فهرست مطالب

International Journal of Organ Transplantation Medicine
Volume:15 Issue: 1, Winter 2024
- تاریخ انتشار: 1403/11/14
- تعداد عناوین: 6
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Pages 9-18Background
Chemokines seriously affecting immune responses to viral infections and allograft rejections.
ObjectiveTherefore, the current study aims to evaluate the expression levels of CXCLs and CXCR3 in liver transplanted (LT) patients with hepatitis B (HBV), hepatitis C (HCV), HBV/HCV co-infection, and noninfected ones.
MethodsThe mRNA expression levels of studied genes were evaluated in LT patients with HBV (n=69), HCV (n=15), HBV/HCV co-infection (n=16), and non-infected (n=48) patients, compared to the control group (n=25). HBsAg and HBeAg were analyzed using ELISA methods. HBV-DNA and HCV-RNA were evaluated using simple PCR and nested RT-PCR protocols.
ResultsThe mRNA expression level of CXCL10 was significantly up-regulated in HBV-infected and noninfected groups compared to controls (p≤ 0.05). The CXCL11 and CXCR3 mRNA expression levels were significantly increased in the patient groups compared with controls (p≤ 0.05). The expression levels of CXCL9 and CXCL10 were significantly correlated in the HBV group (r= 0.6, p≤ 0.05). The correlation between CXCL10 and CXCL11 was also significantly positive (r= 0.4, p≤ 0.05). Additionally, CXCL11 mRNA expression significantly associated with CXCR3 (r= 0.4, p≤ 0.05).
ConclusionThe up-regulation of CXCL11, CXCL10, and CXCR3 in HBV and HCV-infected and non-infected liver transplant patients compared to the controls and the direct correlations between the expression levels of CXCLs and CXCR3 in HBV liver transplant patients put more emphasis on the critical function of these molecules in the HBV and HCV infections pathogenesis in post-liver transplantation. However, more investigations are needed.
Keywords: Hepatitis B Virus, Hepatitis C Virus, CXCL9, CXCL10, CXCL11, CXCR3 -
Pages 19-25Background
Post-reperfusion syndrome (PRS) during liver allograft reperfusion is characterized by hemodynamic instability, including hypotension, bradycardia, and arrhythmias. The incidence and risk factors of PRS are primarily studied in cadaveric liver transplantation. This study aims to estimate the incidence of PRS and identify associated factors in living donor liver transplantation (LDLT).
ObjectiveTo estimate the incidence of PRS and evaluate factors associated with its development in LDLT.
MethodsWe prospectively observed 70 adult patients with chronic liver disease who underwent LDLT between August 2020 and March 2022. Patients were categorized into two groups: those who developed PRS (PRS group) and those who did not (non-PRS group).
ResultsPRS occurred in 26 of 70 recipients (37.1%). The PRS group had significantly higher mean MELD scores, lower preoperative fibrinogen levels, and longer graft cold ischemia times (p= 0.027, p= 0.015, p= 0.045, respectively). These patients also experienced greater intraoperative blood loss and required more blood product transfusions. Postoperatively, the PRS group had longer mechanical ventilation times, a prolonged vasopressor requirement, and higher peak bilirubin levels in the first 7 days (p= 0.009, p= 0.001, p= 0.002, respectively).
ConclusionPRS is associated with more severe liver disease, greater intraoperative blood loss, and higher blood product transfusions. Postoperatively, patients with PRS had longer mechanical ventilation, prolonged vasopressor use, and elevated bilirubin levels.
Keywords: End-Stage Liver Disease, Liver Transplantation, Reperfusion, Living Donor -
Pages 26-37Background
Several genes that control the commitment and differentiation of hematopoietic stem cells are regulated by miRNAs. Hematologic cancers like acute myeloid leukemia (AML) have been found to express miRNAs abnormally.
ObjectiveIn this current study, we assessed the apoptotic effect of miR-181b and miR-222 blockage, which can influence the expression of WT1, CEBPA, and C-KIT genes in an HL-60 cell line.
MethodsRelative gene expression was observed by the SYBR Green Real-Time PCR method. By transfecting the HL-60 cell line with locked nucleic acid (LNA)-anti-miRNA, miRNA expression was suppressed. MTT assay was used to determine the viability of transfected cells, and PE Annexin V apoptosis detection kit I was used to evaluate the apoptosis.
ResultsAfter LNA transfection, the results showed a reduction in the expression of miR-181b and miR- 222. The flow cytometry data showed the apoptosis reduction by the inhibition of miR-181b and apoptosis increase by the inhibition of miR-222. We also found that miR-222 inhibition dramatically reduced c-KIT level, however, miR-181b blockage was associated with up-regulated of C-KIT expression. Moreover, the LNA-modified miR-222 could up-regulate BAX and down-regulate Bcl-2, whereas, after the transfection of the LNA-anti-miR-181b, BAX expression levels were significantly lower on average.
ConclusionWe concluded that the inhibiting of miR-222 and increasing miR-181b could help to control AML disease. MiR-222 could be a possible prognostic biomarker in patients who had hematopoietic stemcell transplantation (HSCT) due to its higher expression in HSCT patients who got a graft-versus-host disease (GVHD).
Keywords: Microrna, Locked Nucleic Acid (LNA), Apoptosis, WT1, CEBPA, C-KIT -
Pages 38-50Objective
This systematic review evaluated the economic impact of clinical transplant pharmacists’ intervention for solid organ transplant patients.
MethodsA PRISMA compliant search of the literature was conducted up to 31th March 2024 using PubMed, Cochrane and Embase databases to identify the original articles published on economic outcomes of transplant pharmacists’ services. The quality of each included study was assessed using the CHEERS, ROBINS-I, and RoB 2 checklists.
ResultsNine studies were included, six of which performed cost-benefit analyses and three conducted cost-saving analyses. Findings indicated that clinical pharmacist interventions led to reduced health-care cost through mechanisms such as increased cost savings, cost avoidance, and reduction in hospital length of stay. The reported range of benefit to cost ratio is 2.39 to 4.16. Some studies also highlighted the important role of pharmacists in improving patient care and clinical outcomes. Most of the pharmacists’ interventions were detection and management of drug related problems and prevention of adverse drug events.
ConclusionFindings indicates that clinical transplant pharmacist interventions in various settings, from inpatient wards to specialty clinics, pharmacies and mHealth platforms, contribute positively to economic outcomes and clinical care quality in solid organ transplant patients.
Keywords: Clinical Transplant Pharmacist, Cost, Economic Evaluation, Pharmacist, Solid Organ Transplantation -
Pages 51-53
Appendicitis following a live laparoscopic donor nephrectomy (LLDN) is rare complication and can present a diagnostic challenge. LLDN patients represent a unique group of patients for which there is limited research. Preventing a second operation and preserving residual kidney function are important considerations. Herein we present a case of appendicitis 9 days post hand assisted laparoscopic donor nephrectomy which presented as right sided abdominal pain and was confirmed on computed tomography. It was successfully managed through a conservative approach of intravenous antibiotics and fluid. This case demonstrated successful conservative management of appendicitis post LLDN and is the first reported case of conservative management in LLDN patients and only the second reported case of appendicitis post LLDN.
Keywords: Live Laparoscopic Donor Nephrectomy, Appendicitis, Abdominal Pain