Multi-omics analysis reveals distinct gene regulatory mechanisms between primary and organoid-derived human hepatocytes.

Hepatic organoid cultures are a powerful model to study liver development and diseases in vitro. However, hepatocyte-like cells differentiated from these organoids remain immature compared to primary human hepatocytes (PHHs), which are the benchmark in the field. Here, we applied integrative single-cell transcriptome and chromatin accessibility analysis to reveal gene regulatory mechanisms underlying these differences.

Physiological arterial pressure improves renal performance during normothermic machine perfusion in a porcine kidney DCD model.

Background: Normothermic machine perfusion (NMP) provides a platform for kidney quality assessment. Donation after circulatory death (DCD) donor kidneys are associated with great ischemic injury and high intrarenal resistance (IRR). This experimental study aims to investigate the impact of different perfusion pressures on marginal kidney function and injury during NMP.

Corticosteroids in severe alcohol-associated hepatitis? Not so fast: A systematic review of randomized controlled trials.

Background: Severe alcohol-associated hepatitis (AH) is rising in incidence with a high mortality burden. While corticosteroids are recommended for eligible patients with severe AH, no guidance exists for the timing of steroid initiation, tapering regimens, and surveillance of adverse events.

Objective: We aim to systematically review these variables and provide evidence-based recommendations for the inpatient and outpatient management of severe AH.

Desensitization With Imlifidase for HLA-Incompatible Deceased Donor Kidney Transplantation: A Delphi International Expert Consensus.

Highly sensitized (HS) patients in need of kidney transplantation (KTx) typically spend a longer time waiting for compatible kidneys, are unlikely to receive an organ offer, and are at increased risk of antibody-mediated rejection (AMR). Desensitization using imlifidase, which is more rapid and removes total body immunoglobulin G (IgG) to a greater extent than other methods, enables transplantation to occur between HLA-incompatible (HLAi) donor-recipient pairs and allows patients to have greater access to KTx. However, when the project was launched there was limited data and clinical experience with desensitization in general and with imlifidase specifically.

Activation of autophagy with PF-06409577 alleviates heatstroke-induced organ injury.

Heat waves are a significant environmental issue threatening global human health. Extreme temperatures can lead to various heat-related illnesses, with heatstroke being among the most severe. Currently, there are no effective treatments to mitigate the multi-organ damage caused by heatstroke.

Cost-effectiveness of Dual Hypothermic Oxygenated Machine Perfusion Versus Static Cold Storage in DCD Liver Transplantation.

Background: Ex situ machine perfusion of the donor liver, such as dual hypothermic oxygenated machine perfusion (DHOPE), is increasingly used in liver transplantation. Although DHOPE reduces ischemia/reperfusion-related complications after liver transplantation, data on cost-effectiveness are lacking. Our objective was to evaluate the cost-effectiveness of DHOPE in donation after circulatory death (DCD) liver transplantation.

Xenotransplantation: future frontiers and challenges.

Purpose Of Review: Recent advancements in genetic engineering have propelled the field of xenotransplantation from preclinical models to early compassionate use cases. As first-in-human clinical trials (FIHCTs) approach, we examine recent developments, ethical and regulatory challenges, immunological considerations, and the clinical infrastructure necessary for successful xenotransplantation trials.

Recent Findings: Expanded access transplants of pig hearts, kidneys, and livers have identified key challenges.

Cost-effectiveness Analysis of Uterus Transplantation versus Gestational Carrier for Treatment of Absolute Uterine Factor Infertility.

Importance: Patients with uterine factor infertility (UFI) have few options for family building. Uterus transplant is a feasible treatment for some patients; however, cost remains a significant concern.

Objective: To compare the cost effectiveness of treatment for patients with absolute uterine factor infertility to achieve 1-2 singleton births by gestational carrier or uterus transplant DESIGN: Decision analysis from the United States healthcare sector perspective, with time horizons to achieve one or two singleton births.

Coronary Computed Tomography Angiography in Heart Transplant Patients: Current Insights and Future Directions.

Cardiac allograft vasculopathy (CAV) remains a significant challenge after heart transplantation, necessitating effective surveillance methods. This review centers around the role of coronary computed tomography angiography (CCTA) in CAV surveillance, given its unique capabilities to visualize and quantify CAV in comparison with other imaging modalities, including invasive coronary angiography and intravascular ultrasound. CCTA has shown good diagnostic performance for detecting and monitoring CAV, exemplified by a higher sensitivity and negative predictive value compared with invasive coronary angiography.

Current practices in prevention, screening, and treatment of diabetes in kidney transplant recipients: European survey highlights from the ERA DESCARTES Working Group.

Background: Although post-transplant diabetes mellitus (PTDM) is a common complication after kidney transplantation, there are few data on prevention, optimal screening, and treatment strategies.

Methods: The European Renal Association's DESCARTES working group distributed a web-based survey to European transplant centres to gather information on risk assessment, screening procedures, and management practices for preventing and treating PTDM in kidney transplant recipients.

Results: Answers were obtained from 121/241 transplant centres (50%) across 15 European countries.

Nurse-Led Self-Management Support After Organ Transplantation - A Multicenter, Stepped-Wedge Randomized Controlled Trial.

Unlabelled: In this unblinded multi-center stepped-wedge randomized controlled trial the effectiveness of the nurse-led ZENN-intervention was tested in promoting self-management skills in comparison to standard care among heart, lung and kidney transplant recipients. This intervention is based on behaviour change theories and was conducted in four sessions over 6 months at the outpatient clinic. The experimental group received standard care, plus the ZENN-intervention, while the control group received only standard care.

Expanding the Scope of Microvascular Inflammation: Unveiling Its Presence Beyond Antibody-Mediated Rejection Into T-Cell Mediated Contexts.

Microvascular inflammation (MVI) in kidney transplant biopsies is mainly associated with antibody-mediated rejection (AMR), sparking debate within the Banff Classification of Renal Allograft Pathology regarding its exclusivity. This study reviewed the literature on MVI in T cell-mediated rejection (TCMR) and analyzed MVI in our transplant population. We searched English publications in MEDLINE, Embase, Web of Science, Cochrane, and Google Scholar until June 2024, focusing on glomerulitis (g), peritubular capillaritis (ptc), or MVI in kidney transplant biopsies classified as TCMR.

Negative Pressure Ventilation Ex-Situ Lung Perfusion Preserves Porcine and Human Lungs for 36-Hours.

Introduction: Preclinically, 24-hour continuous Ex-Situ Lung Perfusion (ESLP) is the longest duration achieved in large animal models and rejected human lungs. Here, we present our 36-hour Negative Pressure Ventilation (NPV)-ESLP protocol applied to porcine and rejected human lungs.

Methods: Five sets of donor domestic pig lungs (45-55 kg) underwent 36-hour NPV-ESLP.

Outcomes of pediatric liver retransplantation candidates in the modern era: Strategies are needed to avoid waitlist mortality in the United States.

Pediatric liver retransplantation (rLT) has historically shown poorer outcomes compared to primary liver transplantation (pLT). Comprehensive studies assessing outcomes for pediatric rLT candidates under the modern allocation policy are lacking. OPTN data from January 1, 2010, to December 31, 2022 were obtained; exclusion criteria included candidates ≥18years of age and those listed or transplanted for multiple organs.

Predictors of Mortality among End-Stage Renal Disease Patients with COVID-19 Admitted in a Philippine Tertiary Government Hospital: A Retrospective Cohort Study.

Background And Objective: Several studies have examined the predictors of mortality among COVID-19-infected patients; however, to date, few published studies focused on end-stage renal disease patients. The present study, therefore, aims to determine the predictors of in-hospital mortality among end-stage renal disease patients with COVID-19 admitted to a Philippine tertiary hospital.

Methods: The researcher utilized a retrospective cohort design.

Multimodal transesophageal echocardiography in the surgical resection of patients with hepatocellular carcinoma and inferior vena cava tumor thrombus.

Background: The incidence and mortality rate of hepatocellular carcinoma (HCC) are increasing globally. HCC with inferior vena cava tumor thrombus (HCCIVCTT) represents an advanced stage of the disease. Research suggests that for patients with advanced HCCIVCTT, liver resection combined with thrombectomy is a safe and feasible option that can provide moderate survival benefit.

Comparison of various liver cancer staging systems in predicting prognosis after initial transcatheter arterial chemoembolization: a retrospective study from China.

Background: Hepatocellular carcinoma (HCC) constitutes approximately 75-85% of primary liver cancers and is a heavy burden on public health. Many innovative prediction systems have integrated radiomics, artificial intelligence, pathological information, or even genetic information for the stratification and prognosis prediction of patients with HCC. However, these systems still lack practical and clinical applications.

N-Acetylcysteine and Liver Transplant. Advantages of its Administration in Multi-Organ Donors Especially During World-Economical-Crisis. Long-Term Sub-Group Analysis in a Randomized Study.

Background: Liver transplantation (LT) is the main indication for the treatment of end-stage liver disease but have to face organ shortages. Using marginal donors is an option to increase the donor pool. Previous studies showed that the graft procured using N-acetylcysteine (NAC) provides a longer survival compared to perfusion with standard solutions, especially in marginal liver donors.

Retroperitoneal Soft Tissue Sarcoma and Kidney Autotransplantation: A Case Report.

Soft tissue sarcomas (STSs) are rare malignancies, with retroperitoneal soft tissue sarcoma (RPS) constituting 10%-15% of all STSs. RPS often presents late due to minimal early symptoms, typically requiring complete en-bloc resection for optimal survival outcomes. Achieving radical resection can be challenging due to the tumor's proximity to vital organs.