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Validation and performance of three scoring systems for predicting primary non-function and early allograft failure after liver transplantation 被引量:1
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作者 Yu Nie Jin-Bo Huang +5 位作者 Shu-Jiao He Hua-Di Chen Jun-Jun Jia Jing-Jing Li Xiao-Shun He Qiang Zhao 《Hepatobiliary & Pancreatic Diseases International》 SCIE CAS CSCD 2024年第5期463-471,共9页
Background: Primary non-function(PNF) and early allograft failure(EAF) after liver transplantation(LT) seriously affect patient outcomes. In clinical practice, effective prognostic tools for early identifying recipien... Background: Primary non-function(PNF) and early allograft failure(EAF) after liver transplantation(LT) seriously affect patient outcomes. In clinical practice, effective prognostic tools for early identifying recipients at high risk of PNF and EAF were urgently needed. Recently, the Model for Early Allograft Function(MEAF), PNF score by King's College(King-PNF) and Balance-and-Risk-Lactate(BAR-Lac) score were developed to assess the risks of PNF and EAF. This study aimed to externally validate and compare the prognostic performance of these three scores for predicting PNF and EAF. Methods: A retrospective study included 720 patients with primary LT between January 2015 and December 2020. MEAF, King-PNF and BAR-Lac scores were compared using receiver operating characteristic(ROC) and the net reclassification improvement(NRI) and integrated discrimination improvement(IDI) analyses. Results: Of all 720 patients, 28(3.9%) developed PNF and 67(9.3%) developed EAF in 3 months. The overall early allograft dysfunction(EAD) rate was 39.0%. The 3-month patient mortality was 8.6% while 1-year graft-failure-free survival was 89.2%. The median MEAF, King-PNF and BAR-Lac scores were 5.0(3.5–6.3),-2.1(-2.6 to-1.2), and 5.0(2.0–11.0), respectively. For predicting PNF, MEAF and King-PNF scores had excellent area under curves(AUCs) of 0.872 and 0.891, superior to BAR-Lac(AUC = 0.830). The NRI and IDI analyses confirmed that King-PNF score had the best performance in predicting PNF while MEAF served as a better predictor of EAD. The EAF risk curve and 1-year graft-failure-free survival curve showed that King-PNF was superior to MEAF and BAR-Lac scores for stratifying the risk of EAF. Conclusions: MEAF, King-PNF and BAR-Lac were validated as practical and effective risk assessment tools of PNF. King-PNF score outperformed MEAF and BAR-Lac in predicting PNF and EAF within 6 months. BAR-Lac score had a huge advantage in the prediction for PNF without post-transplant variables. Proper use of these scores will help early identify PNF, standardize grading of EAF and reasonably select clinical endpoints in relative studies. 展开更多
关键词 Primary non-function Early allograft failure Risk predicting model Liver transplantation
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A Single-Cell Landscape of Human Liver Transplantation Reveals a Pathogenic Immune Niche Associated with Early Allograft Dysfunction
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作者 Xin Shao Zheng Wang +8 位作者 Kai Wang Xiaoyan Lu Ping Zhang Rongfang Guo Jie Liao Penghui Yang Shusen Zheng Xiao Xu Xiaohui Fan 《Engineering》 SCIE EI CAS CSCD 2024年第5期193-208,共16页
Liver transplantation(LT)is the standard therapy for individuals afflicted with end-stage liver disease.Despite notable advancements in LT technology,the incidence of early allograft dysfunction(EAD)remains a critical... Liver transplantation(LT)is the standard therapy for individuals afflicted with end-stage liver disease.Despite notable advancements in LT technology,the incidence of early allograft dysfunction(EAD)remains a critical concern,exacerbating the current organ shortage and detrimentally affecting the prognosis of recipients.Unfortunately,the perplexing hepatic heterogeneity has impeded characterization of the cellular traits and molecular events that contribute to EAD.Herein,we constructed a pioneering single-cell transcriptomic landscape of human transplanted livers derived from non-EAD and EAD patients,with 12 liver samples collected from 7 donors during the cold perfusion and portal reperfusion stages.Comparison of the 75231 cells of non-EAD and EAD patients revealed an EAD-associated immune niche comprising mucosal-associated invariant T cells,granzyme B^(+)(GZMB^(+))granzyme K^(+)(GZMK^(+))natural killer cells,and S100 calcium binding protein A12^(+)(S100A12^(+))neutrophils.Moreover,we verified this immune niche and its association with EAD occurrence in two independent cohorts.Our findings elucidate the cellular characteristics of transplanted livers and the EAD-associated pathogenic immune niche at the single-cell level,thus,offering valuable insights into EAD onset. 展开更多
关键词 Human liver transplantation Early allograft dysfunction Pathogenic immune niche Single-cell analysis Cell-cell communication
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Polyethylene glycol has immunoprotective effects on sciatic allografts, but behavioral recovery and graft tolerance require neurorrhaphy and axonal fusion
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作者 Tyler A.Smith Liwen Zhou +6 位作者 Cameron L.Ghergherehchi Michelle Mikesh Cathy Z.Yang Haley O.Tucker JuliAnne Allgood Jared S.Bushman George D.Bittner 《Neural Regeneration Research》 SCIE CAS 2025年第4期1192-1206,共15页
Behavioral recovery using(viable)peripheral nerve allografts to repair ablation-type(segmental-loss)peripheral nerve injuries is delayed or poor due to slow and inaccurate axonal regeneration.Furthermore,such peripher... Behavioral recovery using(viable)peripheral nerve allografts to repair ablation-type(segmental-loss)peripheral nerve injuries is delayed or poor due to slow and inaccurate axonal regeneration.Furthermore,such peripheral nerve allografts undergo immunological rejection by the host immune system.In contrast,peripheral nerve injuries repaired by polyethylene glycol fusion of peripheral nerve allografts exhibit excellent behavioral recovery within weeks,reduced immune responses,and many axons do not undergo Wallerian degeneration.The relative contribution of neurorrhaphy and polyethylene glycol-fusion of axons versus the effects of polyethylene glycol per se was unknown prior to this study.We hypothesized that polyethylene glycol might have some immune-protective effects,but polyethylene glycol-fusion was necessary to prevent Wallerian degeneration and functional/behavioral recovery.We examined how polyethylene glycol solutions per se affect functional and behavioral recovery and peripheral nerve allograft morphological and immunological responses in the absence of polyethylene glycol-induced axonal fusion.Ablation-type sciatic nerve injuries in outbred Sprague–Dawley rats were repaired according to a modified protocol using the same solutions as polyethylene glycol-fused peripheral nerve allografts,but peripheral nerve allografts were loose-sutured(loose-sutured polyethylene glycol)with an intentional gap of 1–2 mm to prevent fusion by polyethylene glycol of peripheral nerve allograft axons with host axons.Similar to negative control peripheral nerve allografts not treated by polyethylene glycol and in contrast to polyethylene glycol-fused peripheral nerve allografts,animals with loose-sutured polyethylene glycol peripheral nerve allografts exhibited Wallerian degeneration for all axons and myelin degeneration by 7 days postoperatively and did not recover sciatic-mediated behavioral functions by 42 days postoperatively.Other morphological signs of rejection,such as collapsed Schwann cell basal lamina tubes,were absent in polyethylene glycol-fused peripheral nerve allografts but commonly observed in negative control and loose-sutured polyethylene glycol peripheral nerve allografts at 21 days postoperatively.Loose-sutured polyethylene glycol peripheral nerve allografts had more pro-inflammatory and less anti-inflammatory macrophages than negative control peripheral nerve allografts.While T cell counts were similarly high in loose-sutured-polyethylene glycol and negative control peripheral nerve allografts,loose-sutured polyethylene glycol peripheral nerve allografts expressed some cytokines/chemokines important for T cell activation at much lower levels at 14 days postoperatively.MHCI expression was elevated in loose-sutured polyethylene glycol peripheral nerve allografts,but MHCII expression was modestly lower compared to negative control at 21 days postoperatively.We conclude that,while polyethylene glycol per se reduces some immune responses of peripheral nerve allografts,successful polyethylene glycol-fusion repair of some axons is necessary to prevent Wallerian degeneration of those axons and immune rejection of peripheral nerve allografts,and produce recovery of sensory/motor functions and voluntary behaviors.Translation of polyethylene glycol-fusion technologies would produce a paradigm shift from the current clinical practice of waiting days to months to repair ablation peripheral nerve injuries. 展开更多
关键词 allograft rejection AXOTOMY macrophage MYELIN nerve repair polyethylene glycol(PEG) sciatic nerve T cell transplantation Wallerian degeneration
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Comparison of resistive index and shear-wave elastography in the evaluation of chronic kidney allograft dysfunction
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作者 Ameet Kumar Jesrani Syed M Faiq +5 位作者 Rahma Rashid Tariq Ali Kalwar Rehan Mohsin Tahir Aziz Nida Amin Khan Muhammed Mubarak 《World Journal of Transplantation》 2024年第1期154-163,共10页
BACKGROUND Detection of early chronic changes in the kidney allograft is important for timely intervention and long-term survival.Conventional and novel ultrasound-based investigations are being increasingly used for ... BACKGROUND Detection of early chronic changes in the kidney allograft is important for timely intervention and long-term survival.Conventional and novel ultrasound-based investigations are being increasingly used for this purpose with variable results.AIM To compare the diagnostic performance of resistive index(RI)and shear wave elastography(SWE)in the diagnosis of chronic fibrosing changes of kidney allograft with histopathological results.METHODS This is a cross-sectional and comparative study.A total of 154 kidney transplant recipients were included in this study,which was conducted at the Departments of Transplantation and Radiology,Sindh Institute of Urology and Transplantation,Karachi,Pakistan,from August 2022 to February 2023.All consecutive patients with increased serum creatinine levels and reduced glomerular filtration rate(GFR)after three months of transplantation were enrolled in this study.SWE and RI were performed and the findings of these were evaluated against the kidney allograft biopsy results to determine their diagnostic utility.RESULTS The mean age of all patients was 35.32±11.08 years.Among these,126(81.8%)were males and 28(18.2%)were females.The mean serum creatinine in all patients was 2.86±1.68 mg/dL and the mean estimated GFR was 35.38±17.27 mL/min/1.73 m2.Kidney allograft biopsy results showed chronic changes in 55(37.66%)biopsies.The sensitivity,specificity,positive predictive value(PPV),and negative predictive value(NPV)of SWE for the detection of chronic allograft damage were 93.10%,96.87%%,94.73%,and 95.87%,respectively,and the diagnostic accuracy was 95.45%.For RI,the sensitivity,specificity,PPV,and NPV were 76.92%,83.33%,70.17%,and 87.62%,respectively,and the diagnostic accuracy was 81.16%.CONCLUSION The results from this study show that SWE is more sensitive and specific as compared to RI in the evaluation of chronic allograft damage.It can be of great help during the routine follow-up of kidney transplant recipients for screening and early detection of chronic changes and selecting patients for allograft biopsy. 展开更多
关键词 Shear wave SONOELASTOGRAPHY Resistive index Chronic allograft changes Biopsy HISTOPATHOLOGY
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Risk scores for allograft failure: Are they still useful in liver recipients from donation after circulatory death?
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作者 Mohamed H Mohamed Chairi Mónica Mogollón González +3 位作者 Jennifer Triguero Cabrera Inmaculada Segura Jiménez Maria T Villegas Herrera Jesús M Villar del Moral 《World Journal of Transplantation》 2024年第4期95-100,共6页
BACKGROUND Liver grafts from donation after circulatory death(DCD)are associated with a higher risk of early graft dysfunction,determined by the warm ischemia and cold ischemia times.It is essential to have precise cr... BACKGROUND Liver grafts from donation after circulatory death(DCD)are associated with a higher risk of early graft dysfunction,determined by the warm ischemia and cold ischemia times.It is essential to have precise criteria to identify this complication in order to guide therapeutic strategies.AIM To validate different graft and recipient survival scores in patients undergoing liver transplantation(LT)with DCD grafts.METHODS A retrospective and observational unicentric study was conducted on 65 LT patients with grafts obtained from controlled DCD donors from November 2013 to November 2022.The United Kingdom(UK)risk score,early allograft dysfunction(EAD)Olthoff score,and model for early allograft function(MEAF)score were used to evaluate the risk of graft and recipient survival post-transplant.For survival analysis purposes,we used the Kaplan-Meier method,and the differences between subgroups were compared using the log-rank(Mantel-Cox)test.RESULTS Sixty-five patients were included in the study.The UK risk score did not demonstrate predictive capacity for recipient or graft survival.However,in donors aged over 70 years old(18.4%),it significantly predicted graft survival(P<0.05).According to Kaplan-Meier survival curves,graft survival rates at 6 months,2 years,and 5 years in the futility group dramatically decreased to 50%compared to the other groups(log-rank 8.806,P<0.05).The EAD Olthoff and MEAF scores did not demonstrate predictive capacity for recipient or graft survival.Based on Kaplan-Meier survival curves,patients with a MEAF score≥7 had a lower graft survival rate at 6 months,2 years,and 5 years compared to patients with a lower MEAF score(log-rank 4.667,P<0.05).CONCLUSION In our series,both UK DCD risk score and MEAF score showed predictive capability for graft survival. 展开更多
关键词 Liver transplantation Donation after circulatory death Early allograft dysfunction Risk scores Graft surviva
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Evolution of human kidney allograft pathology diagnostics through 30 years of the Banff classification process
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作者 Muhammed Mubarak Amber Raza +1 位作者 Rahma Rashid Shaheera Shakeel 《World Journal of Transplantation》 2023年第5期221-238,共18页
The second half of the previous century witnessed a tremendous rise in the number of clinical kidney transplants worldwide.This activity was,however,accompanied by many issues and challenges.An accurate diagnosis and ... The second half of the previous century witnessed a tremendous rise in the number of clinical kidney transplants worldwide.This activity was,however,accompanied by many issues and challenges.An accurate diagnosis and appropriate management of causes of graft dysfunction were and still are,a big challenge.Kidney allograft biopsy played a vital role in addressing the above challenge.However,its interpretation was not standardized for many years until,in 1991,the Banff process was started to fill this void.Thereafter,regular Banff meetings took place every 2 years for the past 30 years.Marked changes have taken place in the interpretation of kidney allograft biopsies,diagnosis,and classification of rejection and other non-rejection pathologies from the original Banff 93 classification.This review attempts to summarize those changes for increasing the awareness and understanding of kidney allograft pathology through the eyes of the Banff process.It will interest the transplant surgeons,physicians,pathologists,and allied professionals associated with the care of kidney transplant patients. 展开更多
关键词 Banff process REJECTION Kidney allograft biopsy Transplant pathology Review
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Renal allograft procurement from living unrelated donors in Iran: What falls under the eclipse
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作者 Saeed Taheri 《World Journal of Transplantation》 2023年第5期250-253,共4页
Renal transplantation is the treatment of choice for end stage kidney disease.However,despite all the efforts to expand the donor pool,the shortage of donors is increasing and as a consequence,there has been a signifi... Renal transplantation is the treatment of choice for end stage kidney disease.However,despite all the efforts to expand the donor pool,the shortage of donors is increasing and as a consequence,there has been a significant increase in the number of patients on transplant waiting lists globally.Societies worldwide have employed different methods to address this,each with specific ethical concerns surrounding them.Over three decades ago,a governmentally regulated program of kidney transplantation from living unrelated donors was introduced in Iran and since practiced which has been the subject of hot debate in the literature.Nevertheless,despite all these extensive discussions and publications,several key aspects of the program have still not been properly elucidated and addressed.In this article,the author aims to illuminate some dark corners related to this issue that have largely escaped the notice of ethicists. 展开更多
关键词 allograft procurement Renal transplantation Living unrelated donor Organ market Iran
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Fibula allograft transplantation combined with locking plate for treatment of recurrent monostotic fibular fibrous dysplasia:A case report
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作者 Lun-Li Xie Xiao Yuan +2 位作者 Hong-Xia Zhu Lei Fu Dan Pu 《World Journal of Clinical Cases》 SCIE 2023年第33期8050-8057,共8页
BACKGROUND Fibrous dysplasia is a congenital disorder in which normal bone is replaced by fibro-osseous tissue or irregular trabeculae of woven bone intermixed with mature collagenous tissue.A single or multiple bones... BACKGROUND Fibrous dysplasia is a congenital disorder in which normal bone is replaced by fibro-osseous tissue or irregular trabeculae of woven bone intermixed with mature collagenous tissue.A single or multiple bones are affected.This rare bone disorder has three clinical patterns including monostotic,polyostotic,and that associated with McCune-Albright syndrome.Most studies report primary fibrous dysplasia.However,a few cases of recurrent monostotic fibular fibrous dysplasia have been reported.Here,we report a therapeutic strategy for recurrent fibular fibrous dysplasia.CASE SUMMARY A 4-year-old boy was admitted for persistent pain in the left lower limb and abnormal gait over the previous 9 mo.He had no history of present or past illness.Preoperative imaging data showed erosion-like changes with bone expansion of the left middle and lower fibular segment.Tumor tissue in the fibular bone marrow cavity was removed by curettage,and rapid intraoperative pathological examination suggested fibular fibrous dysplasia.An allograft was implanted into the fibular medullary cavity.However,he was readmitted with clinical symptoms including persistent pain,abnormal gait,and local swelling at the age of 6 years.He was diagnosed with recurrent fibular fibrous dysplasia based on the second medical examination.He underwent fibular bone tumor radical resection and longus fibular allograft transplantation combined with fibular bone locking plate and screws.Good host bone to allogenic bone graft fusion was observed by the physician on postoperative regular follow-up.CONCLUSION Radical resection of fibrous dysplasia and longus fibula allograft combined with internal fixation for reconstruction are suitable for the treatment of recurrent monostotic fibular fibrous dysplasia. 展开更多
关键词 Recurrent fibrous dysplasia Longus fibula allograft Bone fusion Case report
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Transitioning of renal transplant pathology from allograft to xenograft and tissue engineering pathology:Are we prepared?
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作者 Muhammed Mubarak 《World Journal of Transplantation》 2023年第3期86-95,共10页
Currently,the most feasible and widely practiced option for patients with endstage organ failure is the transplantation of part of or whole organs,either from deceased or living donors.However,organ shortage has posed... Currently,the most feasible and widely practiced option for patients with endstage organ failure is the transplantation of part of or whole organs,either from deceased or living donors.However,organ shortage has posed and is still posing a big challenge in this field.Newer options being explored are xenografts and engineered/bioengineered tissues/organs.Already small steps have been taken in this direction and sooner or later,these will become a norm in this field.However,these developments will pose different challenges for the diagnosis and management of problems as compared with traditional allografts.The approach to pathologic diagnosis of dysfunction in these settings will likely be significantly different.Thus,there is a need to increase awareness and prepare transplant diagnosticians to meet this future challenge in the field of xenotransplantation/regenerative medicine.This review will focus on the current status of transplant pathology and how it will be changed in the future with the emerging scenario of routine xenotransplantation. 展开更多
关键词 XENOTRANSPLANTATION Bioengineered tissues PATHOLOGY allograft XENOGRAFT
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Urine exosome mRNA-based test for monitoring kidney allograft rejection:Effects of sample transportation and storage,and interference substances
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作者 Matt McFaul Chris Ventura +5 位作者 Sean Evans Halil Dundar Marc J Rumpler Christopher McCloskey Dave Lowe Alexandre V Vlassov 《World Journal of Methodology》 2023年第5期492-501,共10页
BACKGROUND Exosomes are 30-150 nm nanovesicles with sophisticated nucleic acids cargo,actively secreted by all cells within human body,and found in abundance in all body fluids,including urine.These extracellular vesi... BACKGROUND Exosomes are 30-150 nm nanovesicles with sophisticated nucleic acids cargo,actively secreted by all cells within human body,and found in abundance in all body fluids,including urine.These extracellular vesicles have tremendous potential for next generation diagnostics,theoretically enabling noninvasive assessment of organ and tissue function via liquid biopsy analysis.AIM Recently,feasibility of an exosomal molecular test was demonstrated for postorgan transplant monitoring:Analysis of urine-derived exosomal mRNA cargo allowed early detection of kidney allograft rejection.Here,we further studied urine-derived exosomes and their mRNA content as a highly promising diagnostic modality.This included stability studies of urine samples and exosomal mRNA upon transportation from the point of collection to a centralized testing facility,short-term storage of urine at different conditions upon receipt till the point molecular assay is performed,and effects of various potentially interfering substances on the downstream quantitative polymerase chain reaction(qPCR)assay.METHODS The urine specimens were stored at various conditions and pre-processed in different ways.Next,samples were passed through the columns to capture all extracellular vesicles,the vesicles were lysed to release their content and the exosomal RNA was purified on the mini-columns,reverse transcription was performed,next pre-amplification,followed by a qPCR analysis for a panel of RESULTS To ensure exosomal RNA integrity,the harvested urine specimens should be shipped refrigerated,by overnight delivery.Urine can next be stored at the test site for up to 1 wk at 4°C,and long term should be frozen at-80°C.Urine specimens must be centrifuge at low G-force to deplete cells and debris,to ensure consistent top results in downstream molecular assays.All commonly used medications(tacrolimus,cyclosporin A,mycophenolic acid,everolimus,sirolimus,ascomycin,teriflunomide)were tested and confirmed that they do not cause assay interference.CONCLUSION mRNA from urine-derived exosomes was shown to be stable across a broad range of conditions and produced accurate results when analyzed via qPCR assay for detection of kidney allograft rejection.We identified the most optimal conditions for every step of the process,ensuring pre-analytical sample integrity and robust qPCR results. 展开更多
关键词 Kidney allograft Post-transplant monitoring Liquid biopsy EXOSOME MRNA Quantitative polymerase chain reaction
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琥珀酰化修饰对马氏珠母贝植核免疫的影响
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作者 梁海鹰 陈洁 张美珍 《广东海洋大学学报》 CAS CSCD 北大核心 2024年第2期39-45,共7页
【目的】研究蛋白质琥珀酰化修饰在马氏珠母贝(Pinctada fucata martensii)植核后免疫应答中的作用,为阐明珍珠贝植核反应的分子调控机制提供理论依据。【方法】通过对马氏珠母贝注射琥珀酸钠模拟提高琥珀酰化修饰水平,检测马氏珠母贝... 【目的】研究蛋白质琥珀酰化修饰在马氏珠母贝(Pinctada fucata martensii)植核后免疫应答中的作用,为阐明珍珠贝植核反应的分子调控机制提供理论依据。【方法】通过对马氏珠母贝注射琥珀酸钠模拟提高琥珀酰化修饰水平,检测马氏珠母贝植核后鳃组织总蛋白琥珀酰化程度、免疫相关基因表达、抗氧化相关酶酶活以及珍珠贝的存活率和留核率。【结果与结论】注射琥珀酸钠后,鳃组织琥珀酰化修饰水平在12 h和72 h显著上升;使用实时荧光定量PCR检测胁迫应激相关基因的时序表达,胁迫应激相关因子SOD和Caspase2在6 h表达量显著上调,NF-κB和IRAK1在48 h表达量显著上调,TRAF3和IκK的表达量在96 h显著上调(P <0.05),表明琥珀酰化修饰水平提高后受体贝机体细胞免疫增强;抗氧化相关酶、过氧化物酶和谷胱甘肽活性都在96 h出现显著上调(P <0.05),表明受体贝体液免疫增强。与对照组[磷酸盐缓冲溶液(PBS)+植核]和植核组相比,实验组(琥珀酸钠+植核)中珍珠贝的存活率在7 d和45 d存在显著差异,在60 d留核率显著上升(P <0.05)。结果说明,琥珀酰化修饰参与了马氏珠母贝的植核免疫反应,注射琥珀酸钠可以提高受体贝的免疫活力,并提高其在植核后的存活率和留核率。 展开更多
关键词 马氏珠母贝 植核免疫 琥珀酰化修饰 琥珀酸钠
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自体髂骨和同种异体骨植入治疗SchatzkerⅡ型胫骨平台骨折的疗效比较
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作者 庞涛 郭燕芬 陈纪宝 《中国现代药物应用》 2024年第1期56-59,共4页
目的 比较SchatzkerⅡ型胫骨平台骨折应用自体髂骨和同种异体骨植入治疗的临床疗效。方法 74例SchatzkerⅡ型胫骨平台骨折患者,按手术植骨治疗方法不同分为自体髂骨组和异体骨组,各37例。两组均采用胫骨近端外侧锁定钢板内固定,自体髂... 目的 比较SchatzkerⅡ型胫骨平台骨折应用自体髂骨和同种异体骨植入治疗的临床疗效。方法 74例SchatzkerⅡ型胫骨平台骨折患者,按手术植骨治疗方法不同分为自体髂骨组和异体骨组,各37例。两组均采用胫骨近端外侧锁定钢板内固定,自体髂骨组胫骨平台塌陷处植入自体髂骨,异体骨组胫骨平台塌陷处植入异体骨。比较两组手术相关指标,术后3、6个月的美国特种外科医院(HSS)评分及膝关节屈曲活动度,并发症发生情况。结果 自体髂骨组术中出血量(62.70±3.34)ml多于异体骨组的(44.50±3.03)ml,手术时间(86.50±5.87)min、骨折愈合时间(18.40±3.20)周长于异体骨组的(77.30±2.98)min、(14.80±2.29)周,差异有统计学意义(P<0.05)。两组术后3、6个月的HSS评分比较,差异无统计学意义(P>0.05)。两组术后3、6个月的膝关节屈曲活动度比较,差异无统计学意义(P>0.05)。异体骨组并发症发生率为5.4%(2/37),与自体髂骨组的8.1(3/37)比较,差异无统计学意义(P>0.05)。结论 同种异体骨较自体髂骨在骨折愈合时间、手术时间、出血量方面相对具有优势,但在术后膝关节功能、膝关节活动度方面效果相当,说明同种异体骨与自体髂骨植骨治疗schatkzerⅡ型胫骨平台骨折各有优势,可根据患者具体情况进行手术的选择。 展开更多
关键词 SchatzkerⅡ型胫骨平台骨折 自体髂骨 同种异体骨 植骨 锁定钢板
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小鼠颈部同种异体心脏移植模型学习曲线分析
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作者 王辉 刘一纬 +2 位作者 刘圆 杨鹏杰 梁越 《外科研究与新技术》 2024年第1期7-12,共6页
目的探讨小鼠颈部同种异体心脏移植模型建立的学习曲线特点。方法回顾性分析课题组行60只小鼠颈部同种异体心脏移植模型制备的资料,分别记录手术过程中移植总时间、受体准备时间、供体准备时间、动静脉套管制成时间、供体心血管连接时间... 目的探讨小鼠颈部同种异体心脏移植模型建立的学习曲线特点。方法回顾性分析课题组行60只小鼠颈部同种异体心脏移植模型制备的资料,分别记录手术过程中移植总时间、受体准备时间、供体准备时间、动静脉套管制成时间、供体心血管连接时间,采用累积和(CUSUM)分析法及最佳拟合曲线获取各阶段移植手术的学习曲线中渡过学习期所需最小手术样本数。以学习曲线最长手术阶段的最小手术样本数作为界限将小鼠分为学习阶段组和成熟阶段组,比较各组手术时间及手术失败率的差异。结果60只小鼠完成颈部心脏移植,移植总时间为(119.80±43.17)min,受体准备时间为(76.43±26.46)min,供体准备时间为(29.85±9.82)min,动静脉套管制成时间为(32.10±21.62)min,供体心血管连接时间为(17.47±8.43)min。对CUSUM学习曲线进行拟合,采用三次方时拟合度最高,各阶段手术时间学习曲线所对应的最小手术样本数依次是受体手术25,供体手术19,动静脉套管制成29,供体心血管连接24,手术全过程25。以学习曲线最长的手术阶段(动脉套管制成)的最小样本数29为分界点分为两组,与学习阶段组相比,成熟阶段组移植总时间[(156.80±32.80)min对(85.06±9.45)min]、受体准备时间[(95.41±18.89)min对(50.94±7.45)min]、供体准备时间[(37.03±9.51)min对(23.13±2.95)min]、动静脉套管制成时间[(50.41±16.65)min对(14.97±5.74)min]、供体心血管连接时间[(24.38±7.16)min对(11.00±1.55)min],均明显减少,差异有统计学意义(P<0.01)。成熟阶段组手术失败率较学习阶段组明显降低(48.28%对9.68%,P=0.0013)。结论建立小鼠颈部同种异体心脏移植模型的学习曲线在各手术阶段略有差异,手术样本数达29以后技术基本成熟。手术技术成熟后手术时间及成功率都会有明显改善。 展开更多
关键词 小鼠颈部同种异体心脏移植 学习曲线 累积和分析法 最佳拟合曲线
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移植物类型对前交叉韧带重建后患者膝关节功能的影响 被引量:1
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作者 李露祎 厉晓杰 +1 位作者 黑泽明 刘华 《中国组织工程研究》 CAS 北大核心 2024年第17期2753-2758,共6页
背景:临床上常采用移植物重建前交叉韧带,而不同移植物类型又影响着患者术后膝关节功能和康复方案的制定。目的:回顾分析不同移植物类型对前交叉韧带重建后患者肌力、关节稳定性、功能性活动及重返运动的影响。方法:在PubMed、Web of Sc... 背景:临床上常采用移植物重建前交叉韧带,而不同移植物类型又影响着患者术后膝关节功能和康复方案的制定。目的:回顾分析不同移植物类型对前交叉韧带重建后患者肌力、关节稳定性、功能性活动及重返运动的影响。方法:在PubMed、Web of Science、Cochrane、中国知网、万方数据库中进行检索,中文检索词为“前交叉韧带重建术,自体移植物,同种异体移植物,人工韧带,骨-髌腱-骨,股四头肌肌腱,腘绳肌肌腱,腓骨长肌肌腱,康复训练,重返运动”;英文检索词为“anterior cruciate ligament reconstruction,autografts,allografts,artificial ligaments,bone-patellatendon-bone,quadriceps tendon autograft,hamstring tendon autograft,peroneus longus tendon autograft,rehabilitation,exercise,protocol,return to sport”。结果与结论:选用骨-髌腱-骨移植物的患者应加强股四头肌离心收缩练习,康复后期应关注股四头肌耐力和爆发力的恢复。与骨-髌腱-骨移植物和腘绳肌肌腱移植物相比,选用股四头肌肌腱移植物的患者在5-8个月内符合回归标准的患者明显更少,应制定较长时间的训练计划,训练周期尽量持续到3年以上。选用腘绳肌肌腱移植物应强化多角度下腘绳肌力量训练,尤其是屈膝60°以上的周期至少持续至术后18周。选用腓骨长肌肌腱移植物的患者后续应加强踝关节周围肌肉力量,以足底肌肉力量为主。选用同种异体移植物应注意移植物经低剂量辐射消毒后其抗张力性降低20%,因此应关注膝关节稳定性训练。选用人工韧带移植物的患者3-6周内可渐进性增强股四头肌和腘绳肌力量训练,重视早期本体感觉练习,对平衡、跳跃及灵活性进行针对性训练。 展开更多
关键词 前交叉韧带重建 自体移植物 同种异体移植物 人工韧带 康复 膝关节功能
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膝前交叉韧带重建10年后自体和同种异体移植物成熟度及术后临床效果分析
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作者 崔勇 杨靖琦 +3 位作者 王建朝 邵德成 陈百成 张晓阳 《中国运动医学杂志》 CAS CSCD 北大核心 2024年第3期175-180,共6页
目的:评估并比较膝前交叉韧带重建10年后自体和异体移植物成熟度及术后临床效果。方法:对64名前交叉韧带重建的患者进行平均约10年的回顾性分析。其中自体移植物36例(56.2%),同种异体移植物28例(43.8%),记录两组患者的膝关节Lysholm评分... 目的:评估并比较膝前交叉韧带重建10年后自体和异体移植物成熟度及术后临床效果。方法:对64名前交叉韧带重建的患者进行平均约10年的回顾性分析。其中自体移植物36例(56.2%),同种异体移植物28例(43.8%),记录两组患者的膝关节Lysholm评分、IKDC主观评分和稳定性试验结果(KT-1000侧-侧差值、Lachman试验),并通过膝关节磁共振成像(MRI)扫描,记录两种移植物的成熟度[信噪比(SNQ)]、对两组患者的上述指标进行对比分析。结果:术后平均随访时间自体移植物组为10.1±2.1年,同种异体移植物组为10.5±1.8年,两组间差异无统计学意义(P=0.376);SNQ值自体移植物组为24.1±8.8,同种异体移植物组为23.2±8.7,两组间差异无统计学意义(P=0.652);Lysholm评分自体移植物组为90±10.3分,同种异体移植物组为89.4±8.9分,两组间差异无统计学意义(P=0.805);IKDC评分自体移植物组(84.5±8.3分)高于同种异体移植物组(80.4±7.8分),但两组间差异无统计学意义(P=0.075);KT1000测量韧带紧张度异常的发生率,同种异体移植物组(14.3%)高于自体移植物组(8.3%),但差异无统计学意义(P=0.724);两组患者术后随访时的关节前向稳定性差异无统计学意义(P=0.923);自体移植物组中2例发生ACL再撕裂(5.6%),同种异体移植物组为2例(7.1%),两组间差异无统计学意义(P=0.795)。结论:在ACLR术后平均10年的患者中,使用自体或同种异体移植物的两组患者的移植物成熟度差异无统计学意义,两组间的临床效果、关节稳定性差异无统计学意义,移植物再撕裂率相当。 展开更多
关键词 前交叉韧带 信噪比 腘绳肌腱 同种异体肌腱 临床效果
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Use of machine learning models for the prognostication of liver transplantation: A systematic review 被引量:2
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作者 Gidion Chongo Jonathan Soldera 《World Journal of Transplantation》 2024年第1期164-188,共25页
BACKGROUND Liver transplantation(LT)is a life-saving intervention for patients with end-stage liver disease.However,the equitable allocation of scarce donor organs remains a formidable challenge.Prognostic tools are p... BACKGROUND Liver transplantation(LT)is a life-saving intervention for patients with end-stage liver disease.However,the equitable allocation of scarce donor organs remains a formidable challenge.Prognostic tools are pivotal in identifying the most suitable transplant candidates.Traditionally,scoring systems like the model for end-stage liver disease have been instrumental in this process.Nevertheless,the landscape of prognostication is undergoing a transformation with the integration of machine learning(ML)and artificial intelligence models.AIM To assess the utility of ML models in prognostication for LT,comparing their performance and reliability to established traditional scoring systems.METHODS Following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines,we conducted a thorough and standardized literature search using the PubMed/MEDLINE database.Our search imposed no restrictions on publication year,age,or gender.Exclusion criteria encompassed non-English studies,review articles,case reports,conference papers,studies with missing data,or those exhibiting evident methodological flaws.RESULTS Our search yielded a total of 64 articles,with 23 meeting the inclusion criteria.Among the selected studies,60.8%originated from the United States and China combined.Only one pediatric study met the criteria.Notably,91%of the studies were published within the past five years.ML models consistently demonstrated satisfactory to excellent area under the receiver operating characteristic curve values(ranging from 0.6 to 1)across all studies,surpassing the performance of traditional scoring systems.Random forest exhibited superior predictive capabilities for 90-d mortality following LT,sepsis,and acute kidney injury(AKI).In contrast,gradient boosting excelled in predicting the risk of graft-versus-host disease,pneumonia,and AKI.CONCLUSION This study underscores the potential of ML models in guiding decisions related to allograft allocation and LT,marking a significant evolution in the field of prognostication. 展开更多
关键词 Liver transplantation Machine learning models PROGNOSTICATION allograft allocation Artificial intelligence
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Association of donor hepatectomy time with liver transplantation outcomes: A multicenter retrospective study 被引量:1
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作者 Geisiane Custodio Andrew Maykon Massutti +6 位作者 Aline Caramori Taynara Gonçalves Pereira Augusto Dalazen Gabriela Scheidt Ludmilla Thomazini Cristiane Bauermann Leitão Tatiana Helena Rech 《World Journal of Transplantation》 2024年第1期130-140,共11页
BACKGROUND Prolonged donor hepatectomy time may be implicated in early and late complications of liver transplantation.AIM To evaluate the impact of donor hepatectomy time on outcomes of liver transplant recipients,ma... BACKGROUND Prolonged donor hepatectomy time may be implicated in early and late complications of liver transplantation.AIM To evaluate the impact of donor hepatectomy time on outcomes of liver transplant recipients,mainly early allograft dysfunction.METHODS This multicenter retrospective study included brain-dead donors and adult liver graft recipients.Donor-recipient matching was obtained through a crossover list.Clinical and laboratory data were recorded for both donors and recipients.Donor hepatectomy,cold ischemia,and warm ischemia times were recorded.Primary outcome was early allograft dysfunction.Secondary outcomes included need for retransplantation,length of intensive care unit and hospital stay,and patient and graft survival at 12 months.RESULTS From January 2019 to December 2021,a total of 243 patients underwent a liver transplant from a brain-dead donor.Of these,57(25%)developed early allograft dysfunction.The median donor hepatectomy time was 29(23–40)min.Patients with early allograft dysfunction had a median hepatectomy time of 25(22–38)min,whereas those without it had a median time of 30(24–40)min(P=0.126).CONCLUSION Donor hepatectomy time was not associated with early allograft dysfunction,graft survival,or patient survival following liver transplantation. 展开更多
关键词 Brain death HEPATECTOMY Liver transplantation Early allograft dysfunction Graft survival
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同种异体带瓣管道的研究进展
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作者 刘子钰 杨斌 郭志坤 《解剖学杂志》 CAS 2024年第4期348-351,共4页
根治复杂性心瓣膜病需采用心外管道,目前心外管道有人工材料、同种异体带瓣管道(VHC)及异种带瓣管道。VHC具有符合人体的抗钙化、抗感染和无需终生抗凝等生理特点,然而VHC仍存在供体短缺和无法长期保存等问题,导致其无法被大力推广,但... 根治复杂性心瓣膜病需采用心外管道,目前心外管道有人工材料、同种异体带瓣管道(VHC)及异种带瓣管道。VHC具有符合人体的抗钙化、抗感染和无需终生抗凝等生理特点,然而VHC仍存在供体短缺和无法长期保存等问题,导致其无法被大力推广,但深低温保存技术有望解决长期保存这一问题。笔者综述了VHC供体的筛选、保存方法及其临床应用的研究进展,为VHC在临床上对左、右心室流出道的重建提供参考。 展开更多
关键词 同种异体带瓣管道 脱细胞 低温保存
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常规超声联合瞬时弹性成像预测肝移植患者早期同种异体移植物功能障碍的临床价值
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作者 杨子祯 王艺颖 +2 位作者 吴晓冬 蔡金贞 王建红 《临床超声医学杂志》 CSCD 2024年第2期120-124,共5页
目的 探讨常规超声联合瞬时弹性成像预测肝移植患者早期同种异体移植物功能障碍(EAD)的临床价值。方法 回顾性分析我院37例脑死亡器官捐献(DBD)供者肝脏(以下简称供肝)影像学资料,所有供肝移植前均行常规超声及瞬时弹性成像检查获取超... 目的 探讨常规超声联合瞬时弹性成像预测肝移植患者早期同种异体移植物功能障碍(EAD)的临床价值。方法 回顾性分析我院37例脑死亡器官捐献(DBD)供者肝脏(以下简称供肝)影像学资料,所有供肝移植前均行常规超声及瞬时弹性成像检查获取超声分级、受控衰减参数(CAP)、肝脏硬度值(LS),根据相应受者术后1周内是否发生EAD将其分为EAD组17例和非EAD组20例,比较两组供肝超声分级、CAP及LS的差异。绘制受试者工作特征(ROC)曲线分析供肝超声分级、CAP、LS单独及联合预测肝移植患者EAD的诊断效能。结果 EAD组供肝CAP、LS及超声分级均高于非EAD组,差异均有统计学意义(均P<0.05)。ROC曲线分析显示,供肝CAP、LS、超声分级截断值分别为206 dB/m、5.5 kPa、3.5级时,预测肝移植患者EAD的曲线下面积(AUC)分别为0.854、0.729、0.762,供肝超声分级联合CAP、LS预测肝移植患者EAD的AUC最高,为0.888,与供肝超声分级、LS的AUC比较差异均有统计学意义(均P<0.05);其余两两比较差异均无统计学意义。结论 常规超声联合瞬时弹性成像在预测肝移植患者EAD中有一定的临床价值。 展开更多
关键词 超声检查 瞬时弹性成像 超声分级 肝移植 早期同种异体移植物功能障碍
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异体移植炎症因子1对草鱼白细胞活力及炎性因子释放的影响
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作者 王祎琳 伍迎欢 赵燕英 《水产学报》 CAS CSCD 北大核心 2024年第3期154-161,共8页
为了阐明草鱼异体移植炎症因子1在宿主免疫应答中的作用,实验采用蛋白质免疫印迹(Western blot)检测了脂多糖刺激后草鱼外周血白细胞分泌异体移植炎症因子1的水平。将不同浓度草鱼异体移植炎症因子1重组蛋白加入到外周血白细胞培养液中... 为了阐明草鱼异体移植炎症因子1在宿主免疫应答中的作用,实验采用蛋白质免疫印迹(Western blot)检测了脂多糖刺激后草鱼外周血白细胞分泌异体移植炎症因子1的水平。将不同浓度草鱼异体移植炎症因子1重组蛋白加入到外周血白细胞培养液中。48 h后,利用CCK-8试剂盒检测白细胞增殖,流式细胞仪检测细胞凋亡,活性氧和一氧化氮试剂盒检测细胞氧自由基和一氧化氮水平,ATP试剂盒和线粒体膜电位试剂盒检测线粒体功能状态,ELISA试剂盒检测肿瘤坏死因子α、白细胞介素1β和白细胞介素6释放。结果显示,脂多糖刺激了草鱼外周血白细胞异体移植炎症因子1的分泌,而过量的异体移植炎症因子1诱导了白细胞增殖,通过改善线粒体膜电位,增强了ATP的产生,从而抑制细胞凋亡。同时异体移植炎症因子1激发了白细胞产生炎性介质活性氧和一氧化氮及释放炎性细胞因子肿瘤坏死因子α、白细胞介素1β和白细胞介素6。本研究表明,草鱼异体移植炎症因子1增强了白细胞活力和炎性因子的释放。本实验首次证实草鱼异体移植炎症因子1是一个新的免疫细胞因子,参与了宿主细胞的免疫应答,同时阐明了异体移植炎症因子1诱导草鱼白细胞增殖并抑制其凋亡,且促进白细胞释放炎性因子,从而增强草鱼对外源物质的免疫抵抗作用,为草鱼免疫应答相关的研究提供了新的思路。 展开更多
关键词 草鱼 异体移植炎症因子1 白细胞活力 炎症因子
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