BACKGROUND Many patients have bone defects that exceed the healing size. This study aimed to construct polycaprolactone/nano-hydroxyapatite (PCL/nHA) composite scaffolds with different pore sizes and investigate the osteogenesis and histocompatibility of cortical bone mesenchymal stem cells (BMSCs-C) seeded on it after inoculation. MATERIAL AND METHODS After mixing PCL and nHA proportionally, three-dimensional (3D) printing was used to print scaffolds. Porosity, compressive strength, and elastic modulus of PCL/nHA scaffolds were tested. The proliferation of BMSCs-C cells was examined and osteogenesis, chondrogenesis, and adipogenesis were evaluated. BMSCs-C cells were inoculated into 3D printing scaffolds, and histocompatibility between BMSCs-C cells and scaffolds was observed by the cell count kit (CCK-8) assay and LIVE/DEAD staining. After inoculating BMSCs-C cells into scaffolds, alkaline phosphatase (ALP) activity and calcium content were measured. RESULTS There was no obvious difference in characteristics between the 3 PCL/nHA composite scaffolds. The porosity, compressive strength, and elastic modulus of the 300/500-μm scaffold were between those of the 300-μm and 500-μm scaffolds. With increasing pore size, the mechanical properties of the scaffold decrease. BMSCs-C cells demonstrated faster growth and better osteogenic, adipogenic, and chondrogenic differentiation; therefore, BMSCs-C cells were selected as seed cells. PCL/nHA composite scaffolds with different pore sizes had no obvious toxicity and demonstrated good biocompatibility. All scaffolds showed higher ALP activity and calcium content. CONCLUSIONS The 300/500 μm mixed pore size scaffold took into account the mechanical properties of the 300 μm scaffold and the cell culture area of the 500 μm scaffold, therefore, 300/500 μm scaffold is a better model for the construction of tissue engineering scaffolds.
{"title":"Three-Dimensional Printing of Polycaprolactone/Nano-Hydroxyapatite Composite Scaffolds with a Pore Size of 300/500 µm is Histocompatible and Promotes Osteogenesis Using Rabbit Cortical Bone Marrow Stem Cells.","authors":"Yang Yang, Bing Qiu, Zhuxing Zhou, Chaoran Hu, Jia Li, Cheng Zhou","doi":"10.12659/AOT.940365","DOIUrl":"10.12659/AOT.940365","url":null,"abstract":"<p><p>BACKGROUND Many patients have bone defects that exceed the healing size. This study aimed to construct polycaprolactone/nano-hydroxyapatite (PCL/nHA) composite scaffolds with different pore sizes and investigate the osteogenesis and histocompatibility of cortical bone mesenchymal stem cells (BMSCs-C) seeded on it after inoculation. MATERIAL AND METHODS After mixing PCL and nHA proportionally, three-dimensional (3D) printing was used to print scaffolds. Porosity, compressive strength, and elastic modulus of PCL/nHA scaffolds were tested. The proliferation of BMSCs-C cells was examined and osteogenesis, chondrogenesis, and adipogenesis were evaluated. BMSCs-C cells were inoculated into 3D printing scaffolds, and histocompatibility between BMSCs-C cells and scaffolds was observed by the cell count kit (CCK-8) assay and LIVE/DEAD staining. After inoculating BMSCs-C cells into scaffolds, alkaline phosphatase (ALP) activity and calcium content were measured. RESULTS There was no obvious difference in characteristics between the 3 PCL/nHA composite scaffolds. The porosity, compressive strength, and elastic modulus of the 300/500-μm scaffold were between those of the 300-μm and 500-μm scaffolds. With increasing pore size, the mechanical properties of the scaffold decrease. BMSCs-C cells demonstrated faster growth and better osteogenic, adipogenic, and chondrogenic differentiation; therefore, BMSCs-C cells were selected as seed cells. PCL/nHA composite scaffolds with different pore sizes had no obvious toxicity and demonstrated good biocompatibility. All scaffolds showed higher ALP activity and calcium content. CONCLUSIONS The 300/500 μm mixed pore size scaffold took into account the mechanical properties of the 300 μm scaffold and the cell culture area of the 500 μm scaffold, therefore, 300/500 μm scaffold is a better model for the construction of tissue engineering scaffolds.</p>","PeriodicalId":7935,"journal":{"name":"Annals of Transplantation","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2023-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10625337/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71410308","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jeeyeon Lee, Maria Jose Aguilera Chuchuca, Jisang Yu, Liam Il-Young Chung, Ankit Bharat, Young Kwang Chae
Background To evaluate the role of double-lung transplantation (DLT) for lung cancer, the survival outcomes of patients who underwent DLT for lung cancer and the incidence of de novo lung cancer after DLT were assessed. Material/Methods Data from all cases reported in the literature were pooled for analysis and additional data were collected from the Organ Procurement Transplantation Network (OPTN) registry. Recurrence-free survival (RFS), overall survival (OS), and cancer-specific survival (CSS) of patients who underwent DLT for lung cancer were determined. Moreover, the incidence of de novo lung cancer and associated OS in lung transplant recipients were examined. Results Of the 20 cases series and 15 cases from the OPTN registry, the 5-year RFS was 55.0% and 66.7% and the 5-year OS was 55.0% and 26.7%, respectively, and the median CSS was 48.0 (range, 2.0–144.0) and 27.7 (range, 0.2–66.6) months, respectively. In the OPTN data, the incidence of post-transplant lung cancer in patients who underwent DLT for the non-cancerous disease was 0.8% and the 5-year OS was 47.3%. Conclusions In conclusion, our integrated analysis of the case series and the OPTN registry demonstrated promising survival outcomes for patients with refractory bilateral lung cancer who underwent DLT. Although there are limitations to consider, the results of this study underscore the potential benefits of DLT in managing refractory lung-limited lung cancer.
{"title":"Survival Outcomes After Double-Lung Transplantation for Refractory Lung-Limited Cancers and Incidence of Post-Transplant Lung Cancer","authors":"Jeeyeon Lee, Maria Jose Aguilera Chuchuca, Jisang Yu, Liam Il-Young Chung, Ankit Bharat, Young Kwang Chae","doi":"10.12659/aot.941301","DOIUrl":"https://doi.org/10.12659/aot.941301","url":null,"abstract":"Background To evaluate the role of double-lung transplantation (DLT) for lung cancer, the survival outcomes of patients who underwent DLT for lung cancer and the incidence of de novo lung cancer after DLT were assessed. Material/Methods Data from all cases reported in the literature were pooled for analysis and additional data were collected from the Organ Procurement Transplantation Network (OPTN) registry. Recurrence-free survival (RFS), overall survival (OS), and cancer-specific survival (CSS) of patients who underwent DLT for lung cancer were determined. Moreover, the incidence of de novo lung cancer and associated OS in lung transplant recipients were examined. Results Of the 20 cases series and 15 cases from the OPTN registry, the 5-year RFS was 55.0% and 66.7% and the 5-year OS was 55.0% and 26.7%, respectively, and the median CSS was 48.0 (range, 2.0–144.0) and 27.7 (range, 0.2–66.6) months, respectively. In the OPTN data, the incidence of post-transplant lung cancer in patients who underwent DLT for the non-cancerous disease was 0.8% and the 5-year OS was 47.3%. Conclusions In conclusion, our integrated analysis of the case series and the OPTN registry demonstrated promising survival outcomes for patients with refractory bilateral lung cancer who underwent DLT. Although there are limitations to consider, the results of this study underscore the potential benefits of DLT in managing refractory lung-limited lung cancer.","PeriodicalId":7935,"journal":{"name":"Annals of Transplantation","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136132748","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Masato Shizuku, Nobuhiko Kurata, Kanta Jobara, Yasuhiro Fujimoto, Yasuhiro Ogura
Background
{"title":"Clinical Outcomes of Administration of Rituximab for Desensitization in Liver Transplant Patients with Preformed Donor-Specific Antibodies: A Single-Center Experience","authors":"Masato Shizuku, Nobuhiko Kurata, Kanta Jobara, Yasuhiro Fujimoto, Yasuhiro Ogura","doi":"10.12659/aot.941456","DOIUrl":"https://doi.org/10.12659/aot.941456","url":null,"abstract":"Background","PeriodicalId":7935,"journal":{"name":"Annals of Transplantation","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136318094","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
İsmail Aytaç, Betül Güven Aytaç, Oya Kilci, Erkan Ölçücüoğlu
BACKGROUND The Naples prognostic score is a comprehensive measure of patients' inflammation and nutritional status, consisting of serum albumin, total cholesterol, neutrophil/lymphocyte ratio (NLR), and lymphocyte/monocyte ratio (LMR). We compared the Naples prognostic scores of kidney transplant patients with a creatinine reduction ratio of less than 30% vs those with greater than 30%. MATERIAL AND METHODS We conducted a retrospective study on 93 patients who received kidney transplants at our hospital from January 2020 to January 2023. Naples prognostic scores were used to calculate the preoperative condition of transplant recipients. The patients were divided into 2 groups based on their creatinine reduction ratio on the second day after surgery. Group A consisted of patients with a ratio above 30%, while group B consisted of those with a ratio below 30%. RESULTS Our analysis revealed that the total cholesterol and albumin values of groups A and B showed no substantial difference. Group B had clearly more patients with Naples prognostic score 3-4 compared to the other group (P=0.032). Multivariate analysis determined that patients with Naples prognostic score 3-4 had a 3.151-fold higher likelihood of experiencing creatinine reduction below 30% (95% CI 1.209-8.215, P value 0.019). CONCLUSIONS The preoperative inflammatory and nutritional status of patients may have an impact on the functioning of grafts during the postoperative period. A high Naples prognostic score may be linked with a decrease in creatinine reduction ratio in post-transplant kidneys, which could lead to graft dysfunction.
{"title":"Naples Prognostic Score for Graft Functions After Renal Transplantation: A Retrospective Analysis.","authors":"İsmail Aytaç, Betül Güven Aytaç, Oya Kilci, Erkan Ölçücüoğlu","doi":"10.12659/AOT.942007","DOIUrl":"10.12659/AOT.942007","url":null,"abstract":"<p><p>BACKGROUND The Naples prognostic score is a comprehensive measure of patients' inflammation and nutritional status, consisting of serum albumin, total cholesterol, neutrophil/lymphocyte ratio (NLR), and lymphocyte/monocyte ratio (LMR). We compared the Naples prognostic scores of kidney transplant patients with a creatinine reduction ratio of less than 30% vs those with greater than 30%. MATERIAL AND METHODS We conducted a retrospective study on 93 patients who received kidney transplants at our hospital from January 2020 to January 2023. Naples prognostic scores were used to calculate the preoperative condition of transplant recipients. The patients were divided into 2 groups based on their creatinine reduction ratio on the second day after surgery. Group A consisted of patients with a ratio above 30%, while group B consisted of those with a ratio below 30%. RESULTS Our analysis revealed that the total cholesterol and albumin values of groups A and B showed no substantial difference. Group B had clearly more patients with Naples prognostic score 3-4 compared to the other group (P=0.032). Multivariate analysis determined that patients with Naples prognostic score 3-4 had a 3.151-fold higher likelihood of experiencing creatinine reduction below 30% (95% CI 1.209-8.215, P value 0.019). CONCLUSIONS The preoperative inflammatory and nutritional status of patients may have an impact on the functioning of grafts during the postoperative period. A high Naples prognostic score may be linked with a decrease in creatinine reduction ratio in post-transplant kidneys, which could lead to graft dysfunction.</p>","PeriodicalId":7935,"journal":{"name":"Annals of Transplantation","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2023-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10612428/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49688470","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
BACKGROUND The COVID-19 pandemic has had a profound impact on mental health worldwide. Kidney transplant recipients represent a vulnerable population that may experience increased anxiety due to their health concerns and the risk of infection. This study aims to delve into the psychological anxiety levels and influential factors of kidney transplant patients during the Omicron variant of COVID-19 pandemic in China. MATERIAL AND METHODS A retrospective analysis was conducted using an online survey questionnaire to investigate the anxiety levels of 203 kidney transplant recipients and 53 individuals from the general population. The Self-Rating Anxiety Scale (SAS) was employed to evaluate anxiety levels, and the influencing factors affecting anxiety levels were analyzed for both cohorts. RESULTS Among the cohort of the 203 kidney transplant recipients, 28 individuals (13.8%) had symptoms indicative of anxiety, with an average SAS score of 40.5±9.0. Out of the 53 individuals from the general population, 9 (17.0%) had symptoms of anxiety, with an average SAS score of 39.6±10.7. Notably, females and those with chronic respiratory diseases within the general population showed higher anxiety levels, and having a chronic respiratory condition was found to be an independent risk factor for anxiety levels in the general population. CONCLUSIONS This investigation demonstrates that anxiety levels in kidney transplant recipients and the general population were comparable during the Omicron variant of COVID-19 pandemic. However, kidney transplant patients showed more stable anxiety levels.
{"title":"Analysis of Anxiety and Influencing Factors in Kidney Transplant Recipients and General Public During the COVID-19 Pandemic.","authors":"Chunkai Du, Yichen Zhu","doi":"10.12659/AOT.941489","DOIUrl":"10.12659/AOT.941489","url":null,"abstract":"<p><p>BACKGROUND The COVID-19 pandemic has had a profound impact on mental health worldwide. Kidney transplant recipients represent a vulnerable population that may experience increased anxiety due to their health concerns and the risk of infection. This study aims to delve into the psychological anxiety levels and influential factors of kidney transplant patients during the Omicron variant of COVID-19 pandemic in China. MATERIAL AND METHODS A retrospective analysis was conducted using an online survey questionnaire to investigate the anxiety levels of 203 kidney transplant recipients and 53 individuals from the general population. The Self-Rating Anxiety Scale (SAS) was employed to evaluate anxiety levels, and the influencing factors affecting anxiety levels were analyzed for both cohorts. RESULTS Among the cohort of the 203 kidney transplant recipients, 28 individuals (13.8%) had symptoms indicative of anxiety, with an average SAS score of 40.5±9.0. Out of the 53 individuals from the general population, 9 (17.0%) had symptoms of anxiety, with an average SAS score of 39.6±10.7. Notably, females and those with chronic respiratory diseases within the general population showed higher anxiety levels, and having a chronic respiratory condition was found to be an independent risk factor for anxiety levels in the general population. CONCLUSIONS This investigation demonstrates that anxiety levels in kidney transplant recipients and the general population were comparable during the Omicron variant of COVID-19 pandemic. However, kidney transplant patients showed more stable anxiety levels.</p>","PeriodicalId":7935,"journal":{"name":"Annals of Transplantation","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2023-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/b8/f8/anntransplant-28-e941489.PMC10591740.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41231861","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Sławomir C. Zmonarski, Mirosław Banasik, Marcelina Żabińska, Tomasz Gołębiowski, Joanna M. Zmonarska, Magdalena Krajewska
{"title":"Toll-Like Receptor 3 mRNA Expression of Peripheral Blood Mononuclear Cells Identifies Kidney Recipients with Potential for Improved Graft Performance","authors":"Sławomir C. Zmonarski, Mirosław Banasik, Marcelina Żabińska, Tomasz Gołębiowski, Joanna M. Zmonarska, Magdalena Krajewska","doi":"10.12659/aot.941266","DOIUrl":"https://doi.org/10.12659/aot.941266","url":null,"abstract":"","PeriodicalId":7935,"journal":{"name":"Annals of Transplantation","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135922927","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
BACKGROUND Arytenoid dislocation (AD) is a rare complication of general anesthesia with tracheal intubation, with a published incidence of 0.009-0.097%. This retrospective case-control study aimed to identify risk factors associated with AD in patients who underwent liver transplantation. MATERIAL AND METHODS This study included 476 patients who underwent liver transplantation between January 2013 and December 2022. Patients with AD who underwent surgery were included in the AD group. For each case of AD, 4 patients matched by anesthesia type and anesthetist were randomly selected as the non-AD group. Data on patient characteristics, anesthetic factors, and surgical factors were collected and compared between patients with and without AD. Logistic regression analysis was performed to determine the risk factors for AD after liver transplantation. RESULTS Of the 476 patients who underwent liver transplantation, 17 (3.57%) had AD. AD occurred on the left side in 13 patients and on the right side in 4 patients. The 17 patients who experienced AD and 68 matched non-AD patients were enrolled. Patients in the AD group had a greater intubation depth (24 [23-24] vs 24 [24-24], P=0.043), a higher level of hemoglobin (134.5 [118-147.5] vs 112 [96.25-125], P=0.014), and prolonged tracheal intubation in the ICU (19.75 [15.87-31.87] vs 13 [10.62-15], P<0.001) compared to those in the non-dislocation group. Multivariate logistic regression analysis showed that prolonged tracheal intubation in the ICU was independently associated with the occurrence of AD in patients who underwent liver transplantation (P=0.013). CONCLUSIONS This study showed that the incidence of AD was 3.57% in patients undergoing liver transplant surgery and that prolonged tracheal intubation in the ICU was a possible risk factor for AD.
{"title":"Prolonged Tracheal Intubation in the ICU as a Possible Risk Factor for Arytenoid Dislocation After Liver Transplant Surgery: A Retrospective Case-Control Study.","authors":"Wenqing Yan, Weihua Dong, Zhi Chen","doi":"10.12659/AOT.940727","DOIUrl":"10.12659/AOT.940727","url":null,"abstract":"<p><p>BACKGROUND Arytenoid dislocation (AD) is a rare complication of general anesthesia with tracheal intubation, with a published incidence of 0.009-0.097%. This retrospective case-control study aimed to identify risk factors associated with AD in patients who underwent liver transplantation. MATERIAL AND METHODS This study included 476 patients who underwent liver transplantation between January 2013 and December 2022. Patients with AD who underwent surgery were included in the AD group. For each case of AD, 4 patients matched by anesthesia type and anesthetist were randomly selected as the non-AD group. Data on patient characteristics, anesthetic factors, and surgical factors were collected and compared between patients with and without AD. Logistic regression analysis was performed to determine the risk factors for AD after liver transplantation. RESULTS Of the 476 patients who underwent liver transplantation, 17 (3.57%) had AD. AD occurred on the left side in 13 patients and on the right side in 4 patients. The 17 patients who experienced AD and 68 matched non-AD patients were enrolled. Patients in the AD group had a greater intubation depth (24 [23-24] vs 24 [24-24], P=0.043), a higher level of hemoglobin (134.5 [118-147.5] vs 112 [96.25-125], P=0.014), and prolonged tracheal intubation in the ICU (19.75 [15.87-31.87] vs 13 [10.62-15], P<0.001) compared to those in the non-dislocation group. Multivariate logistic regression analysis showed that prolonged tracheal intubation in the ICU was independently associated with the occurrence of AD in patients who underwent liver transplantation (P=0.013). CONCLUSIONS This study showed that the incidence of AD was 3.57% in patients undergoing liver transplant surgery and that prolonged tracheal intubation in the ICU was a possible risk factor for AD.</p>","PeriodicalId":7935,"journal":{"name":"Annals of Transplantation","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2023-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/8d/50/anntransplant-28-e940727.PMC10578641.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41181856","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Mikołaj Kuncewicz, Igor Piotr Jaszczyszyn, Kacper Karaban, Paweł Rykowski, Maciej Krasnodębski, Marcin Morawski, Emilia Kruk, Łukasz Koperski, Krzysztof Zieniewicz, Marek Krawczyk, Michał Grąt
Background Malignant and benign neuroendocrine tumors (NET) share many histopathological features. Liver transplantation (LT) is one of the liver-directed therapies for neuroendocrine liver metastases (NELM). The aim of this study was to determine the outcomes of patients undergoing LT for NELM. Material/Methods This was a retrospective study that included 19 patients who underwent LT for unresectable NELM between December 1989 and December 2022 in the Department of General, Transplant, and Liver Surgery of the Medical University of Warsaw. Kaplan-Meier estimator and Cox proportional hazards regression were used for statistical analyses. Results The primary tumor was located most frequently in the pancreas. The median follow-up was 72.5 months. The overall survival (OS) was 94.7%, 88.0%, 88.0%, 70.4%, and 49.3% after 1, 3, 5, 10, and 15 years, respectively. Accordingly, the recurrence-free survival (RFS) rates were 93.8%, 72.9%, 64.8%, 27.8%, and 27.8% after 1, 3, 5, 10, and 15 years, respectively. Ki-67 index ≥5% was found as a risk factor for both worse OS (hazard ratio (HR) 7.13, 95% confidence intervals (95% CI) 1.32–38.63, P=0.023) and RFS (HR 13.68, 95% CI 1.54–121.52, P=0.019). Recipient age ≥55 years was a risk factor for worse RFS (P=0.046, HR 5.47, 95% CI 1.03–29.08). Multivariable analysis revealed Ki-67 ≥5% as the sole independent factor for worse OS (HR 13.78, 95% CI 1.48–128.56, P=0.021). Conclusions Patients with unresectable NELM achieve great OS and satisfying RFS after LT. The risk factors associated with worse outcomes are attributed to primary tumor aggressiveness.
{"title":"Predictors of Long-Term Outcomes After Liver Transplantation for Unresectable Metastatic Neuroendocrine Tumors","authors":"Mikołaj Kuncewicz, Igor Piotr Jaszczyszyn, Kacper Karaban, Paweł Rykowski, Maciej Krasnodębski, Marcin Morawski, Emilia Kruk, Łukasz Koperski, Krzysztof Zieniewicz, Marek Krawczyk, Michał Grąt","doi":"10.12659/aot.941212","DOIUrl":"https://doi.org/10.12659/aot.941212","url":null,"abstract":"Background Malignant and benign neuroendocrine tumors (NET) share many histopathological features. Liver transplantation (LT) is one of the liver-directed therapies for neuroendocrine liver metastases (NELM). The aim of this study was to determine the outcomes of patients undergoing LT for NELM. Material/Methods This was a retrospective study that included 19 patients who underwent LT for unresectable NELM between December 1989 and December 2022 in the Department of General, Transplant, and Liver Surgery of the Medical University of Warsaw. Kaplan-Meier estimator and Cox proportional hazards regression were used for statistical analyses. Results The primary tumor was located most frequently in the pancreas. The median follow-up was 72.5 months. The overall survival (OS) was 94.7%, 88.0%, 88.0%, 70.4%, and 49.3% after 1, 3, 5, 10, and 15 years, respectively. Accordingly, the recurrence-free survival (RFS) rates were 93.8%, 72.9%, 64.8%, 27.8%, and 27.8% after 1, 3, 5, 10, and 15 years, respectively. Ki-67 index ≥5% was found as a risk factor for both worse OS (hazard ratio (HR) 7.13, 95% confidence intervals (95% CI) 1.32–38.63, P=0.023) and RFS (HR 13.68, 95% CI 1.54–121.52, P=0.019). Recipient age ≥55 years was a risk factor for worse RFS (P=0.046, HR 5.47, 95% CI 1.03–29.08). Multivariable analysis revealed Ki-67 ≥5% as the sole independent factor for worse OS (HR 13.78, 95% CI 1.48–128.56, P=0.021). Conclusions Patients with unresectable NELM achieve great OS and satisfying RFS after LT. The risk factors associated with worse outcomes are attributed to primary tumor aggressiveness.","PeriodicalId":7935,"journal":{"name":"Annals of Transplantation","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134945386","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Tomasz Pilecki, Bożena Czarkowska-Pączek, Wojciech Lisik, Sławomir Nazarewski, Leszek Pączek
BACKGROUND Hypertension is a risk factor for graft failure and mortality among kidney transplant recipients (KTRs). The aim of the study was to examine blood pressure (BP) as a factor that contributes to graft failure or death during a 10-year observation period. MATERIAL AND METHODS The study group comprised 70 KTRs who were treated according to their clinical state. Data were collected at 1 month and 1 year after transplantation and included office and ambulatory BP monitoring (ABPM) BP values, eGFR, proteinuria, and BMI. During the observation period, 6 patients died, and 10 lost the graft, but not during the first year. RESULTS Office and ABPM BP values were within normal ranges and did not differ from each other. eGRF and BMI were higher at 1 year compared to 1 month after transplantation, and proteinuria decreased. Among those who died, DBP was lower compared to those of survivors with graft failure. Proteinuria and donor age were positively correlated with BP. CONCLUSIONS Monitoring of BP and adequate treatment of hypertension resulting in BP values within normal values among KTRs contribute to longer survival of the graft and recipient. Older donor age and proteinuria could predict post-transplant hypertension. Low diastolic BP of the recipient could increase the risk of death among KTRs. Despite the fact that ABPM is the blood pressure measurement method of choice, appropriate standard office measurement could also be used for BP monitoring.
{"title":"Impact of Blood Pressure on Risk of Graft Failure or Death Among Patients After Kidney Transplantation in a 10-Year Observational Period: A Single-Center Retrospective Analysis.","authors":"Tomasz Pilecki, Bożena Czarkowska-Pączek, Wojciech Lisik, Sławomir Nazarewski, Leszek Pączek","doi":"10.12659/AOT.939472","DOIUrl":"https://doi.org/10.12659/AOT.939472","url":null,"abstract":"<p><p>BACKGROUND Hypertension is a risk factor for graft failure and mortality among kidney transplant recipients (KTRs). The aim of the study was to examine blood pressure (BP) as a factor that contributes to graft failure or death during a 10-year observation period. MATERIAL AND METHODS The study group comprised 70 KTRs who were treated according to their clinical state. Data were collected at 1 month and 1 year after transplantation and included office and ambulatory BP monitoring (ABPM) BP values, eGFR, proteinuria, and BMI. During the observation period, 6 patients died, and 10 lost the graft, but not during the first year. RESULTS Office and ABPM BP values were within normal ranges and did not differ from each other. eGRF and BMI were higher at 1 year compared to 1 month after transplantation, and proteinuria decreased. Among those who died, DBP was lower compared to those of survivors with graft failure. Proteinuria and donor age were positively correlated with BP. CONCLUSIONS Monitoring of BP and adequate treatment of hypertension resulting in BP values within normal values among KTRs contribute to longer survival of the graft and recipient. Older donor age and proteinuria could predict post-transplant hypertension. Low diastolic BP of the recipient could increase the risk of death among KTRs. Despite the fact that ABPM is the blood pressure measurement method of choice, appropriate standard office measurement could also be used for BP monitoring.</p>","PeriodicalId":7935,"journal":{"name":"Annals of Transplantation","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2023-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/9a/f2/anntransplant-28-e939472.PMC10559831.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41107108","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}