Elucidating the temporal process of immune remodeling under immunosuppressive treatment after liver transplantation(LT)is critical for precise clinical management strategies.Here,we performed a single-cell multi-omics...Elucidating the temporal process of immune remodeling under immunosuppressive treatment after liver transplantation(LT)is critical for precise clinical management strategies.Here,we performed a single-cell multi-omics analysis of peripheral blood mononuclear cells(PBMCs)collected from LT patients(with and without acute cellular rejection[ACR])at 13 time points.Validation was performed in two independent cohorts with additional LT patients and healthy controls.Our study revealed a four-phase recovery process after LT and delineated changes in immune cell composition,expression programs,and interactions along this process.The intensity of the immune response differs between the ACR and non-ACR patients.Notably,the newly identified inflamed NK cells,CD14+RNASE2+monocytes,and FOS-expressing monocytes emerged as predictive indicators of ACR.This study illuminates the longitudinal evolution of the immune cell landscape under tacrolimus-based immunosuppressive treatment during LT recovery,providing a four-phase framework that aids the clinical management of LT patients.展开更多
Background:Minimally invasive surgeries are increasingly central to modern medicine,particularly in liver transplantation.These techniques,which offer reduced trauma,precise operations,minimal bleeding,and swift recov...Background:Minimally invasive surgeries are increasingly central to modern medicine,particularly in liver transplantation.These techniques,which offer reduced trauma,precise operations,minimal bleeding,and swift recovery,are,however,unevenly adopted across China.Only a limited number of centers routinely perform minimally invasive donor hepatectomies,indicating a significant imbalance in the development and application of these advanced procedures.Additionally,there lacks a set of standardized guidelines that are tailored to meet China’s unique healthcare challenges and conditions.Methods:In August 2023,the Branch of Organ Transplant of Chinese Medical Association and the Branch of Organ Transplant Physicians of Chinese Medical Doctor Association convened a group of national liver transplantation experts to establish a guideline development committee.This committee conducted a thorough review of relevant literature,evaluated existing guidelines and consensus,and assessed factors such as the evidence base,patient preferences,and the cost-effectiveness of interventions within China.After multiple rounds of discussions,both online and offline,the committee finalized the guidelines.Results:This collaborative effort led to the creation of the“Chinese guidelines for minimally invasive donor hepatectomy in living donor liver transplantation(2024 edition)”.These guidelines address crucial aspects such as the safety and advantages of minimally invasive surgery for living donor liver transplantation,donor selection criteria,anesthesia strategies,surgical technical details,and learning curves associated with these procedures,resulting in a comprehensive set of 26 recommendations.Conclusions:The formulation of these guidelines represents a significant advancement towards standardizing minimally invasive liver transplantation surgeries in China.They are designed to enhance outcomes for both donors and recipients by synthesizing expert consensus with contemporary research and clinical practices.Moreover,they serve as a crucial reference for surgeons and medical institutions,promoting the refinement and adoption of minimally invasive surgical techniques in liver transplantation.展开更多
基金This work received financial support from the National Natural Science Foundation of China(no.82070677 and 82201964)Natural Science and Technology Major Project of the Xiamen(no.3502Z20231034)+1 种基金Natural Science Fund for Distinguished Young Scholars of Fujian Province(no.2023J01310519)Natural Science Foundation of Xiamen(no.3502Z20227283 and 3502Z20227122).
文摘Elucidating the temporal process of immune remodeling under immunosuppressive treatment after liver transplantation(LT)is critical for precise clinical management strategies.Here,we performed a single-cell multi-omics analysis of peripheral blood mononuclear cells(PBMCs)collected from LT patients(with and without acute cellular rejection[ACR])at 13 time points.Validation was performed in two independent cohorts with additional LT patients and healthy controls.Our study revealed a four-phase recovery process after LT and delineated changes in immune cell composition,expression programs,and interactions along this process.The intensity of the immune response differs between the ACR and non-ACR patients.Notably,the newly identified inflamed NK cells,CD14+RNASE2+monocytes,and FOS-expressing monocytes emerged as predictive indicators of ACR.This study illuminates the longitudinal evolution of the immune cell landscape under tacrolimus-based immunosuppressive treatment during LT recovery,providing a four-phase framework that aids the clinical management of LT patients.
基金supported by grants from National Key R&D Program of China(No.2022YFC2304705 to Jiayin Yang)National Natural Science Foundation of China(No.82270691 to Jiayin Yang)+2 种基金Sichuan Province Key Research and Development Project(Nos.2023YFS0026 and 23ZDYF2182 to Jiayin Yang)Chengdu Province Key Research and Development Project(No.2022YF0900009SN to Jiayin Yang)1.3.5 Project for Disciplines of Excellence from West China Hospital of Sichuan University(No.ZYGD24002 to Jiayin Yang).
文摘Background:Minimally invasive surgeries are increasingly central to modern medicine,particularly in liver transplantation.These techniques,which offer reduced trauma,precise operations,minimal bleeding,and swift recovery,are,however,unevenly adopted across China.Only a limited number of centers routinely perform minimally invasive donor hepatectomies,indicating a significant imbalance in the development and application of these advanced procedures.Additionally,there lacks a set of standardized guidelines that are tailored to meet China’s unique healthcare challenges and conditions.Methods:In August 2023,the Branch of Organ Transplant of Chinese Medical Association and the Branch of Organ Transplant Physicians of Chinese Medical Doctor Association convened a group of national liver transplantation experts to establish a guideline development committee.This committee conducted a thorough review of relevant literature,evaluated existing guidelines and consensus,and assessed factors such as the evidence base,patient preferences,and the cost-effectiveness of interventions within China.After multiple rounds of discussions,both online and offline,the committee finalized the guidelines.Results:This collaborative effort led to the creation of the“Chinese guidelines for minimally invasive donor hepatectomy in living donor liver transplantation(2024 edition)”.These guidelines address crucial aspects such as the safety and advantages of minimally invasive surgery for living donor liver transplantation,donor selection criteria,anesthesia strategies,surgical technical details,and learning curves associated with these procedures,resulting in a comprehensive set of 26 recommendations.Conclusions:The formulation of these guidelines represents a significant advancement towards standardizing minimally invasive liver transplantation surgeries in China.They are designed to enhance outcomes for both donors and recipients by synthesizing expert consensus with contemporary research and clinical practices.Moreover,they serve as a crucial reference for surgeons and medical institutions,promoting the refinement and adoption of minimally invasive surgical techniques in liver transplantation.
