scholarly journals The First Two Liver Transplantations in Syria

2021 ◽  
pp. 296-304
Author(s):  
Fadi Rayya
Keyword(s):  
Arterial Thrombosis ◽  
Liver Diseases ◽  
Metabolic Disorders ◽  
Hepatic Cell ◽  
Routine Procedure ◽  
Curative Therapy ◽  
Vein Thrombosis ◽  
Liver Transplantations ◽  
End Stage

Liver transplantation (LT) is the only curative therapy for the end-stage liver diseases and some metabolic disorders which affect the hepatic cell like the Crigler-Najjar syndrome type 1 (CNSI). Although the LT is a routine procedure in many centers worldwide, the postoperative complications such as rejection, arterial thrombosis, and infection remain serious challenges even in big centers. In our paper, we demonstrate the first two LTs in Syria. The first one was performed on 6 February 2016 for an 11-year-old boy suffering from CNSI using an auxiliary LT, but unfortunately, he had a hepatic artery and portal vein thrombosis, so we removed the necrotic graft on the fifth postoperative day, and he survived. The second LT was for a 9-year-old boy, who had cryptogenic liver cirrhosis, and he lived for 31 days after the transplantation. In both transplants, grafts were obtained from living relative donors.

scholarly journals Stem Cell-Based Therapies for Liver Diseases: State of the Art and New Perspectives

2010 ◽  
Vol 2010 ◽  
pp. 1-10 ◽  
Author(s):  
Anna Chiara Piscaglia ◽  
Mariachiara Campanale ◽  
Antonio Gasbarrini ◽  
Giovanni Gasbarrini
Keyword(s):  
Cell Biology ◽  
Liver Diseases ◽  
Therapeutic Potential ◽  
Organ Shortage ◽  
Cell Therapies ◽  
Curative Therapy ◽  
Induced Pluripotent Cells ◽  
Liver Repopulation ◽  
Induced Pluripotent ◽  
End Stage

Millions of patients worldwide suffer from end-stage liver pathologies, whose only curative therapy is liver transplantation (OLT). Given the donor organ shortage, alternatives to OLT have been evaluated, including cell therapies. Hepatocyte transplantation has been attempted to cure metabolic liver disorders and end-stage liver diseases. The evaluation of its efficacy is complicated by the shortage of human hepatocytes and their difficult expansion and cryopreservation. Recent advances in cell biology have led to the concept of “regenerative medicine”, based on the therapeutic potential of stem cells (SCs). Different types of SCs are theoretically eligible for liver cell replacement. These include embryonic and fetal SCs, induced pluripotent cells, annex SCs, endogenous liver SCs, and extrahepatic adult SCs. Aim of this paper is to critically analyze the possible sources of SCs suitable for liver repopulation and the results of the clinical trials that have been published until now.

scholarly journals Regulated differentiation of stem cells into an artificial 3D liver as a transplantable source

2020 ◽  
Vol 26 (2) ◽  
pp. 163-179
Author(s):  
Feng Chen ◽  
Hua Wang ◽  
Jia Xiao
Keyword(s):  
Stem Cells ◽  
Liver Diseases ◽  
Complex Structure ◽  
Three Dimensional ◽  
Single Layer ◽  
Cell Types ◽  
Hepatic Cell ◽  
New Research ◽  
End Stage ◽  
Transplantation Therapy

End-stage liver disease is one of the leading causes of death around the world. Since insufficient sources of transplantable liver and possible immune rejection severely hinder the wide application of conventional liver transplantation therapy, artificial three-dimensional (3D) liver culture and assembly from stem cells have become a new hope for patients with end-stage liver diseases, such as cirrhosis and liver cancer. However, the induced differentiation of single-layer or 3D-structured hepatocytes from stem cells cannot physiologically support essential liver functions due to the lack of formation of blood vessels, immune regulation, storage of vitamins, and other vital hepatic activities. Thus, there is emerging evidence showing that 3D organogenesis of artificial vascularized liver tissue from combined hepatic cell types derived from differentiated stem cells is practical for the treatment of end-stage liver diseases. The optimization of novel biomaterials, such as decellularized matrices and natural macromolecules, also strongly supports the organogenesis of 3D tissue with the desired complex structure. This review summarizes new research updates on novel differentiation protocols of stem cell-derived major hepatic cell types and the application of new supportive biomaterials. Future biological and clinical challenges of this concept are also discussed.

scholarly journals Decompensated Cirrhosis as Presentation of LKM1/LC1 Positive Type 2 Autoimmune Hepatitis in Adulthood. A Rare Clinical Entity of Difficult Management

2021 ◽  
Vol 12 (1) ◽  
pp. 67-75
Author(s):  
Alessandro Granito ◽  
Simona Pascolini ◽  
Chiara Ricci ◽  
Marco Ferronato ◽  
Luigi Muratori ◽  
...  
Keyword(s):  
Liver Disease ◽  
Autoimmune Hepatitis ◽  
Immunosuppressive Therapy ◽  
Clinical Signs ◽  
Decompensated Cirrhosis ◽  
Positive Type ◽  
Curative Therapy ◽  
End Stage

Background: Autoimmune hepatitis (AIH) is a chronic and aggressive liver disease that rapidly evolves into cirrhosis and end-stage liver disease if not timely diagnosed and treated with immunosuppressive therapy. AIH is classified into type 1 and type 2 according to the autoantibody pattern, with smooth muscle antibodies and/or antinuclear antibodies as serological markers of AIH-1, while antiliver cytosol antibody type 1 and/or antiliver/kidney microsomal antibody type 1 characterize type 2 AIH, which mainly affects children, including infants, and adolescents. Case Summary: We describe a case of type 2 AIH, clinically onset in a 34-year-old woman with decompensated cirrhosis. Only a thorough analysis of the autoantibody profile allowed for a diagnosis of an AIH-2 evolved into cirrhosis. The patient received a moderate corticosteroid therapy without achieving optimal disease control. We discuss the controversial decision of whether or not to treat the patient with immunosuppressive therapy, which should be balanced with the potential risk of infectious and other complications. A review of the literature on the management of patients with autoimmune cirrhosis is also presented. Conclusions: AIH-2 can be clinically onset in adult patients with cirrhosis and its complications, without being preceded by major clinical signs. Due to the difficult management of cirrhosis with immunosuppressive treatments, a patient-tailored strategy with a case-by-case approach is needed to prevent major complications such as infections, potentially precluding liver transplantation the only curative therapy.

scholarly journals Endovascular mechanical thrombectomy and stenting in a case of central vein thrombosis

2021 ◽  
Vol 14 (2) ◽  
pp. e236508
Author(s):  
Rajesh Vijayvergiya ◽  
Navjyot Kaur ◽  
Saroj K Sahoo ◽  
Ashish Sharma
Keyword(s):  
Mechanical Thrombectomy ◽  
Transluminal Angioplasty ◽  
Brachiocephalic Vein ◽  
Central Vein ◽  
Vein Thrombosis ◽  
Catheter Directed Thrombolysis ◽  
Stage Renal Disease ◽  
End Stage ◽  
Vein Stenosis

Central vein stenosis and thrombosis are frequent in patients on haemodialysis for end-stage renal disease. Its management includes anticoagulation, systemic or catheter-directed thrombolysis, mechanical thrombectomy and percutaneous transluminal angioplasty (PTA). Use of mechanical thrombectomy in central vein thrombosis has been scarcely reported. We hereby report a case of right brachiocephalic vein thrombosis with underlying stenosis, which was successfully treated by mechanical thrombectomy followed by PTA and stenting. The patient had a favourable 10 months of follow-up.

scholarly journals The Landscape of microRNAs in βCell: Between Phenotype Maintenance and Protection

2021 ◽  
Vol 22 (2) ◽  
pp. 803
Author(s):  
Giuseppina Emanuela Grieco ◽  
Noemi Brusco ◽  
Giada Licata ◽  
Daniela Fignani ◽  
Caterina Formichi ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Metabolic Disorders ◽  
Molecular Mechanisms ◽  
Β Cell ◽  
Physiological Mechanisms ◽  
Effective Strategies ◽  
Chronic Hyperglycaemia ◽  
Shed Light

Diabetes mellitus is a group of heterogeneous metabolic disorders characterized by chronic hyperglycaemia mainly due to pancreatic β cell death and/or dysfunction, caused by several types of stress such as glucotoxicity, lipotoxicity and inflammation. Different patho-physiological mechanisms driving β cell response to these stresses are tightly regulated by microRNAs (miRNAs), a class of negative regulators of gene expression, involved in pathogenic mechanisms occurring in diabetes and in its complications. In this review, we aim to shed light on the most important miRNAs regulating the maintenance and the robustness of β cell identity, as well as on those miRNAs involved in the pathogenesis of the two main forms of diabetes mellitus, i.e., type 1 and type 2 diabetes. Additionally, we acknowledge that the understanding of miRNAs-regulated molecular mechanisms is fundamental in order to develop specific and effective strategies based on miRNAs as therapeutic targets, employing innovative molecules.

scholarly journals The Role of Endoglin in Hepatocellular Carcinoma

2021 ◽  
Vol 22 (6) ◽  
pp. 3208
Author(s):  
Kuo-Shyang Jeng ◽  
I-Shyan Sheen ◽  
Shu-Sheng Lin ◽  
Chuen-Miin Leu ◽  
Chiung-Fang Chang
Keyword(s):  
Hepatocellular Carcinoma ◽  
Liver Diseases ◽  
Transforming Growth Factor ◽  
Antiangiogenic Therapy ◽  
Transforming Growth Factor Β ◽  
Postoperative Recurrence ◽  
Transmembrane Glycoprotein ◽  
Early Progression

Endoglin (CD105) is a type-1 integral transmembrane glycoprotein and coreceptor for transforming growth factor-β (TGF-β) ligands. The endoglin/TGF-β signaling pathway regulates hemostasis, cell proliferation/migration, extracellular matrix (ECM) synthesis and angiogenesis. Angiogenesis contributes to early progression, invasion, postoperative recurrence, and metastasis in hepatocellular carcinoma (HCC), one of the most widespread malignancies globally. Endoglin is overexpressed in newly formed HCC microvessels. It increases microvessel density in cirrhotic and regenerative HCC nodules. In addition, circulating endoglin is present in HCC patients, suggesting potential for use as a diagnostic or prognostic factor. HCC angiogenesis is dynamic and endoglin expression varies by stage. TRC105 (carotuximab) is an antibody against endoglin, and three of its clinical trials were related to liver diseases. A partial response was achieved when combining TRC105 with sorafenib. Although antiangiogenic therapy still carries some risks, combination therapy with endoglin inhibitors or other targeted therapies holds promise.

Neonatal end-stage renal failure associated with maternal ingestion of cyclo-oxygenase-type-1 selective inhibitor nimesulide as tocolytic

The Lancet ◽  
1999 ◽  
Vol 354 (9190) ◽  
pp. 1615 ◽  
Author(s):  
Licia Peruzzi ◽  
Bruno Gianoglio ◽  
Maria Gabriella Porcellini ◽  
Rosanna Coppo
Keyword(s):  
Renal Failure ◽  
Selective Inhibitor ◽  
End Stage Renal Failure ◽  
End Stage

scholarly journals Low Incidence of End-Stage Renal Disease in Childhood-Onset Type 1 Diabetes Followed for Up to 42 Years

Diabetes Care ◽  
2017 ◽  
Vol 41 (3) ◽  
pp. 420-425 ◽  
Author(s):  
Vibeke Gagnum ◽  
Maryam Saeed ◽  
Lars C. Stene ◽  
Torbjørn Leivestad ◽  
Geir Joner ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Renal Disease ◽  
End Stage Renal Disease ◽  
Childhood Onset ◽  
Onset Type ◽  
Low Incidence ◽  
Stage Renal Disease ◽  
End Stage
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