Liver Transplantation 2023: Status Report, Current and Future Challenges

Terrault, Norah A.; Francoz, Claire; Berenguer, Marina; Charlton, Michael; Heimbach, Julie K.

doi:10.1016/j.cgh.2023.04.005

Cited by 79 publications

(41 citation statements)

References 167 publications

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“…1−3 In clinical practice, there is currently no effective treatment available for liver cirrhosis except for liver transplantation. 4,5 Therefore, there is a strong need for curative interventions in the cirrhosis process (Scheme 1).…”

Section: Introductionmentioning

confidence: 99%

“…Liver disease is a major global health issue, with 2 million deaths occurring each year, accounting for 4% of all global deaths. As the end stage of chronic liver disease, cirrhosis and its complications contribute to more than half of this mortality, causing significant clinical and economic burden around the world. − In clinical practice, there is currently no effective treatment available for liver cirrhosis except for liver transplantation. , Therefore, there is a strong need for curative interventions in the cirrhosis process (Scheme ).…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Dual-Targeting Macrophages and Hepatic Stellate Cells by Modified Albumin Nanoparticles for Liver Cirrhosis Treatment

Tan,

Wang,

Guo

et al. 2024

ACS Appl. Mater. Interfaces

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Hepatic cirrhosis has become a global public health concern with high mortality and currently lacks effective clinical treatment methods. Activation of hepatic stellate cells (HSCs) and the large number of macrophages infiltrating into the liver play a critical role in the development of liver cirrhosis. This study developed a novel modified nanoparticle system (SRF-CS-PSA NPs) in which Sorafenib (SRF) was encapsulated by palmitic acid-modified albumin (PSA) and further modified with chondroitin sulfate (CS). These modifications enabled the SRF-CS-PSA NPs to effectively target hepatic stellate cells (HSCs) and macrophages. SRF-CS-PSA NPs showed uniform particle size distribution of approximately 120 nm and high loading efficiency of up to 99.5% and can be taken up by HSCs and macrophages via CD44 and SR-A receptors, respectively. In a mouse model of liver cirrhosis, SRF-CS-PSA NPs demonstrated superior targeting and inhibition of HSCs and macrophages, effectively reversing the process of liver cirrhosis. Overall, our study demonstrates the potential of SRF-CS-PSA NPs as a targeted therapy for liver cirrhosis, with promising clinical applications.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Dual-Targeting Macrophages and Hepatic Stellate Cells by Modified Albumin Nanoparticles for Liver Cirrhosis Treatment

Tan,

Wang,

Guo

et al. 2024

ACS Appl. Mater. Interfaces

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“…The one-year patient survival rates for adults and children after primary liver transplantation were 94% and 94.4%, respectively [6], and the short-term patient survival rates were not significantly different between patients treated with LDLT and DDLT [7]. The survival rate following transplantation has significantly improved due to advancements in surgery and the development of immunosuppressive agents [8][9][10]. Acute cellular rejection (ACR) manifests as the sudden decrease of allograft function and inflammation in portal, bile duct, and portal veins, and generally occurs from 5 to 30 days after liver transplantation [11][12][13][14].…”

Section: Introductionmentioning

confidence: 99%

Usefulness of Diffusion-Weighted Imaging in Evaluating Acute Cellular Rejection and Monitoring Treatment Response in Liver Transplant Recipients

Chiang,

Chuang,

et al. 2024

Diagnostics

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Acute cellular rejection (ACR) is a significant immune issue among recipients following liver transplantation. Although diffusion-weighted magnetic resonance imaging (DWI) is widely used for diagnosing liver disease, it has not yet been utilized for monitoring ACR in patients after liver transplantation. Therefore, the aim of this study was to evaluate the efficacy of DWI in monitoring treatment response among recipients with ACR. This study enrolled 25 recipients with highly suspected ACR rejection, and all subjects underwent both biochemistry and DWI scans before and after treatment. A pathological biopsy was performed 4 to 24 h after the first MRI examination to confirm ACR and degree of rejection. All patients were followed up and underwent a repeated MRI scan when their liver function returned to the normal range. After data acquisition, the DWI data were post-processed to obtain the apparent diffusion coefficient (ADC) map on a voxel-by-voxel basis. Five regions of interest were identified on the liver parenchyma to measure the mean ADC values from each patient. Finally, the mean ADC values and biochemical markers were statistically compared between ACR and non-ACR groups. A receiver operating characteristic (ROC) curve was constructed to evaluate the performance of the ADC and biochemical data in detecting ACR, and correlation analysis was used to understand the relationship between the ADC values, biochemical markers, and the degree of rejection. The histopathologic results revealed that 20 recipients had ACR, including 10 mild, 9 moderate, and 1 severe rejection. The results demonstrated that the ACR patients had significantly lower hepatic ADC values than those in patients without ACR. After treatment, the hepatic ADC values in ACR patients significantly increased to levels similar to those in non-ACR patients with treatment. The ROC analysis showed that the sensitivity and specificity for detecting ACR were 80% and 95%, respectively. Furthermore, the correlation analysis revealed that the mean ADC value and alanine aminotransferase level had strong and moderate negative correlation with the degree of rejection, respectively (r = −0.72 and −0.47). The ADC values were useful for detecting hepatic ACR and monitoring treatment response after immunosuppressive therapy.

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“…Two donor sources are used: living and deceased. In the Western world, deceased donor transplants exceed 90%, while in many Asian countries, living donors contribute to 24% of global LTx in 2022 9 . By 2022, the Global Observatory on Donation and Transplantation (GODT) reported 37,436 LTx surgeries, an 8% increase from 2021 10 .…”

Section: Introductionmentioning

confidence: 99%

Evaluation of liver transplantation services in Kazakhstan from 2012 to 2023

Semenova,

Beyembetova,

Shaisultanova

et al. 2024

Sci Rep

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There is a scarcity of publications evaluating the performance of the national liver transplantation (LTx) program in Kazakhstan. Spanning from 2012 to 2023, it delves into historical trends in LTx surgeries, liver transplant centers, and the national cohort of patients awaiting LTx. Survival analysis for those awaiting LTx, using life tables and Kaplan–Meier, is complemented by time series analysis projecting developments until 2030. The overall per million population (pmp) LTx rate varied from 0.35 to 3.77, predominantly favoring living donor LTx. Liver transplant center rates ranged from 0.06 to 0.40. Of 474 LTx patients, 364 on the waiting list did not receive transplantation. The 30-day and 1-year survival rates on the waiting list were 87.0% and 68.0%, respectively. Viral hepatitis and cirrhosis prevalence steadily rose from 2015 to 2023, with projections indicating a persistent trend until 2030. Absent targeted interventions, stable pmp rates of LTx and liver transplant centers may exacerbate the backlog of unoperated patients. This study sheds light on critical aspects of the LTx landscape in Kazakhstan, emphasizing the urgency of strategic interventions to alleviate the burden on patients awaiting transplantation.

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Liver Transplantation 2023: Status Report, Current and Future Challenges

Cited by 79 publications

References 167 publications

Dual-Targeting Macrophages and Hepatic Stellate Cells by Modified Albumin Nanoparticles for Liver Cirrhosis Treatment

Dual-Targeting Macrophages and Hepatic Stellate Cells by Modified Albumin Nanoparticles for Liver Cirrhosis Treatment

Usefulness of Diffusion-Weighted Imaging in Evaluating Acute Cellular Rejection and Monitoring Treatment Response in Liver Transplant Recipients

Evaluation of liver transplantation services in Kazakhstan from 2012 to 2023

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