS reads. The primary endpoint was non-inferiority of the agreement on Lewis Score (LS) activity category plus stricture status. Secondary endpoints included LS category agreement, equivalence of continuous LS/CECDAI, within-tolerance agreement, stricture sensitivity, performance with short transit and low Brotz quality, and reading-time superiority.</div></div><div><h3>Results</h3><div>We analyzed 153 paired studies. SS and FV agreed on both LS category and stricture in 96.1 % (147/153), surpassing the non-inferiority (NI) margin (<em>p</em> = 0.005). LS category exact match was 96.7 %. Continuous scores were equivalent, and stricture sensitivity 100 % (11/11). Within-tolerance agreement was 91.5 % (140/153) but failed to meet the prespecified NI criteria. Results were similar with short transit and low Brotz quality. Mean reading time fell from 41.5 to 12.8 min (<em>p</em> < 0.001).</div></div><div><h3>Conclusions</h3><div>SS achieved NI for the primary composite endpoint and preserved equivalence of continuous LS/CECDAI, while markedly reduced reading time. These data support an AI-triaged, human-reviewed workflow with selective escalation to FV when uncertainty arises.</div></div>","PeriodicalId":11268,"journal":{"name":"Digestive and Liver Disease","volume":"58 3","pages":"Pages 377-383"},"PeriodicalIF":3.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146099727","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-03-01Epub Date: 2026-01-31DOI: 10.1016/j.dld.2026.01.211
Gael S. Roth , Jérôme Cros , Cindy Neuzillet , Emilie Barbier , Meriem Guarssifi , Amel Bennacer , Michel Ducreux , Marie Muller , Julien Edeline , Sylvain Manfredi , Nicolas Williet , Nelson Dusetti , Pierre Laurent-Puig , Victoire Ruffino , Brice Chanez , Rémy Nicolle , Julien Taieb , David Malka
Background
Ampullary adenocarcinoma (AAC) is a rare and aggressive cancer with a 5-year overall survival (OS) rate ranging from 30% to 67% after resection due to a high recurrence rate. Yet, adjuvant therapy's role is still debated. Recent French FFCD-AC cohort study highlighted that adjuvant therapy, can benefit intermediate and high-risk patients. Chemotherapy regimens, include gemcitabine and 5-fluorouracil (5FU) but practices are highly heterogenous due to the low level of evidence. Previous studies suggest that combination chemotherapy, such as mFOLFIRINOX, could offer improved outcomes.
Design
PRODIGE 98 - AMPIRINOX trial (NCT06813976) is a multicenter, open-label, randomized phase 3 trial designed to compare the efficacy of adjuvant mFOLFIRINOX versus single-agent chemotherapy (capecitabine or gemcitabine) in patients with resected AAC. Primary outcome is disease free survival and secondary outcomes include overall survival (OS), safety and quality of life. Patients (ages 18–79) must have undergone macroscopically complete (R0/R1) resection of AAC, with exclusion of patients previously treated with chemotherapy, and pT1N0M0 tumors. Ancillary studies will focus on an in-depth molecular profiling of AAC to identify prognostic and predictive biomarkers.
AMPIRINOX is currently recruiting and is expected to provide essential data on how to optimize treatment for AAC patients in the coming years.
{"title":"Randomized, multicenter Phase III trial of adjuvant chemotherapy with modified FOLFIRINOX versus capecitabine or gemcitabine in patients with resected ampullary adenocarcinoma","authors":"Gael S. Roth , Jérôme Cros , Cindy Neuzillet , Emilie Barbier , Meriem Guarssifi , Amel Bennacer , Michel Ducreux , Marie Muller , Julien Edeline , Sylvain Manfredi , Nicolas Williet , Nelson Dusetti , Pierre Laurent-Puig , Victoire Ruffino , Brice Chanez , Rémy Nicolle , Julien Taieb , David Malka","doi":"10.1016/j.dld.2026.01.211","DOIUrl":"10.1016/j.dld.2026.01.211","url":null,"abstract":"<div><h3>Background</h3><div>Ampullary adenocarcinoma (AAC) is a rare and aggressive cancer with a 5-year overall survival (OS) rate ranging from 30% to 67% after resection due to a high recurrence rate. Yet, adjuvant therapy's role is still debated. Recent French FFCD-AC cohort study highlighted that adjuvant therapy, can benefit intermediate and high-risk patients. Chemotherapy regimens, include gemcitabine and 5-fluorouracil (5FU) but practices are highly heterogenous due to the low level of evidence. Previous studies suggest that combination chemotherapy, such as mFOLFIRINOX, could offer improved outcomes.</div></div><div><h3>Design</h3><div>PRODIGE 98 - AMPIRINOX trial (NCT06813976) is a multicenter, open-label, randomized phase 3 trial designed to compare the efficacy of adjuvant mFOLFIRINOX versus single-agent chemotherapy (capecitabine or gemcitabine) in patients with resected AAC. Primary outcome is disease free survival and secondary outcomes include overall survival (OS), safety and quality of life. Patients (ages 18–79) must have undergone macroscopically complete (R0/R1) resection of AAC, with exclusion of patients previously treated with chemotherapy, and pT1N0M0 tumors. Ancillary studies will focus on an in-depth molecular profiling of AAC to identify prognostic and predictive biomarkers.</div><div>AMPIRINOX is currently recruiting and is expected to provide essential data on how to optimize treatment for AAC patients in the coming years<strong>.</strong></div></div>","PeriodicalId":11268,"journal":{"name":"Digestive and Liver Disease","volume":"58 3","pages":"Pages 308-314"},"PeriodicalIF":3.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146099723","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-03-01Epub Date: 2026-01-08DOI: 10.1016/j.dld.2025.12.015
Stefano Di Sandro , Barbara Catellani , Roberta Odorizzi , Daniela Caracciolo , Samuele Frassoni , Vincenzo Bagnardi , Cristiano Quintini , Cristiano Guidetti , Paolo Magistri , Leonardo Centonze , Gian Piero Guerrini , Charles Miller , Antonio D. Pinna , Fabrizio Di Benedetto
Background and Aims
Living donor liver transplantation (LDLT) helps address organ shortages but remains complex, particularly in Western countries where deceased donor liver transplantation (DDLT) is preferred. This study evaluates improvements in LDLT outcomes over time for both donors and recipients.
Study Design
A single-center retrospective analysis from 2001–2023 including two periods: P-ONE (2001–2003, 36 cases) and P-TWO (2020–2023, 27 cases). Donor surgery after October 2022 marked the shift to a full robotic approach. Recipient procedures preserved the retro-hepatic vena cava, with standard vascular and biliary reconstruction. Comparisons include demographics, complications, and survival.
Results
P-ONE donors were younger (median age 32 vs. 46, P=0.003), while P-TWO recipients were older (63 vs. 56 years, P=0.005) with more comorbidities. P-TWO had more cases of hepatocellular carcinoma and low-MELD cirrhosis. Donor safety improved in P-TWO, with similar major complication rates (14% vs. 11%). Recipients in P-TWO had fewer severe complications (7% vs. 81%, P<0.001) and better 3-year graft survival.
Conclusions
Advances in patient selection, minimally invasive surgery, and perioperative care have significantly improved LDLT outcomes. Despite persistent biliary challenges, LDLT remains a promising solution for end-stage liver disease and liver cancer.
{"title":"Excellent outcomes of living donor liver transplantation: A contemporary report from Western Center","authors":"Stefano Di Sandro , Barbara Catellani , Roberta Odorizzi , Daniela Caracciolo , Samuele Frassoni , Vincenzo Bagnardi , Cristiano Quintini , Cristiano Guidetti , Paolo Magistri , Leonardo Centonze , Gian Piero Guerrini , Charles Miller , Antonio D. Pinna , Fabrizio Di Benedetto","doi":"10.1016/j.dld.2025.12.015","DOIUrl":"10.1016/j.dld.2025.12.015","url":null,"abstract":"<div><h3>Background and Aims</h3><div>Living donor liver transplantation (LDLT) helps address organ shortages but remains complex, particularly in Western countries where deceased donor liver transplantation (DDLT) is preferred. This study evaluates improvements in LDLT outcomes over time for both donors and recipients.</div></div><div><h3>Study Design</h3><div>A single-center retrospective analysis from 2001–2023 including two periods: P-ONE (2001–2003, 36 cases) and P-TWO (2020–2023, 27 cases). Donor surgery after October 2022 marked the shift to a full robotic approach. Recipient procedures preserved the retro-hepatic vena cava, with standard vascular and biliary reconstruction. Comparisons include demographics, complications, and survival.</div></div><div><h3>Results</h3><div>P-ONE donors were younger (median age 32 vs. 46, P=0.003), while P-TWO recipients were older (63 vs. 56 years, P=0.005) with more comorbidities. P-TWO had more cases of hepatocellular carcinoma and low-MELD cirrhosis. Donor safety improved in P-TWO, with similar major complication rates (14% vs. 11%). Recipients in P-TWO had fewer severe complications (7% vs. 81%, P<0.001) and better 3-year graft survival.</div></div><div><h3>Conclusions</h3><div>Advances in patient selection, minimally invasive surgery, and perioperative care have significantly improved LDLT outcomes. Despite persistent biliary challenges, LDLT remains a promising solution for end-stage liver disease and liver cancer.</div></div>","PeriodicalId":11268,"journal":{"name":"Digestive and Liver Disease","volume":"58 3","pages":"Pages 365-376"},"PeriodicalIF":3.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145942982","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-03-01Epub Date: 2026-01-22DOI: 10.1016/j.dld.2026.01.009
Voulgaris Theodoros , Fousekis Fotios , Mousourakis Konstantinos , Cholongitas Euaggelos , Argyriou Konstantinos , Michalopoulos George , Tsitsigiannis Konsantinos , Fytili Paraskevi , Michopoulos Spyridon , Mathou Nikoletta , Giouleme Olga , Vlahou Evangelina , Geramoutsos George , Drygiannakis Ioannis , Karatzas Pantelis , Tzouvala Maria , Zacharopoulou Eirini , Tribonias George , Arna Despoina , Ioannidou Panagiota , Papatheodoridis George
Background
Studies from northern Europe indicate that patients with primary sclerosing cholangitis (PSC) are predominantly males and often have ulcerative colitis (UC) and increased risk of colorectal cancer (CRC).
Aim
To evaluate the epidemiological and clinical features and natural history of PSC in Greece, a southern European country.
Methods
In the HERACLIS-PSC study, consecutive patients with PSC-IBD followed at Greek inflammatory bowel disease (IBD) centers were included and compared to data from consecutive patients with PSC-only followed at a Greek liver center.
Results
Among PSC-IBD patients (n=112, males:56%), 62.5% had UC (pancolitis:76%), 35.7% Crohn’s disease and 1.8% indeterminate colitis. PSC was diagnosed at a younger age in PSC-IBD than PSC-only patients (n=39; males:54%) (32±15 vs 40±15 years; p=0.007), while the two groups did not differ significantly in gender, extrahepatic bile duct involvement, or development of cirrhosis, cholangiocarcinoma or CRC, although CRC occurred only in PSC-IBD (n=8). Transplant-free survival was higher in PSC-IBD than PSC-only (5-/10-year:95%/87% vs 85%/77%; p=0.021), while older age at PSC diagnosis and cirrhosis development were independently associated with lower transplant-free survival.
Conclusion
In Greece, PSC-IBD patients are usually males with UC, in whom PSC is diagnosed at a younger age demonstrating better transplant-free survival, compared to PSC-only.
背景：来自北欧的研究表明，原发性硬化性胆管炎（PSC）患者以男性为主，通常伴有溃疡性结肠炎（UC）和结直肠癌（CRC）的风险增加。目的：了解南欧国家希腊PSC的流行病学、临床特征及自然病史。方法：在HERACLIS-PSC研究中，纳入了在希腊炎症性肠病（IBD）中心连续随访的PSC-IBD患者，并与在希腊肝脏中心连续随访的PSC-IBD患者的数据进行了比较。结果：PSC-IBD患者（n=112，男性：56%）中，62.5%患有UC（全结肠炎：76%），35.7%患有克罗恩病，1.8%患有不确定性结肠炎。PSC- ibd患者比仅PSC患者确诊PSC的年龄更小（n=39；男性：54%）（32±15岁vs 40±15岁；p=0.007），而两组在性别、肝外胆管受累性、肝硬化、胆管癌或结直肠癌的发展方面没有显著差异，尽管只有PSC- ibd患者发生结直肠癌（n=8）。PSC- ibd患者的无移植生存率高于单纯PSC患者（5年/10年：95%/87% vs 85%/77%； p=0.021），而PSC诊断时年龄较大和肝硬化发展与较低的无移植生存率独立相关。结论：在希腊，PSC- ibd患者通常是患有UC的男性，与仅PSC相比，PSC在更年轻的年龄被诊断出具有更好的无移植生存。
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