Many mechanisms have been proposed to explain the hypothetical state of hepatic tolerance,which is described by eventual imbalances or deregulation in the balance of cytokines,mediators,effectors,and regulatory cells ...Many mechanisms have been proposed to explain the hypothetical state of hepatic tolerance,which is described by eventual imbalances or deregulation in the balance of cytokines,mediators,effectors,and regulatory cells in the complex milieu of the liver.In this section,we will comment on the importance of donorspecific anti-human leukocyte antigen(HLA)antibodies(DSA)as well as the compatibility and pairings of HLA and killer-cell immunoglobulin-like receptor(KIR)genotypes in the evolution of liver transplantation.Thus,HLA compatibility,viral infections,and HLA-C/KIR combinations have all been linked to liver transplant rejection and survival.There have been reports of increased risk of acute and chronic rejection with ductopenia,faster graft fibrosis,biliary problems,poorer survival,and even de novo autoimmune hepatitis when DSAs are present in the recipient.Higher mean fluorescence intensity(MFI)values of the DSAs and smaller graft size were associated with poorer patient outcomes,implying that high-risk patients with preformed DSAs should be considered for selecting the graft placed and desensitization methods,according to the investigators.Similarly,in a combined kidney-liver transplant,a pretransplant with a visible expression of several DSAs revealed that these antibodies were resistant to treatment.The renal graft was lost owing to antibody-mediated rejection(AMR).The HLA antigens expressed by the transplanted liver graft influenced antibody elimination.Pathologists are increasingly diagnosing AMR in liver transplants,and desensitization therapy has even been employed in situations of AMR,particularly in patients with DSAs in kidney-hepatic transplants and high-class II MFI due to Luminex.In conclusion,after revealing the negative impacts of DSAs with high MFI,pretransplant virtual crossmatch techniques may be appropriate to improve evolution;however,they may extend cold ischemia periods by requiring the donor to be typed.展开更多
The authors of this study note that in liver transplantation(LT),the survival rates of hepatitis C virus(HCV)-positive donors and HCV-negative receivers are compa-rable to those of HCV-negative donors and recipients.D...The authors of this study note that in liver transplantation(LT),the survival rates of hepatitis C virus(HCV)-positive donors and HCV-negative receivers are compa-rable to those of HCV-negative donors and recipients.Direct-acting antiviral(DAA)therapies have nearly 100%effectiveness in treating HCV.Between 2006 and 2016,the percentages of HCV-positive patients on the waiting list and HCVpositive LT recipients fell by 8.2 percent and 7.6 percent,respectively.Records from April 1,2014,in which the donor and receiver were both at least 18 years old and had a positive HCV status,were the only ones eligible for the study.The analysis for this study was restricted to the first transplant recorded for each patient using a data element that documented the number of prior transplants for each recipient,although some recipients appeared multiple times in the data set.HCV-positive recipients or people with fulminant hepatic failure were the main beneficiaries of primary biliary cirrhosis among HCV-positive donors.However,there is still a reticence to use HCV-positive donor organs in HCV recipients due to clinical and ethical considerations.Similar survival rates between HCV-positive donors and recipients and HCV-negative donors and receivers illustrate the efficacy of these DAA regimens.展开更多
End-stage liver disease is frequently caused by hepatitis B virus (HBV) andalcohol consumption. Notably, the mechanism by which alcohol affects the courseof HBV-associated liver disease is unknown, and additional rese...End-stage liver disease is frequently caused by hepatitis B virus (HBV) andalcohol consumption. Notably, the mechanism by which alcohol affects the courseof HBV-associated liver disease is unknown, and additional research is needed inthis area. A reduced immunological response, oxidative stress, endoplasmicreticulum stress, Golgi apparatus stress, and enhanced HBV replication are a fewpotential causes.展开更多
Alcohol intake is a risk factor for cancer development and metastatic disease progression.Extracellular vesicle(EV)-mediated interorgan communication is assumed to be significant in boosting tumorigenic pathways and d...Alcohol intake is a risk factor for cancer development and metastatic disease progression.Extracellular vesicle(EV)-mediated interorgan communication is assumed to be significant in boosting tumorigenic pathways and disease progression.Recent research indicates that exosomes have a variety of roles in the development of cancer during pathophysiological conditions.The involvement of EV signaling during cancer progression in the alcohol environment is unknown.Therefore,understanding communication networks and the role of EVs as biomarkers can contribute significantly to developing strategies to address the serious public health problems associated with alcohol consumption and cancer.展开更多
We have read with great attention and special interest the paper by Carrique and collaborators entitled:Results of Early Transplantation for Alcohol-Related Cirrhosis:Integrated Addiction Treatment with Low Rate of Re...We have read with great attention and special interest the paper by Carrique and collaborators entitled:Results of Early Transplantation for Alcohol-Related Cirrhosis:Integrated Addiction Treatment with Low Rate of Relapse(1).In this prospective study,the authors initiated a pilot program to challenge the paradigm of the“6-month rule”of abstinence for patients with alcohol-related liver disease(ALD)requiring a transplant(2).展开更多
基金Instituto de Salud Carlos III,Spanish Ministry of Economy and Competitiveness,No.PI15/01370 and P19/01194and the European Union with the European Fund of Regional Development with the principle of“A manner to build Europe”.
文摘Many mechanisms have been proposed to explain the hypothetical state of hepatic tolerance,which is described by eventual imbalances or deregulation in the balance of cytokines,mediators,effectors,and regulatory cells in the complex milieu of the liver.In this section,we will comment on the importance of donorspecific anti-human leukocyte antigen(HLA)antibodies(DSA)as well as the compatibility and pairings of HLA and killer-cell immunoglobulin-like receptor(KIR)genotypes in the evolution of liver transplantation.Thus,HLA compatibility,viral infections,and HLA-C/KIR combinations have all been linked to liver transplant rejection and survival.There have been reports of increased risk of acute and chronic rejection with ductopenia,faster graft fibrosis,biliary problems,poorer survival,and even de novo autoimmune hepatitis when DSAs are present in the recipient.Higher mean fluorescence intensity(MFI)values of the DSAs and smaller graft size were associated with poorer patient outcomes,implying that high-risk patients with preformed DSAs should be considered for selecting the graft placed and desensitization methods,according to the investigators.Similarly,in a combined kidney-liver transplant,a pretransplant with a visible expression of several DSAs revealed that these antibodies were resistant to treatment.The renal graft was lost owing to antibody-mediated rejection(AMR).The HLA antigens expressed by the transplanted liver graft influenced antibody elimination.Pathologists are increasingly diagnosing AMR in liver transplants,and desensitization therapy has even been employed in situations of AMR,particularly in patients with DSAs in kidney-hepatic transplants and high-class II MFI due to Luminex.In conclusion,after revealing the negative impacts of DSAs with high MFI,pretransplant virtual crossmatch techniques may be appropriate to improve evolution;however,they may extend cold ischemia periods by requiring the donor to be typed.
文摘The authors of this study note that in liver transplantation(LT),the survival rates of hepatitis C virus(HCV)-positive donors and HCV-negative receivers are compa-rable to those of HCV-negative donors and recipients.Direct-acting antiviral(DAA)therapies have nearly 100%effectiveness in treating HCV.Between 2006 and 2016,the percentages of HCV-positive patients on the waiting list and HCVpositive LT recipients fell by 8.2 percent and 7.6 percent,respectively.Records from April 1,2014,in which the donor and receiver were both at least 18 years old and had a positive HCV status,were the only ones eligible for the study.The analysis for this study was restricted to the first transplant recorded for each patient using a data element that documented the number of prior transplants for each recipient,although some recipients appeared multiple times in the data set.HCV-positive recipients or people with fulminant hepatic failure were the main beneficiaries of primary biliary cirrhosis among HCV-positive donors.However,there is still a reticence to use HCV-positive donor organs in HCV recipients due to clinical and ethical considerations.Similar survival rates between HCV-positive donors and recipients and HCV-negative donors and receivers illustrate the efficacy of these DAA regimens.
文摘End-stage liver disease is frequently caused by hepatitis B virus (HBV) andalcohol consumption. Notably, the mechanism by which alcohol affects the courseof HBV-associated liver disease is unknown, and additional research is needed inthis area. A reduced immunological response, oxidative stress, endoplasmicreticulum stress, Golgi apparatus stress, and enhanced HBV replication are a fewpotential causes.
文摘Alcohol intake is a risk factor for cancer development and metastatic disease progression.Extracellular vesicle(EV)-mediated interorgan communication is assumed to be significant in boosting tumorigenic pathways and disease progression.Recent research indicates that exosomes have a variety of roles in the development of cancer during pathophysiological conditions.The involvement of EV signaling during cancer progression in the alcohol environment is unknown.Therefore,understanding communication networks and the role of EVs as biomarkers can contribute significantly to developing strategies to address the serious public health problems associated with alcohol consumption and cancer.
基金Our work was possible thanks to supporting from Instituto de Salud Carlos Ⅲ(ISCⅢ),Spanish Ministry of Economy and Competitiveness.Grant Number P19/01194,and PI20/00050 and co-funding the European Union with the European Fund of Regional Development(FEDER)with the principle of“A manner to build Europe”.
文摘We have read with great attention and special interest the paper by Carrique and collaborators entitled:Results of Early Transplantation for Alcohol-Related Cirrhosis:Integrated Addiction Treatment with Low Rate of Relapse(1).In this prospective study,the authors initiated a pilot program to challenge the paradigm of the“6-month rule”of abstinence for patients with alcohol-related liver disease(ALD)requiring a transplant(2).
