Publications by authors named "Pereyra D"

Background: Corroborating evidence for use of hypothermic oxygenated machine perfusion (HOPE) prior to orthotopic liver transplantation (OLT) suggests a beneficial effect in regards to biliary complications. Here, we aim to evaluate whether perfusion via portal vein alone (sHOPE) or via additional perfusion of the hepatic artery (dHOPE) have diverging impact on outcomes after OLT when compared to use of static cold storage (SCS).

Methods: Consecutive patients undergoing OLT at Medical University of Vienna (2018 to 2023) were retrospectively analyzed.

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  • Post-hepatectomy liver failure (PHLF) poses a major risk for patients after partial liver surgery, with a need for better prognostic markers and treatments to boost liver recovery.
  • A study analyzed plasma samples from nine hepatocellular carcinoma (HCC) patients before and after surgery to identify proteins in extracellular vesicles (EVs) that might indicate liver regeneration status.
  • The findings revealed significant changes in protein levels in patients with PHLF, highlighting disruptions in critical cellular processes and suggesting potential biomarkers that were present before the surgery.
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Induction therapy with depleting antibodies in the setting of liver transplantation (LT) is discussed controversially to this day. The rabbit antithymocyteglobulin (ATG) Thymoglobulin (rATG) was introduced as early as 1984 and was frequently used as a standard regime for induction therapy after LT. There are no public reports characterizing Grafalon (ATG-F), a novel ATG, as an induction agent after LT.

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Liver resection (LR) is the primary treatment for hepatic tumors, yet posthepatectomy liver failure (PHLF) remains a significant concern. While the precise etiology of PHLF remains elusive, dysregulated inflammatory processes are pivotal. Therefore, we explored the theragnostic potential of extracellular high-mobility-group-box protein 1 (HMGB1), a key damage-associated molecular pattern (DAMP) released by hepatocytes, in liver recovery post LR in patients and animal models.

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  • The study investigates the use of von Willebrand factor antigen (vWF-Ag) as a non-invasive biomarker to assess complications related to portal hypertension and predict patient outcomes in hepatocellular carcinoma (HCC) after liver resection.
  • The research found that vWF-Ag levels were strongly linked to time to recurrence and overall survival, with specific cutoff values indicating significant risk for posthepatectomy liver failure (PHLF) and clinically significant portal hypertension (CSPH).
  • Results suggest that measuring vWF-Ag could enhance preoperative risk assessment for patients with resectable HCC, potentially guiding treatment decisions based on identified risk levels.
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Platelets were shown to be relevant for liver regeneration. In particular, platelet-stored serotonin (5-HT) proved to be a pro-regenerative factor in this process. The present study aimed to investigate the perioperative course of 5-HT and evaluate associations with patient and graft outcomes after othotopic liver transplantation (OLT).

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Background: Posthepatectomy liver failure (PHLF) represents a life-threatening complication with limited therapeutic options. Neutrophils play a critical and dynamic role during regeneratory processes, but their role in human liver regeneration is incompletely understood, especially as underlying liver disease, detectable in the majority of patients, critically affects hepatic regeneration. Here we explored intrahepatic neutrophil accumulation and neutrophil extracellular traps (NETs) in patients with PHLF and validated the functional relevance of NETs in a murine partial hepatectomy (PHx) model.

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Purpose: The efficacy of the novel SphinKeeper® procedure for the treatment of fecal incontinence (FI) is not yet well defined. This study aimed to assess long-term functional outcomes after SphinKeeper® surgery.

Methods: We included 32 patients with FI (28 female), who were operated at a tertiary referral center between August 2018 and September 2021.

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Objective And Background: Clinically significant posthepatectomy liver failure (PHLF B+C) remains the main cause of mortality after major hepatic resection. This study aimed to establish an APRI+ALBI, aspartate aminotransferase to platelet ratio (APRI) combined with albumin-bilirubin grade (ALBI), based multivariable model (MVM) to predict PHLF and compare its performance to indocyanine green clearance (ICG-R15 or ICG-PDR) and albumin-ICG evaluation (ALICE).

Methods: 12,056 patients from the National Surgical Quality Improvement Program (NSQIP) database were used to generate a MVM to predict PHLF B+C.

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Accumulating evidence suggests that metabolic demands of the regenerating liver are met via lipid metabolism and critical regulators of this process. As such, glucagon-like peptide-1 (GLP-1) and glucagon-like peptide-2 (GLP-2) critically affect hepatic regeneration in rodent models. The present study aimed to evaluate potential alterations and dynamics of circulating GLP-1 and GLP-2 in patients undergoing liver resections, focusing on post-hepatectomy liver failure (PHLF).

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The Sphinkeeper procedure for treating faecal incontinence (FI) may be associated with potential implant migration (IM) and dislocation (ID), with considerable variations regarding their occurrence and effects on consecutive functional outcome. This study assessed IM and ID following the Sphinkeeper procedure and its correlation with physical activity. This was a prospective observational clinical study of ten patients undergoing Sphinkeeper operation due to FI between August 2020 and November 2020 at the Medical University of Vienna.

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  • The study investigates early transcriptional changes in human liver regeneration and how underlying liver diseases affect this process.
  • Researchers analyzed blood and tissue samples from patients undergoing liver surgery, focusing on those with dysfunctional liver regeneration.
  • Results showed that patients with dysfunctional regeneration exhibited heightened inflammatory responses and reduced expression of a critical gene (DUSP4) linked to adhesion molecule regulation, potentially hindering effective liver recovery.
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  • * It was found that YAP-1 levels increased shortly after the onset of LR and that specific deletion of YAP-1 in biliary epithelial cells (BECs) impaired LR in mice.
  • * The research indicates that serotonin promotes YAP-1 activation through tyrosine phosphorylation in BECs, leading to increased osteopontin (OPN) expression and supporting liver regeneration.
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  • Research has traditionally focused on skin bacteria as the main cause of surgical infections, but recent findings show that intestinal bacteria are actually the primary culprits in postoperative infections.
  • In experiments with mice, it was found that CCR6 group 3 innate lymphoid cells (ILC3s) play a crucial role in controlling bacterial spread after surgery by producing interleukin-22 (IL-22).
  • The study highlights that ILC3s are essential for liver regeneration and suggests they could be new targets for preventing infections linked to intestinal bacteria in postoperative patients.
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  • Activin A plays a crucial role in liver regeneration, but its effects on humans after liver surgery are not well studied, prompting this research on its predictive value for posthepatectomy liver failure (PHLF).
  • The study tested levels of activin A and its antagonist FSTL-3 in 59 patients undergoing liver surgery and found significant changes in their individual levels post-surgery, but not in their ratio.
  • The activin A/FSTL-3 ratio was a strong predictor for PHLF and related complications, suggesting its use in preoperative evaluations, although further research is needed for confirmation.
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Age represents the major risk factor for fatal disease outcome in coronavirus disease (COVID-19) due to age-related changes in immune responses. On the one hand lymphocyte counts continuously decline with advancing age, on the other hand somatic hyper-mutations of B-lymphocytes and levels of class-switched antibodies diminish, resulting in lower neutralizing antibody titers. To date the impact of age on immunoglobulin G (IgG) production in response to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection is unknown.

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Background: Tocilizumab and baricitinib are recommended treatment options for hospitalized COVID-19 patients requiring oxygen support. Literature about its efficacy and safety in a head-to-head comparison is scarce.

Methods: Hospitalized COVID-19 patients requiring oxygen were treated with tocilizumab or baricitinib additionally to dexamethasone.

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Background & Aims: Surgical resection of the cancerous tissue represents one of the few curative treatment options for neoplastic liver disease. Such partial hepatectomy (PHx) induces hepatocyte hyperplasia, which restores liver function. PHx is associated with bacterial translocation, leading to an immediate immune response involving neutrophils and macrophages, which are indispensable for the priming phase of liver regeneration.

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Background: Von Willebrand factor antigen (VWF) is a non-invasive marker for clinically significant portal hypertension (HVPG≥10 mmHg) and confers HVPG-independent prognostic information. While quantification of increased VWF-levels is not relevant in the context of von Willebrand disease, highly elevated VWF may be of clinical significance in ACLD. Thus, we have modified our analytical approach to quantify very high VWF-levels (i.

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Berries have been implicated as the probable vehicle of infection in multiple outbreaks of norovirus and hepatitis A virus (HAV). These foods often receive minimal or no processing and may be exposed to virus contamination at each stage of production. In an increasingly globalized world, berries have a wide distribution and can give rise to the spread of diseases in distant parts of the world.

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  • COVID-19 causes a hypercoagulatory state that can lead to serious blood clot issues, and while anticoagulation helps reduce mortality, the benefits of antiplatelet therapy are uncertain.
  • A study of 578 hospitalized COVID-19 patients found no correlation between antiplatelet therapy and survival rates, with adverse outcomes more tied to an overactive coagulation system.
  • Analysis of postmortem lung biopsies and patient blood samples indicated that while clotting was problematic, platelet function appeared impaired in severe cases, suggesting that antiplatelet therapy did not improve outcomes and might even worsen platelet issues.
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Objective: To develop and validate a prognostic model for in-hospital mortality after four days based on age, fever at admission and five haematological parameters routinely measured in hospitalized Covid-19 patients during the first four days after admission.

Methods: Haematological parameters measured during the first 4 days after admission were subjected to a linear mixed model to obtain patient-specific intercepts and slopes for each parameter. A prediction model was built using logistic regression with variable selection and shrinkage factor estimation supported by bootstrapping.

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Thromboembolic complications are frequently observed in Coronavirus disease 2019 (COVID-19). While COVID-19 is linked to platelet dysregulation, the association between disease outcome and platelet function is less clear. We prospectively monitored platelet activation and reactivity in 97 patients during the first week of hospitalization and determined plasma markers of platelet degranulation and inflammation.

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AXL and its corresponding ligand growth arrest-specific 6 (GAS-6) are critically involved in hepatic immunomodulation and regenerative processes. Pleiotropic inhibitory effects on innate inflammatory responses might essentially involve the shift of macrophage phenotype from a pro-inflammatory M1 to an anti-inflammatory M2. We aimed to assess the relevance of the AXL/GAS-6-pathway in human liver regeneration and, consequently, its association with clinical outcome after hepatic resection.

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