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Short-term postoperative bacteriobilia or fungibilia in liver transplantation patients with donation after circulatory death allografts associated with a longer hospital stay: A single-center retrospective observational study in China 循环死亡后捐献同种异体肝移植患者术后短期细菌或真菌感染与住院时间延长有关:中国单中心回顾性观察研究
IF 3.3 3区 医学 Q2 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2024-04-16 DOI: 10.1016/j.hbpd.2024.04.001
Chen-Xue Guo, Jian-Hua Li, Zheng-Xin Wang, Wan-Zhen Li, Jing Zhang, Hao Xing, Su Liu, Tian Wei, Li Li, Rui-Dong Li
Normal bile is sterile. Studies have shown that cholangitis after liver transplantation (LT) was associated with a relatively poor prognosis. It remains unclear whether the bacteriobilia or fungibilia impact the patient outcomes in LT recipients, especially with donation after circulatory death (DCD) allografts, which was correlated with a higher risk of allograft failure. This retrospective study included 139 LT recipients of DCD grafts from 2019 to 2021. All patients were divided into two groups according to the presence or absence of bacteriobilia or fungibilia. The prevalence and microbial spectrum of postoperative bacteriobilia or fungibilia and its possible association with outcomes, especially hospital stay were analyzed. Totally 135 and 171 organisms were isolated at weeks 1 and 2, respectively. Among all patients included in this analysis, 83 (59.7%) developed bacteriobilia or fungibilia within 2 weeks post-transplantation. The occurrence of bacteriobilia or fungibilia (β = 7.43, 95% CI: 0.02 to 14.82, = 0.049), particularly the detection of (β = 18.84, 95% CI: 6.51 to 31.07, = 0.003) within 2 weeks post-transplantation was associated with a longer hospital stay. However, it did not affect the graft and patient survival. The occurrence of bacteriobilia or fungibilia, particularly within 2 weeks post-transplantation, could influence the recovery of liver function and was associated with prolonged hospital stay but not the graft and patient survival.
正常胆汁是无菌的。研究表明,肝移植(LT)后胆管炎与相对较差的预后有关。目前仍不清楚细菌性胆汁炎或真菌性胆汁炎是否会影响肝移植受者的预后,尤其是循环死亡后捐献(DCD)的异体移植物,这与异体移植物失败的风险较高有关。这项回顾性研究纳入了2019年至2021年期间139名DCD移植的LT受者。根据是否存在细菌或真菌将所有患者分为两组。分析了术后菌血症或真菌病的发病率、微生物谱及其与预后(尤其是住院时间)可能存在的关联。第 1 周和第 2 周分别分离出 135 种和 171 种微生物。在所有参与分析的患者中,83人(59.7%)在移植后两周内出现了菌血症或真菌病。移植后两周内出现菌血症或真菌病(β=7.43,95% CI:0.02 至 14.82,=0.049),尤其是发现菌血症或真菌病(β=18.84,95% CI:6.51 至 31.07,=0.003)与住院时间延长有关。不过,这并不影响移植物和患者的存活率。细菌或真菌感染的发生,尤其是在移植后两周内,可能会影响肝功能的恢复,并且与住院时间的延长有关,但与移植物和患者的存活率无关。
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引用次数: 0
Enhanced fluorescence cholangiography with indocyanine green: A methodology for reducing the potential hazard of bile duct injury during laparoscopic cholecystectomy. 吲哚菁绿增强荧光胆管造影:减少腹腔镜胆囊切除术中胆管损伤潜在危险的方法。
IF 3.3 3区 医学 Q2 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2024-04-12 DOI: 10.1016/j.hbpd.2024.04.002
Yu-Kun Hou, Wei-Kang Liu, Yi-Bo Gao, Xiao-Dong Tian, Yin-Mo Yang
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引用次数: 0
Meetings and Courses 会议和课程
IF 3.3 3区 医学 Q2 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2024-04-11 DOI: 10.1016/S1499-3872(24)00030-4
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引用次数: 0
Palmar metastasis of hepatocellular carcinoma: An uncommon case report. 肝细胞癌掌转移:一例不常见的病例报告。
IF 3.3 3区 医学 Q2 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2024-04-10 DOI: 10.1016/j.hbpd.2024.04.003
Feng-Ran Chu, Xian-Wen Liang, Hai-Fei Zhang, Xiang-Xiang Luo, Jia-Cheng Chen, Liang Chen, Jin-Cai Wu
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引用次数: 0
Endoscopic ultrasound-guided liver biopsy in liver transplant recipients: A preliminary experience. 肝移植受者在内窥镜超声引导下进行肝活检:初步经验。
IF 3.3 3区 医学 Q2 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2024-03-23 DOI: 10.1016/j.hbpd.2024.03.005
Wei Rao, Yue-Ping Jiang, Jin-Zhen Cai, Man Xie
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引用次数: 0
A rare case of IgG4-related pancreatitis diagnosed preoperatively by endoscopic ultrasound-guided fine needle aspiration. 一例罕见的 IgG4 相关性胰腺炎病例,术前通过内镜超声引导下细针穿刺确诊。
IF 3.3 3区 医学 Q2 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2024-03-23 DOI: 10.1016/j.hbpd.2024.03.004
Jun-Feng Zhou, Zhong Chen
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引用次数: 0
Pancreas Integrated chromosomal instability and tumor microbiome redefined prognosis-related subtypes of pancreatic cancer 胰腺综合染色体不稳定性和肿瘤微生物组重新定义了胰腺癌预后相关亚型
IF 3.3 3区 医学 Q2 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2024-03-19 DOI: 10.1016/j.hbpd.2024.03.002
Rui-Han Chen, Jia-Ying Cao, Shi Feng, Hai-Tao Huang, Yi-Mou Lin, Jing-Yu Jiang, Xue-Wen Yi, Qi Ling
: Pancreatic cancer is a common malignancy with poor prognosis and limited treatment. Here we aimed to investigate the role of host chromosomal instability (CIN) and tumor microbiome in the prognosis of pancreatic cancer patients. : One hundred formalin-fixed paraffin-embedded (FFPE) pancreatic cancer samples were collected. DNA extracted from FFPE samples were analyzed by low-coverage whole-genome sequencing (WGS) via a customized bioinformatics workflow named ultrasensitive chromosomal aneuploidy detector. : Samples are tested according to the procedure of ultrasensitive chromosomal aneuploidy detector (UCAD). We excluded 2 samples with failed quality control, 1 patient lost to follow-up and 6 dead in the perioperative period. The final 91 patients were admitted for the following analyses. Thirteen (14.3%) patients with higher CIN score had worse overall survival (OS) than those with lower CIN score. The top 20 microbes in pancreatic cancer samples included 15 species of bacteria and 5 species of viruses. Patients with high human herpesvirus (HHV)-7 and HHV-5 DNA reads exhibited worse OS. Furthermore, we classified 91 patients into 3 subtypes. Patients with higher CIN score ( =13) had the worst prognosis (median OS 6.9 mon); patients with lower CIN score but with HHV-7/5 DNA load ( = 24) had worse prognosis (median OS 10.6 mon); while patients with lower CIN score and HHV-7/5 DNA negative ( = 54) had the best prognosis (median OS 21.1 mon). : High CIN and HHV-7/5 DNA load were associated with worse survival of pancreatic cancer. The novel molecular subtypes of pancreatic cancer based on CIN and microbiome had prognostic value.
:胰腺癌是一种常见的恶性肿瘤,预后差且治疗效果有限。在此,我们旨在研究宿主染色体不稳定性(CIN)和肿瘤微生物组在胰腺癌患者预后中的作用。 收集了 100 份福尔马林固定石蜡包埋(FFPE)胰腺癌样本。从 FFPE 样本中提取的 DNA 通过名为超敏染色体非整倍体检测器的定制生物信息学工作流程进行低覆盖全基因组测序(WGS)分析。 样本按照超敏染色体非整倍体检测器(UCAD)的程序进行检测。我们排除了 2 份质量控制不合格的样本、1 名失去随访的患者和 6 名在围手术期死亡的患者。最后 91 名患者被纳入以下分析。13例(14.3%)CIN评分较高的患者的总生存率(OS)低于CIN评分较低的患者。胰腺癌样本中排名前 20 位的微生物包括 15 种细菌和 5 种病毒。人类疱疹病毒(HHV)-7和HHV-5 DNA读数较高的患者OS较差。此外,我们还将 91 例患者分为 3 个亚型。CIN评分较高的患者(=13)预后最差(中位生存期为6.9个月);CIN评分较低但有HHV-7/5 DNA载量的患者(=24)预后较差(中位生存期为10.6个月);而CIN评分较低且HHV-7/5 DNA阴性的患者(=54)预后最好(中位生存期为21.1个月)。 结论:高CIN和HHV-7/5 DNA载量与胰腺癌生存期较差有关。基于CIN和微生物组的新型胰腺癌分子亚型具有预后价值。
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引用次数: 0
Local recurrence rate as quality indicator in surgery for pancreatic cancer? 将局部复发率作为胰腺癌手术的质量指标?
IF 3.6 3区 医学 Q2 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2024-03-16 DOI: 10.1016/j.hbpd.2024.03.003
Carlo Alberto Pacilio , Alessandro Cucchetti , Giorgio Ercolani
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引用次数: 0
Advancing immunosuppression in liver transplantation: A narrative review 推进肝移植中的免疫抑制:叙述性综述
IF 3.6 3区 医学 Q2 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2024-03-16 DOI: 10.1016/j.hbpd.2024.03.001
Samuele Iesari , Francesca Laura Nava , Ilaria Elena Zais , Laurent Coubeau , Mariano Ferraresso , Evaldo Favi , Jan Lerut

Immunosuppression is essential to ensure recipient and graft survivals after liver transplantation (LT). However, our understanding and management of the immune system remain suboptimal. Current immunosuppressive therapy cannot selectively inhibit the graft-specific immune response and entails a significant risk of serious side effects, i.e., among others, de novo cancers, infections, cardiovascular events, renal failure, metabolic syndrome, and late graft fibrosis, with progressive loss of graft function. Pharmacological research, aimed to develop alternative immunosuppressive agents in LT, is behind other solid-organ transplantation subspecialties, and, therefore, the development of new compounds and strategies should get priority in LT. The research trajectories cover mechanisms to induce T-cell exhaustion, to inhibit co-stimulation, to mitigate non-antigen-specific inflammatory response, and, lastly, to minimize the development and action of donor-specific antibodies. Moreover, while cellular modulation techniques are complex, active research is underway to foster the action of T-regulatory cells, to induce tolerogenic dendritic cells, and to promote the function of B-regulatory cells. We herein discuss current lines of research in clinical immunosuppression, particularly focusing on possible applications in the LT setting.

免疫抑制对确保肝移植(LT)后受者和移植物的存活至关重要。然而,我们对免疫系统的了解和管理仍未达到最佳水平。目前的免疫抑制疗法不能有选择性地抑制移植物特异性免疫反应,而且存在严重副作用的巨大风险,如癌症、感染、心血管事件、肾功能衰竭、代谢综合征和晚期移植物纤维化,以及移植物功能的逐渐丧失。旨在开发LT替代免疫抑制剂的药理学研究落后于其他实体器官移植亚专科,因此LT应优先开发新的化合物和策略。研究方向包括诱导 T 细胞衰竭、抑制共刺激、减轻非抗原特异性炎症反应,最后是尽量减少供体特异性抗体的产生和作用。此外,虽然细胞调节技术很复杂,但目前正在积极研究如何促进 T 调节细胞的作用、诱导产生耐受性的树突状细胞以及促进 B 调节细胞的功能。在此,我们将讨论当前临床免疫抑制的研究方向,尤其是在LT环境中的可能应用。
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引用次数: 0
Meetings and Courses 会议和课程
IF 3.3 3区 医学 Q2 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2024-03-06 DOI: 10.1016/S1499-3872(24)00013-4
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Hepatobiliary & Pancreatic Diseases International
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