Patients with chronic hepatitis C virus （HCV） infection have a significantly increased prevalence of type 2 diabetes mellitus compared to controls or HBV-infected patients. Moreover, the incidence rate of post-liver...Patients with chronic hepatitis C virus （HCV） infection have a significantly increased prevalence of type 2 diabetes mellitus compared to controls or HBV-infected patients. Moreover, the incidence rate of post-liver transplantation diabetes mellitus （PTDM） also appears to be higher among patients wibh HCM infection. PTDM is often assodated with direct viral infection, autoimmune disorders, and immunosuppressive regimen. Activation of tumor necrosis factor-α may be the link between HCV infection and diabetes. In this article, we reviewed the epidemiologic association between HCV infection and PTDM, highlighting the most recent pathophysiologic insights into the mechanisms underlying this association.展开更多
To the Editor:Hemolysis,which is caused by a variety of immune and non-immune mechanisms,is a well-recognized complication of solid organ transplantation.;Hemolysis post-liver transplantation can be induced by drug,in...To the Editor:Hemolysis,which is caused by a variety of immune and non-immune mechanisms,is a well-recognized complication of solid organ transplantation.;Hemolysis post-liver transplantation can be induced by drug,infection,autoimmune disorders,blood-group incompatible展开更多
BACKGROUND： The prognostic prediction of liver transplantation（LT） guides the donor organ allocation. However, there is currently no satisfactory model to predict the recipients’ outcome, especially for the patien...BACKGROUND： The prognostic prediction of liver transplantation（LT） guides the donor organ allocation. However, there is currently no satisfactory model to predict the recipients’ outcome, especially for the patients with HBV cirrhosis-related hepatocellular carcinoma（HCC）. The present study was to develop a quantitative assessment model for predicting the post-LT survival in HBV-related HCC patients.METHODS： Two hundred and thirty-eight LT recipients at the Liver Transplant Center, First Affiliated Hospital, Zhejiang University School of Medicine between 2008 and 2013 were included in this study. Their post-LT prognosis was recorded and multiple risk factors were analyzed using univariate and multivariate analyses in Cox regression.RESULTS： The score model was as follows： 0.114×（Child-Pugh score）-0.002×（positive HBV DNA detection time）＋0.647×（number of tumor nodules）＋0.055×（max diameter of tumor nodules）＋0.231×ln AFP＋0.437×（tumor differentiation grade）.The receiver operating characteristic curve analysis showed that the area under the curve of the scoring model for predicting the post-LT survival was 0.887. The cut-off value was 1.27, which was associated with a sensitivity of 72.5% and a specificity of 90.7%, respectively.CONCLUSION： The quantitative score model for predicting post-LT survival proved to be sensitive and specific.展开更多
Hepatocellular carcinoma(HCC)is one of the most common indications for liver transplantation(LT).With expanding criteria and increasing number of transplants,post-transplant recurrence of HCC remains an important caus...Hepatocellular carcinoma(HCC)is one of the most common indications for liver transplantation(LT).With expanding criteria and increasing number of transplants,post-transplant recurrence of HCC remains an important cause for concern and portends a poor survival in these patients.Traditionally,HCC recurrence post-LT has been notoriously difficult to manage and their outcomes dismal.A better understanding of the tumour biology and its interplay with the immune system,combined with newer oncological interventions has allowed for improved survivals in these patients.A useful classification of HCC recurrence is where it is divided into oligo-recurrence and disseminated recurrence.This system helps strategize their multi-disciplinary management algorithm and prognosticate outcomes.We provide an overview of the factors which may predict recurrence and summarise the current evidence on the management of post-LT HCC recurrence.展开更多
文摘Patients with chronic hepatitis C virus （HCV） infection have a significantly increased prevalence of type 2 diabetes mellitus compared to controls or HBV-infected patients. Moreover, the incidence rate of post-liver transplantation diabetes mellitus （PTDM） also appears to be higher among patients wibh HCM infection. PTDM is often assodated with direct viral infection, autoimmune disorders, and immunosuppressive regimen. Activation of tumor necrosis factor-α may be the link between HCV infection and diabetes. In this article, we reviewed the epidemiologic association between HCV infection and PTDM, highlighting the most recent pathophysiologic insights into the mechanisms underlying this association.
基金supported by a grant from the Natural Science Foundation of Hunan Province(2016JJ4105)
文摘To the Editor:Hemolysis,which is caused by a variety of immune and non-immune mechanisms,is a well-recognized complication of solid organ transplantation.;Hemolysis post-liver transplantation can be induced by drug,infection,autoimmune disorders,blood-group incompatible
基金supported by grants from National S&T Major Project(2012ZX10002017)the Foundation for Innovative Research Groups of the National Natural Science Foundation of China(81121002)the National Natural Science Foundation of China(81200331)
文摘BACKGROUND： The prognostic prediction of liver transplantation（LT） guides the donor organ allocation. However, there is currently no satisfactory model to predict the recipients’ outcome, especially for the patients with HBV cirrhosis-related hepatocellular carcinoma（HCC）. The present study was to develop a quantitative assessment model for predicting the post-LT survival in HBV-related HCC patients.METHODS： Two hundred and thirty-eight LT recipients at the Liver Transplant Center, First Affiliated Hospital, Zhejiang University School of Medicine between 2008 and 2013 were included in this study. Their post-LT prognosis was recorded and multiple risk factors were analyzed using univariate and multivariate analyses in Cox regression.RESULTS： The score model was as follows： 0.114×（Child-Pugh score）-0.002×（positive HBV DNA detection time）＋0.647×（number of tumor nodules）＋0.055×（max diameter of tumor nodules）＋0.231×ln AFP＋0.437×（tumor differentiation grade）.The receiver operating characteristic curve analysis showed that the area under the curve of the scoring model for predicting the post-LT survival was 0.887. The cut-off value was 1.27, which was associated with a sensitivity of 72.5% and a specificity of 90.7%, respectively.CONCLUSION： The quantitative score model for predicting post-LT survival proved to be sensitive and specific.
文摘Hepatocellular carcinoma(HCC)is one of the most common indications for liver transplantation(LT).With expanding criteria and increasing number of transplants,post-transplant recurrence of HCC remains an important cause for concern and portends a poor survival in these patients.Traditionally,HCC recurrence post-LT has been notoriously difficult to manage and their outcomes dismal.A better understanding of the tumour biology and its interplay with the immune system,combined with newer oncological interventions has allowed for improved survivals in these patients.A useful classification of HCC recurrence is where it is divided into oligo-recurrence and disseminated recurrence.This system helps strategize their multi-disciplinary management algorithm and prognosticate outcomes.We provide an overview of the factors which may predict recurrence and summarise the current evidence on the management of post-LT HCC recurrence.
文摘目的探讨低病毒载量乙肝肝癌人群发生肝切除术后肝衰(post-hepatectomy liver failure,PHLF)的影响因素,并构建风险预测模型。方法选择2015年1月1日至2023年3月1日在陆军军医大学第一附属医院麻醉科首次接受肝切除术的403例低病毒载量乙肝肝癌患者作为研究对象,按照7:3比例采用简单随机抽样法分为训练集和验证集,通过Lasso回归和多因素Logistic回归分析筛选PHLF发生的影响因素并建立列线图预测模型。通过多种指标对模型的性能进行评估,包括受试者工作特征曲线下面积(area under the receiver operating characteristic curve,AUC)、校准曲线、决策曲线分析和临床影响曲线分析。结果本研究确定抗病毒治疗史、饮酒史、乙肝表面抗原值及国际标准化比值为低病毒载量乙肝肝癌人群发生PHLF的独立影响因素。基于上述指标建立的预测模型在训练集和验证集中表现出卓越的区分能力,AUC值分别为0.744(95%CI:0.671~0.818)和0.737(95%CI:0.599~0.876)。校准曲线显示出模型的高准确性(训练集:P=0.995;验证集:P=0.701),决策曲线分析和临床影响曲线分析均表明模型提供了更大的临床益处。结论本研究建立的预测模型能够有效评估低病毒载量乙肝肝癌人群发生PHLF的风险,具有良好的预测性能,对及时识别高危人群具有一定的指导意义。
