1
|
Krupa L, Kalinowski P, Ligocka J, Dauer M, Jankowski K, Gozdowska J, Kruk B, Milkiewicz P, Zieniewicz K, Krawczyk M, Weber SN, Lammert F, Krawczyk M. The ABCG8 polymorphism increases the risk of gallbladder cancer in the general population and gallstones in obese patients from Poland. Eur J Clin Invest 2024:e14213. [PMID: 38616505 DOI: 10.1111/eci.14213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2023] [Revised: 03/28/2024] [Accepted: 03/29/2024] [Indexed: 04/16/2024]
Abstract
BACKGROUND Gallstone disease (GD) is common but remains asymptomatic in most cases. However, gallstones can lead to complications like choledocholithiasis or gallbladder cancer. In this study, we analyse the common genetic risk factor for GD, the p.D19H variant in the sterol transporter ABCG8, in Polish patients with gallstones and gallbladder cancer. METHODS Three adult cohorts were prospectively recruited: 65 patients with gallbladder cancer, 170 obese individuals scheduled for bariatric surgery and 72 patients who underwent endoscopic retrograde cholangiopancreatography due to recurrent choledocholithiasis. The control cohort consisted of 172 gallstone-free adults. The ABCG8 p.D19H (rs11887534) polymorphism was genotyped using TaqMan assays. RESULTS The minor allele frequency (MAF) of the ABCG8 p.D19H polymorphism was significantly (p = .02) higher among cases with either gallstones or gallbladder cancer (MAF = 8.4%) as compared to controls (MAF = 4.0%). The highest frequency of the risk allele was detected in patients with gallbladder cancer (18.5%) and obese patients with GD (17.5%), followed by individuals with choledocholithiasis (13.9%). Notably, the p.19H variant was associated with an increased risk of developing gallbladder cancer (OR 2.76, 95% CI 1.16-6.54, p = .01) and an increased risk of GD in obese individuals scheduled for bariatric surgery (OR = 2.70, 95% CI 1.05-6.49, p = .03), but did not significantly affect the risk of choledocholithiasis. CONCLUSIONS The ABCG8 p.D19H common risk variant increases the risk of developing gallbladder cancer in Central Europeans and enhances the risk of gallstones in the obese. Carriers of the p.D19H variant might benefit from personalized preventive strategies, particularly regarding gallbladder cancer.
Collapse
Affiliation(s)
- Lukasz Krupa
- Department of Gastroenterology and Hepatology with Internal Disease Unit, Teaching Hospital No 1 in Rzeszów, Rzeszów, Poland
- Medical Department, University of Rzeszów, Rzeszów, Poland
| | - Piotr Kalinowski
- Department of General, Transplant and Liver Surgery, Medical University of Warsaw, Warsaw, Poland
| | - Joanna Ligocka
- Department of Gastroenterology and Internal Medicine, Medical University of Warsaw, Warsaw, Poland
| | - Marc Dauer
- Department of Medicine II, Saarland University Medical Center, Saarland University, Homburg, Germany
| | - Krzysztof Jankowski
- Department of Internal Medicine and Cardiology, Medical University of Warsaw, Warsaw, Poland
- Department of Social Medicine and Public Health, Medical University of Warsaw, Warsaw, Poland
| | - Jolanta Gozdowska
- Department of Transplantation Medicine and Nephrology, Medical University of Warsaw, Warsaw, Poland
| | - Beata Kruk
- Laboratory of Metabolic Liver Diseases, Department of General, Transplant and Liver Surgery, Medical University of Warsaw, Warsaw, Poland
| | - Piotr Milkiewicz
- Translational Medicine Group, Pomeranian Medical University, Szczecin, Poland
- Liver and Internal Medicine Unit, Medical University of Warsaw, Warsaw, Poland
| | - Krzysztof Zieniewicz
- Department of General, Transplant and Liver Surgery, Medical University of Warsaw, Warsaw, Poland
| | - Marek Krawczyk
- Department of General, Transplant and Liver Surgery, Medical University of Warsaw, Warsaw, Poland
| | - Susanne N Weber
- Department of Medicine II, Saarland University Medical Center, Saarland University, Homburg, Germany
| | | | - Marcin Krawczyk
- Department of Medicine II, Saarland University Medical Center, Saarland University, Homburg, Germany
- Laboratory of Metabolic Liver Diseases, Department of General, Transplant and Liver Surgery, Medical University of Warsaw, Warsaw, Poland
| |
Collapse
|
2
|
Okruszek Ł, Jarkiewicz M, Piejka A, Chrustowicz M, Krawczyk M, Schudy A, Harvey PD, Penn DL, Ludwig K, Green MF, Pinkham AE. Loneliness is associated with mentalizing and emotion recognition abilities in schizophrenia, but only in a cluster of patients with social cognitive deficits. J Int Neuropsychol Soc 2024; 30:27-34. [PMID: 37154103 DOI: 10.1017/s1355617723000206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
OBJECTIVE Loneliness is a concern for patients with schizophrenia. However, the correlates of loneliness in patients with schizophrenia are unclear; thus, the aim of the study is to investigate neuro- and social cognitive mechanisms associated with loneliness in individuals with schizophrenia. METHOD Data from clinical, neurocognitive, and social cognitive assessments were pooled from two cross-national samples (Poland/USA) to examine potential predictors of loneliness in 147 patients with schizophrenia and 103 healthy controls overall. Furthermore, the relationship between social cognition and loneliness was explored in clusters of patients with schizophrenia differing in social cognitive capacity. RESULTS Patients reported higher levels of loneliness than healthy controls. Loneliness was linked to increased negative and affective symptoms in patients. A negative association between loneliness and mentalizing and emotion recognition abilities was found in the patients with social-cognitive impairments, but not in those who performed at normative levels. CONCLUSIONS We have elucidated a novel mechanism which may explain previous inconsistent findings regarding the correlates of loneliness in individuals with schizophrenia.
Collapse
Affiliation(s)
- Ł Okruszek
- Social Neuroscience Lab, Institute of Psychology, Polish Academy of Sciences, Warsaw, Poland
| | - M Jarkiewicz
- Third Department of Psychiatry, Institute of Psychiatry and Neurology, Warsaw, Poland
| | - A Piejka
- Social Neuroscience Lab, Institute of Psychology, Polish Academy of Sciences, Warsaw, Poland
| | - M Chrustowicz
- Social Neuroscience Lab, Institute of Psychology, Polish Academy of Sciences, Warsaw, Poland
| | - M Krawczyk
- Social Neuroscience Lab, Institute of Psychology, Polish Academy of Sciences, Warsaw, Poland
| | - A Schudy
- Faculty of Psychology, University of Warsaw, Warsaw, Poland
| | - P D Harvey
- University of Miami Miller School of Medicine, Miami VA Healthcare System, Miami, FL, USA
| | - D L Penn
- Department of Psychology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- School of Psychology, Australian Catholic University, Melbourne, Victoria, Australia
| | - K Ludwig
- Department of Psychology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - M F Green
- Desert Pacific Mental Illness Research, Education, and Clinical Center, VA Greater Los Angeles, Los Angeles, CA, USA
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
| | - A E Pinkham
- Department of Psychology, University of Texas at Dallas, Richardson, TX, USA
- Department of Psychiatry, UT Southwestern Medical Center, Dallas, TX, USA
| |
Collapse
|
3
|
Janardhanan S, Mielcarek S, Głowiński H, Kowacz M, Kuświk P, Krawczyk M, Trzaskowska A. Investigation of spin wave dynamics in Au/CoFeB/Au multilayers with perpendicular magnetic anisotropy. Sci Rep 2023; 13:22494. [PMID: 38110449 PMCID: PMC10728143 DOI: 10.1038/s41598-023-49859-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Accepted: 12/12/2023] [Indexed: 12/20/2023] Open
Abstract
We have carried out an experimental investigation of the spin-wave dynamics in the Au/CoFeB/Au multilayer consisting of a ferromagnetic film with thicknesses of 0.8, 0.9 and 1.0 nm. We employed the Brillouin light scattering spectroscopy to measure the frequency of the spin waves in dependence on the wave vector. Additionally, we characterized the samples by ferromagnetic resonance measurements. We found that the considered samples exhibit perpendicular magnetic anisotropy with low damping, indicating small pumping effects. Furthermore, we found a nonreciprocal dispersion relation pointing at a non-negligible Dzyaloshinskii-Moriya interaction. These results make the Au/CoFeB/Au multilayer a compelling subject for further analysis and as a potential material for future applications within magnonics.
Collapse
Affiliation(s)
- S Janardhanan
- ISQI, Faculty of Physics, Adam Mickiewicz University, Poznan, Poland.
| | - S Mielcarek
- ISQI, Faculty of Physics, Adam Mickiewicz University, Poznan, Poland
| | - H Głowiński
- Institute of Molecular Physics, Polish Academy of Science, Poznan, Poland
| | - M Kowacz
- Institute of Molecular Physics, Polish Academy of Science, Poznan, Poland
| | - P Kuświk
- Institute of Molecular Physics, Polish Academy of Science, Poznan, Poland
| | - M Krawczyk
- ISQI, Faculty of Physics, Adam Mickiewicz University, Poznan, Poland
| | - A Trzaskowska
- ISQI, Faculty of Physics, Adam Mickiewicz University, Poznan, Poland
| |
Collapse
|
4
|
Kuncewicz M, Jaszczyszyn IP, Karaban K, Rykowski P, Krasnodębski M, Morawski M, Kruk E, Koperski Ł, Zieniewicz K, Krawczyk M, Grąt M. Predictors of Long-Term Outcomes After Liver Transplantation for Unresectable Metastatic Neuroendocrine Tumors. Ann Transplant 2023; 28:e941212. [PMID: 37986542 PMCID: PMC10675983 DOI: 10.12659/aot.941212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Accepted: 07/28/2023] [Indexed: 11/22/2023] Open
Abstract
BACKGROUND Malignant and benign neuroendocrine tumors (NET) share many histopathological features. Liver transplantation (LT) is one of the liver-directed therapies for neuroendocrine liver metastases (NELM). The aim of this study was to determine the outcomes of patients undergoing LT for NELM. MATERIAL AND METHODS This was a retrospective study that included 19 patients who underwent LT for unresectable NELM between December 1989 and December 2022 in the Department of General, Transplant, and Liver Surgery of the Medical University of Warsaw. Kaplan-Meier estimator and Cox proportional hazards regression were used for statistical analyses. RESULTS The primary tumor was located most frequently in the pancreas. The median follow-up was 72.5 months. The overall survival (OS) was 94.7%, 88.0%, 88.0%, 70.4%, and 49.3% after 1, 3, 5, 10, and 15 years, respectively. Accordingly, the recurrence-free survival (RFS) rates were 93.8%, 72.9%, 64.8%, 27.8%, and 27.8% after 1, 3, 5, 10, and 15 years, respectively. Ki-67 index ≥5% was found as a risk factor for both worse OS (hazard ratio (HR) 7.13, 95% confidence intervals (95% CI) 1.32-38.63, P=0.023) and RFS (HR 13.68, 95% CI 1.54-121.52, P=0.019). Recipient age ≥55 years was a risk factor for worse RFS (P=0.046, HR 5.47, 95% CI 1.03-29.08). Multivariable analysis revealed Ki-67 ≥5% as the sole independent factor for worse OS (HR 13.78, 95% CI 1.48-128.56, P=0.021). CONCLUSIONS Patients with unresectable NELM achieve great OS and satisfying RFS after LT. The risk factors associated with worse outcomes are attributed to primary tumor aggressiveness.
Collapse
Affiliation(s)
- Mikołaj Kuncewicz
- Department of General, Transplant, and Liver Surgery, Medical University of Warsaw, Warsaw, Poland
| | - Igor Piotr Jaszczyszyn
- Department of General, Transplant, and Liver Surgery, Medical University of Warsaw, Warsaw, Poland
| | - Kacper Karaban
- Department of General, Transplant, and Liver Surgery, Medical University of Warsaw, Warsaw, Poland
| | - Paweł Rykowski
- Department of General, Transplant, and Liver Surgery, Medical University of Warsaw, Warsaw, Poland
| | - Maciej Krasnodębski
- Department of General, Transplant, and Liver Surgery, Medical University of Warsaw, Warsaw, Poland
| | - Marcin Morawski
- Department of General, Transplant, and Liver Surgery, Medical University of Warsaw, Warsaw, Poland
| | - Emilia Kruk
- Department of General, Transplant, and Liver Surgery, Medical University of Warsaw, Warsaw, Poland
| | - Łukasz Koperski
- Department of Pathology, Medical University of Warsaw, Warsaw, Poland
| | - Krzysztof Zieniewicz
- Department of General, Transplant, and Liver Surgery, Medical University of Warsaw, Warsaw, Poland
| | - Marek Krawczyk
- Department of General, Transplant, and Liver Surgery, Medical University of Warsaw, Warsaw, Poland
| | - Michał Grąt
- Department of General, Transplant, and Liver Surgery, Medical University of Warsaw, Warsaw, Poland
| |
Collapse
|
5
|
Grąt M, Morawski M, Zhylko A, Rykowski P, Krasnodębski M, Wyporski A, Borkowski J, Lewandowski Z, Kobryń K, Stankiewicz R, Stypułkowski J, Hołówko W, Patkowski W, Mielczarek-Puta M, Struga M, Szczepankiewicz B, Górnicka B, Krawczyk M. Routine End-ischemic Hypothermic Oxygenated Machine Perfusion in Liver Transplantation From Donors After Brain Death: A Randomized Controlled Trial. Ann Surg 2023; 278:662-668. [PMID: 37497636 DOI: 10.1097/sla.0000000000006055] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/28/2023]
Abstract
OBJECTIVE To assess whether end-ischemic hypothermic oxygenated machine perfusion (HOPE) is superior to static cold storage (SCS) in preserving livers procured from donors after brain death (DBD). BACKGROUND There is increasing evidence of the benefits of HOPE in liver transplantation, but predominantly in the setting of high-risk donors. METHODS In this randomized clinical trial, livers procured from DBDs were randomly assigned to either end-ischemic dual HOPE for at least 2 hours or SCS (1:3 allocation ratio). The Model for Early Allograft Function (MEAF) was the primary outcome measure. The secondary outcome measure was 90-day morbidity (ClinicalTrials. gov, NCT04812054). RESULTS Of the 104 liver transplantations included in the study, 26 were assigned to HOPE and 78 to SCS. Mean MEAF was 4.94 and 5.49 in the HOPE and SCS groups ( P =0.24), respectively, with the corresponding rates of MEAF >8 of 3.8% (1/26) and 15.4% (12/78; P =0.18). Median Comprehensive Complication Index was 20.9 after transplantations with HOPE and 21.8 after transplantations with SCS ( P =0.19). Transaminase activity, bilirubin concentration, and international normalized ratio were similar in both groups. In the case of donor risk index >1.70, HOPE was associated with significantly lower mean MEAF (4.92 vs 6.31; P =0.037) and lower median Comprehensive Complication Index (4.35 vs 22.6; P =0.050). No significant differences between HOPE and SCS were observed for lower donor risk index values. CONCLUSION Routine use of HOPE in DBD liver transplantations does not seem justified as the clinical benefits are limited to high-risk donors.
Collapse
Affiliation(s)
- Michał Grąt
- Department of General, Transplant and Liver Surgery, Medical University of Warsaw, Warsaw, Poland
| | - Marcin Morawski
- Department of General, Transplant and Liver Surgery, Medical University of Warsaw, Warsaw, Poland
| | - Andriy Zhylko
- Department of General, Transplant and Liver Surgery, Medical University of Warsaw, Warsaw, Poland
| | - Paweł Rykowski
- Department of General, Transplant and Liver Surgery, Medical University of Warsaw, Warsaw, Poland
| | - Maciej Krasnodębski
- Department of General, Transplant and Liver Surgery, Medical University of Warsaw, Warsaw, Poland
| | - Anya Wyporski
- Department of General, Transplant and Liver Surgery, Medical University of Warsaw, Warsaw, Poland
| | - Jan Borkowski
- Department of General, Transplant and Liver Surgery, Medical University of Warsaw, Warsaw, Poland
| | - Zbigniew Lewandowski
- Department of Epidemiology and Biostatistics, Medical University of Warsaw, Warsaw, Poland
| | - Konrad Kobryń
- Department of General, Transplant and Liver Surgery, Medical University of Warsaw, Warsaw, Poland
| | - Rafał Stankiewicz
- Department of General, Transplant and Liver Surgery, Medical University of Warsaw, Warsaw, Poland
| | - Jan Stypułkowski
- Department of General, Transplant and Liver Surgery, Medical University of Warsaw, Warsaw, Poland
| | - Wacław Hołówko
- Department of General, Transplant and Liver Surgery, Medical University of Warsaw, Warsaw, Poland
| | - Waldemar Patkowski
- Department of General, Transplant and Liver Surgery, Medical University of Warsaw, Warsaw, Poland
| | | | - Marta Struga
- Department of Biochemistry, Medical University of Warsaw, Warsaw, Poland
| | | | - Barbara Górnicka
- Department of Pathology, Medical University of Warsaw, Warsaw, Poland
| | - Marek Krawczyk
- Department of General, Transplant and Liver Surgery, Medical University of Warsaw, Warsaw, Poland
| |
Collapse
|
6
|
Kościelska M, Matuszkiewicz-Rowińska J, Giercuszkiewicz D, Krawczyk M, Niewiński G, Sierdziński J, Zieniewicz K, Żebrowski P, Małyszko J. Corrigendum to 'Simultaneous Liver- Kidney Transplantation and The Use of Intraoperative Dialysis- A Monocenter Study' [Transplantation Proceedings 54/4 (2022) 1002-1006]. Transplant Proc 2023; 55:1765-1766. [PMID: 36202671 DOI: 10.1016/j.transproceed.2022.08.045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Affiliation(s)
- Małgorzata Kościelska
- Department of Nephrology, Dialysis and Internal Diseases, Medical University of Warsaw, Warsaw.
| | | | | | - Marek Krawczyk
- Department of General, Transplant and Liver Surgery, Medical University of Warsaw, Warsaw
| | - Grzegorz Niewiński
- Department of Anaesthesiology and Intensive Care, Medical University of Warsaw, Warsaw
| | - Janusz Sierdziński
- Department of Medical Informatics and Telemedicine, Medical University of Warsaw, Warsaw, Poland
| | - Krzysztof Zieniewicz
- Department of General, Transplant and Liver Surgery, Medical University of Warsaw, Warsaw
| | - Paweł Żebrowski
- Department of Nephrology, Dialysis and Internal Diseases, Medical University of Warsaw, Warsaw
| | - Jolanta Małyszko
- Department of Nephrology, Dialysis and Internal Diseases, Medical University of Warsaw, Warsaw
| |
Collapse
|
7
|
Raszeja-Wyszomirska J, Macech M, Kolanowska M, Krawczyk M, Nazarewski S, Wójcicka A, Małyszko J. Free-Circulating Nucleic Acids as Biomarkers in Patients After Solid Organ Transplantation. Ann Transplant 2023; 28:e939750. [PMID: 37580899 PMCID: PMC10439677 DOI: 10.12659/aot.939750] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Accepted: 05/17/2023] [Indexed: 08/16/2023] Open
Abstract
A number types of extracellular DNA (eg, cell-free, cfDNA) circulate in human blood, including mitochondrial, transcriptome, and regulatory DNA, usually at low concentrations. Larger amounts of cfDNA appear in any inflammatory condition, including organ damage due to a variety of reasons. The role of cfDNA in solid organ transplantation is discussed in this review as a valuable additional tool in the standard of care of transplant patients. Post-transplant monitoring requires the use of high-quality biomarkers for early detection of graft damage or rejection to be able to apply early therapeutic intervention. CfDNA complements the traditional monitoring strategies, being a risk stratification tool and an important prognostic marker. However, improving the sensitivity and specificity of cfDNA detection is necessary to facilitate personalized patient management, warranting further research in terms of measurement, test standardization, and storage, processing, and shipping. A diagnostic test (Allosure, CareDx, Inc., Brisbane, CA) for kidney, heart and lung transplant patients is now commercially available, and validation for other organs (eg, liver) is pending. To date, donor-derived cfDNA in combination with other biomarkers appears to be a promising tool in graft rejection as it is minimally invasive, time-sensitive, and cost-effective. However, improvement of sensitivity and specificity is required to facilitate personalized patient management. Whether it could be an alternate to graft biopsy remains unclear.
Collapse
Affiliation(s)
- Joanna Raszeja-Wyszomirska
- Department of Hepatology, Transplantology, and Internal Medicine, Medical University of Warsaw, Warsaw, Poland
| | - Michał Macech
- Department of General, Vascular, and Transplant Surgery, Medical University of Warsaw, Warsaw, Poland
| | | | - Marek Krawczyk
- Department of General, Transplant, and Liver Surgery, Medical University of Warsaw, Warsaw, Poland
| | - Sławomir Nazarewski
- Department of General, Vascular, and Transplant Surgery, Medical University of Warsaw, Warsaw, Poland
| | | | - Jolanta Małyszko
- Department of Nephrology, Dialysis, and Internal Medicine, Medical University of Warsaw, Warsaw, Poland
| |
Collapse
|
8
|
Masior Ł, Krasnodębski M, Kuncewicz M, Karaban K, Jaszczyszyn I, Kruk E, Małecka-Giełdowska M, Korzeniowski K, Figiel W, Krawczyk M, Wróblewski T, Grąt M. Alpha-Fetoprotein Response after First Transarterial Chemoembolization (TACE) and Complete Pathologic Response in Patients with Hepatocellular Cancer. Cancers (Basel) 2023; 15:3962. [PMID: 37568778 PMCID: PMC10417598 DOI: 10.3390/cancers15153962] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2023] [Revised: 07/27/2023] [Accepted: 07/31/2023] [Indexed: 08/13/2023] Open
Abstract
Transarterial chemoembolization (TACE) is used as a bridging treatment in liver transplant candidates with hepatocellular carcinoma (HCC). Alpha-fetoprotein (AFP) is the main tumor marker used for HCC surveillance. The aim of this study was to assess the potential of using the AFP change after the first TACE in the prediction of complete tumor necrosis. The study comprised 101 patients with HCC who underwent liver transplantation (LT) after TACE in the period between January 2011 and December 2020. The ΔAFP was defined as the difference between the AFP value before the first TACE and AFP either before the second TACE or the LT. The receiver operator characteristics (ROC) curves were used to identify an optimal cut-off value. Complete tumor necrosis was found in 26.1% (18 of 69) and 6.3% (2 of 32) of patients with an initial AFP level under and over 100 ng/mL, respectively (p = 0.020). The optimal cut-off value of ΔAFP for the prediction of complete necrosis was a decline of ≥10.2 ng/mL and ≥340.5 ng/mL in the corresponding subgroups. Complete tumor necrosis rates were: 62.5% (5 of 8) in patients with an initial AFP < 100 ng/mL and decline of ≥10.2 ng/mL; 21.3% (13 of 61) in patients with an initial AFP < 100 ng/mL and decline of <10.2 ng/mL; 16.7% (2 of 12) in patients with an initial AFP > 100 ng/mL and decline of ≥340.5 ng/mL; and null in 20 patients with an initial AFP > 100 ng/mL and decline of <340.5 ng/mL, respectively (p = 0.003). The simple scoring system, based on the initial AFP and AFP decline after the first treatment, distinguished between a high, intermediate and low probability of complete necrosis, with an area under the ROC curve of 0.699 (95% confidence intervals 0.577 to 0.821, p = 0.001). Combining the initial AFP with its change after the first treatment enables early identification of the efficacy of TACE.
Collapse
Affiliation(s)
- Łukasz Masior
- Department of General, Transplant and Liver Surgery, Medical University of Warsaw, 02-097 Warsaw, Poland; (M.K.); (M.K.); (K.K.); (I.J.); (E.K.); (W.F.); (M.K.); (T.W.); (M.G.)
| | - Maciej Krasnodębski
- Department of General, Transplant and Liver Surgery, Medical University of Warsaw, 02-097 Warsaw, Poland; (M.K.); (M.K.); (K.K.); (I.J.); (E.K.); (W.F.); (M.K.); (T.W.); (M.G.)
| | - Mikołaj Kuncewicz
- Department of General, Transplant and Liver Surgery, Medical University of Warsaw, 02-097 Warsaw, Poland; (M.K.); (M.K.); (K.K.); (I.J.); (E.K.); (W.F.); (M.K.); (T.W.); (M.G.)
| | - Kacper Karaban
- Department of General, Transplant and Liver Surgery, Medical University of Warsaw, 02-097 Warsaw, Poland; (M.K.); (M.K.); (K.K.); (I.J.); (E.K.); (W.F.); (M.K.); (T.W.); (M.G.)
| | - Igor Jaszczyszyn
- Department of General, Transplant and Liver Surgery, Medical University of Warsaw, 02-097 Warsaw, Poland; (M.K.); (M.K.); (K.K.); (I.J.); (E.K.); (W.F.); (M.K.); (T.W.); (M.G.)
| | - Emilia Kruk
- Department of General, Transplant and Liver Surgery, Medical University of Warsaw, 02-097 Warsaw, Poland; (M.K.); (M.K.); (K.K.); (I.J.); (E.K.); (W.F.); (M.K.); (T.W.); (M.G.)
| | | | | | - Wojciech Figiel
- Department of General, Transplant and Liver Surgery, Medical University of Warsaw, 02-097 Warsaw, Poland; (M.K.); (M.K.); (K.K.); (I.J.); (E.K.); (W.F.); (M.K.); (T.W.); (M.G.)
| | - Marek Krawczyk
- Department of General, Transplant and Liver Surgery, Medical University of Warsaw, 02-097 Warsaw, Poland; (M.K.); (M.K.); (K.K.); (I.J.); (E.K.); (W.F.); (M.K.); (T.W.); (M.G.)
| | - Tadeusz Wróblewski
- Department of General, Transplant and Liver Surgery, Medical University of Warsaw, 02-097 Warsaw, Poland; (M.K.); (M.K.); (K.K.); (I.J.); (E.K.); (W.F.); (M.K.); (T.W.); (M.G.)
| | - Michał Grąt
- Department of General, Transplant and Liver Surgery, Medical University of Warsaw, 02-097 Warsaw, Poland; (M.K.); (M.K.); (K.K.); (I.J.); (E.K.); (W.F.); (M.K.); (T.W.); (M.G.)
| |
Collapse
|
9
|
Mehta R, Moalic M, Krawczyk M, Saha S. Tunability of spin-wave spectra in a 2D triangular shaped magnonic fractals. J Phys Condens Matter 2023; 35. [PMID: 37116510 DOI: 10.1088/1361-648x/acd15f] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/26/2022] [Accepted: 04/28/2023] [Indexed: 05/13/2023]
Abstract
Reprogramming the structure of the magnonic bands during their operation is important for controlling spin waves in magnonic devices. Here, we report the tunability of the spin-wave spectra for a triangular shaped deterministic magnonic fractal, which is known as Sierpinski triangle by solving the Landau-Lifshitz-Gilbert equation using a micromagnetic simulations. The spin-wave dynamics change significantly with the variation of iteration number. A wide frequency gap is observed for a structure with an iteration number exceeding some value and a plenty of mini-frequency bandgaps at structures with high iteration number. The frequency gap could be controlled by varying the strength of the magnetic field. A sixfold symmetry in the frequency gap is observed with the variation of the azimuthal angle of the external magnetic field. The spatial distributions of the spin-wave modes allow to identify the bands surrounding the gap. The observations are important for the application of magnetic fractals as a reconfigurable aperiodic magnonic crystals.
Collapse
Affiliation(s)
- R Mehta
- Department of Physics, Ashoka University, Sonipat, Haryana 131029, India
| | - M Moalic
- Institute of Spintronic and Quantum Information, Faculty of Physics, Adam Mickiewicz University, Poznan, Uniwersytetu Poznanskiego 2, Poznan PL-61-614, Poland
| | - M Krawczyk
- Institute of Spintronic and Quantum Information, Faculty of Physics, Adam Mickiewicz University, Poznan, Uniwersytetu Poznanskiego 2, Poznan PL-61-614, Poland
| | - S Saha
- Department of Physics, Ashoka University, Sonipat, Haryana 131029, India
| |
Collapse
|
10
|
Okruszek Ł, Piejka A, Chrustowicz M, Krawczyk M, Jarkiewicz M, Schudy A, Ludwig K, Pinkham A. Social cognitive bias increases loneliness both directly and by decreasing social connection in patients with schizophrenia. Schizophr Res 2023; 256:72-78. [PMID: 37163867 DOI: 10.1016/j.schres.2023.04.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Revised: 04/04/2023] [Accepted: 04/30/2023] [Indexed: 05/12/2023]
Abstract
While considerable emphasis has been put on investigating the mechanisms that drive reduced social connection in patients with schizophrenia (SCZ), recent studies have increasingly focused on the issue of loneliness in SCZ. As both social cognitive bias and self-reported empathy predict loneliness in non-clinical populations, the current study aims to examine the relationship between loneliness, reduced social connection and social cognitive biases, and self-reported empathy in SCZ. Ninety-three adult SCZ and sixty-six matched healthy individuals completed a battery of questionnaires measuring loneliness and social connection (Revised-UCLA Loneliness Scale, Lubben-Social Network Scale, Social Disconnectedness Scale), cognitive biases (Ambiguous Intentions Hostility Questionnaire, Davos Assessment of Cognitive Biases Scale, Cognitive Biases Questionnaire for psychosis) and self-reported empathy (Interpersonal Reactivity Index). Significant predictors of loneliness in SCZ were entered into two latent variables ("Social Threat Bias", "Social Connection"), and structural equation modeling was used to explore the direct and indirect relationships between Social Threat Bias, symptoms. and loneliness in SCZ. Patients reported higher levels of loneliness, cognitive biases and personal distress compared to controls. Furthermore, SCZ reported less social connection and perspective taking compared to controls. Structural equation modeling revealed that Social Threat Bias was linked to increased loneliness in SCZ both directly and indirectly via decreased social connection. Negative symptoms were directly linked with loneliness, while the association between affective symptoms and loneliness was mediated via Social Threat Bias. The results of the current study suggest that social threat bias should be considered while planning the interventions aimed to reduce loneliness in schizophrenia.
Collapse
Affiliation(s)
- Ł Okruszek
- Social Neuroscience Lab, Institute of Psychology, Polish Academy of Sciences, Poland.
| | - A Piejka
- Social Neuroscience Lab, Institute of Psychology, Polish Academy of Sciences, Poland
| | - M Chrustowicz
- Social Neuroscience Lab, Institute of Psychology, Polish Academy of Sciences, Poland
| | - M Krawczyk
- Social Neuroscience Lab, Institute of Psychology, Polish Academy of Sciences, Poland
| | - M Jarkiewicz
- Third Department of Psychiatry, Institute of Psychiatry and Neurology, Poland
| | - A Schudy
- Faculty of Psychology, University of Warsaw, Poland
| | - K Ludwig
- Department of Psychology, University of North Carolina at Chapel Hill, United States of America
| | - A Pinkham
- Department of Psychology, University of Texas at Dallas, United States of America; Department of Psychiatry, UT Southwestern Medical Center, United States of America
| |
Collapse
|
11
|
Figiel W, Niewiński G, Grąt M, Krawczyk M, Stypułkowski J, Lewandowski Z, Krasnodębski M, Patkowski W, Zieniewicz K. Postoperative Supplemental Oxygen in Liver Transplantation (PSOLT) does not reduce the rate of infections: results of a randomized controlled trial. BMC Med 2023; 21:51. [PMID: 36782227 PMCID: PMC9924861 DOI: 10.1186/s12916-023-02741-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2022] [Accepted: 01/18/2023] [Indexed: 02/15/2023] Open
Abstract
BACKGROUND Despite inconsistent evidence, international guidelines underline the importance of perioperative hyperoxygenation in prevention of postoperative infections. Further, data on safety and efficacy of this method in liver transplant setting are lacking. The aim was to evaluate efficacy and safety of postoperative hyperoxygenation in prophylaxis of infections after liver transplantation. METHODS In this randomized controlled trial, patients undergoing liver transplantation were randomly assigned to either 28% or 80% fraction of inspired oxygen (FiO2) for 6 postoperative hours. Infections occurring during 30-day post-transplant period were the primary outcome measure. Secondary outcome measures included 90-day mortality, 90-day severe morbidity, 30-day pulmonary complications, durations of hospital and intensive care unit stay, and 5-day postoperative bilirubin concentration, alanine and aspartate transaminase activity, and international normalized ratio (INR) (clinicatrials.gov NCT02857855). RESULTS A total of 193 patients were included and randomized to 28% (n = 99) and 80% (n = 94) FiO2. With similar patient, operative, and donor characteristics in both groups, infections occurred in 34.0% (32/94) of patients assigned to 80% FiO2 as compared to 23.2% (23/99) of patients assigned to 28% FiO2 (p = 0.112). Patients randomized to 80% FiO2 more frequently developed severe complications (p = 0.035), stayed longer in the intensive care unit (p = 0.033), and had higher bilirubin concentration over first 5 post-transplant days (p = 0.043). No significant differences were found regarding mortality, duration of hospital stay, pulmonary complications, and 5-day aspartate and alanine transaminase activity and INR. CONCLUSIONS Postoperative hyperoxygenation should not be used for prophylaxis of infections after liver transplantation due to the lack of efficacy. TRIAL REGISTRATION ClinicalTrials.gov NCT02857855. Registered 7 July 2016.
Collapse
Affiliation(s)
- Wojciech Figiel
- Department of General, Transplant and Liver Surgery, Medical University of Warsaw, Banacha 1A, 02-097, Warsaw, Poland
| | - Grzegorz Niewiński
- Department of General, Transplant and Liver Surgery, Medical University of Warsaw, Banacha 1A, 02-097, Warsaw, Poland
| | - Michał Grąt
- Department of General, Transplant and Liver Surgery, Medical University of Warsaw, Banacha 1A, 02-097, Warsaw, Poland.
| | - Marek Krawczyk
- Department of General, Transplant and Liver Surgery, Medical University of Warsaw, Banacha 1A, 02-097, Warsaw, Poland
| | - Jan Stypułkowski
- Department of General, Transplant and Liver Surgery, Medical University of Warsaw, Banacha 1A, 02-097, Warsaw, Poland
| | - Zbigniew Lewandowski
- Department of Epidemiology and Biostatistics, Medical University of Warsaw, Oczki 3, 02-007, Warsaw, Poland
| | - Maciej Krasnodębski
- Department of General, Transplant and Liver Surgery, Medical University of Warsaw, Banacha 1A, 02-097, Warsaw, Poland
| | - Waldemar Patkowski
- Department of General, Transplant and Liver Surgery, Medical University of Warsaw, Banacha 1A, 02-097, Warsaw, Poland
| | - Krzysztof Zieniewicz
- Department of General, Transplant and Liver Surgery, Medical University of Warsaw, Banacha 1A, 02-097, Warsaw, Poland
| |
Collapse
|
12
|
Sierzega M, Bobrzynski L, Kolodziejczyk P, Wallner G, Kulig J, Szczepanik A, Sierzega M, Bobrzynski L, Kolodziejczyk P, Wallner G, Kulig J, Szczepanik A, Dadan J, Drews M, Fraczek M, Jeziorski A, Krawczyk M, Starzynska T, Richter P. Nomogram-Based Prognostic Evaluation of Gastric Cancer Patients with Low Counts of Examined Lymph Nodes Outperforms the Predictive Ability of the 7 th and 8 th Editions of the American Joint Committee on Cancer Staging System. J Gastrointest Surg 2023; 27:7-16. [PMID: 36138310 DOI: 10.1007/s11605-022-05334-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2022] [Accepted: 04/09/2022] [Indexed: 02/01/2023]
Abstract
BACKGROUND The American Joint Committee on Cancer (AJCC) staging system has limited accuracy in predicting survival of gastric cancer patients with inadequate counts of evaluated lymph nodes (LNs). We therefore aimed to develop a prognostic nomogram suitable for clinical applications in such cases. METHODS A total of 1511 noncardia gastric cancer patients treated between 1990 and 2010 in the academic surgical center were reviewed to compare the 7th and 8th editions of the AJCC staging system. A nomogram was developed for the prediction of 5-year survival in patients with less than 16 LNs evaluated (n = 546). External validation was performed using datasets derived from the Polish Gastric Cancer Study Group (n = 668) and the SEER database (n = 11,225). RESULTS The 8th edition of AJCC staging showed better overall discriminatory power compared to the previous version, but no improvement was found for patients with < 16 evaluated LNs. The developed nomogram had better concordance index (0.695) than the former (0.682) or latest (0.680) staging editions, including patients subject to neoadjuvant treatment, and calibration curves showed excellent agreement between the nomogram-predicted and actual survival. High discriminatory power was also demonstrated for both validation cohorts. Subsequently, the nomogram showed the best accuracy for the prediction of 5-year survival through the time-dependent ROC curve analysis in the training and validation cohorts. CONCLUSIONS A clinically relevant nomogram was built for the prediction of 5-year survival in patients with inadequate numbers of LNs evaluated in surgical specimens. The predictive accuracy of the nomogram was validated in two Western populations.
Collapse
Affiliation(s)
- Marek Sierzega
- First Department of Surgery, Jagiellonian University Medical College, 2 Jakubowskiego Street, 30-688, Krakow, Poland.
| | - Lukasz Bobrzynski
- First Department of Surgery, Jagiellonian University Medical College, 2 Jakubowskiego Street, 30-688, Krakow, Poland
| | - Piotr Kolodziejczyk
- First Department of Surgery, Jagiellonian University Medical College, 2 Jakubowskiego Street, 30-688, Krakow, Poland
| | - Grzegorz Wallner
- Second Department of General, Gastrointestinal and Oncological Surgery of the Alimentary Tract, Medical University of Lublin, Lublin, Poland
| | - Jan Kulig
- First Department of Surgery, Jagiellonian University Medical College, 2 Jakubowskiego Street, 30-688, Krakow, Poland
| | - Antoni Szczepanik
- First Department of Surgery, Jagiellonian University Medical College, 2 Jakubowskiego Street, 30-688, Krakow, Poland
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
13
|
Okruszek Ł, Chrustowicz M, Jarkiewicz M, Krawczyk M, Manera V, Piejka A, Schudy A, Wiśniewska M, Wysokiński A. Mentalizing abilities mediate the impact of the basic social perception on negative symptoms in patients with schizophrenia. J Psychiatr Res 2022; 155:85-89. [PMID: 35995018 DOI: 10.1016/j.jpsychires.2022.07.069] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Revised: 07/13/2022] [Accepted: 07/30/2022] [Indexed: 10/31/2022]
Abstract
Social cognitive deficits are currently considered as one of the main predictors of clinical symptoms and functional outcome in patients with schizophrenia. Multiple studies have suggested that a two-factor solution (low-level vs. high-level) best describes the structure of social cognitive processes in patients. While higher-order processes have been repeatedly linked to negative symptoms, no such association was found for lower-level processes. Thus, the aim of the current study is to examine whether the association between basic social perception processes and symptoms in patients with schizophrenia is mediated by mentalizing abilities. One hundred thirty-nine patients have completed basic social perception (Communicative Interactions Database task CID-12) and mentalizing (Reading the Mind in the Eyes task) tasks. In line with our hypothesis, we have observed full mediation of the effects of basic social perception abilities on negative symptoms via mentalizing abilities in patients. This effect suggests that, similarly as in the case of positive symptoms, a hierarchical nature of social cognitive processes should be considered while investigating negative symptoms of schizophrenia.
Collapse
Affiliation(s)
- Ł Okruszek
- Social Neuroscience Lab, Institute of Psychology, Polish Academy of Sciences, Poland.
| | - M Chrustowicz
- Social Neuroscience Lab, Institute of Psychology, Polish Academy of Sciences, Poland
| | | | - M Krawczyk
- Social Neuroscience Lab, Institute of Psychology, Polish Academy of Sciences, Poland
| | | | - A Piejka
- Social Neuroscience Lab, Institute of Psychology, Polish Academy of Sciences, Poland
| | - A Schudy
- Faculty of Psychology, University of Warsaw, Poland
| | - M Wiśniewska
- Social Neuroscience Lab, Institute of Psychology, Polish Academy of Sciences, Poland
| | | |
Collapse
|
14
|
Krasnodębski M, Morawski M, Borkowski J, Grąt K, Stypułkowski J, Skalski M, Zhylko A, Krawczyk M, Grąt M. Skin Autofluorescence Measurement as Initial Assessment of Hepatic Parenchyma Quality in Patients Undergoing Liver Resection. J Clin Med 2022; 11:jcm11185341. [PMID: 36142988 PMCID: PMC9503381 DOI: 10.3390/jcm11185341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Revised: 09/01/2022] [Accepted: 09/09/2022] [Indexed: 11/16/2022] Open
Abstract
Skin autofluorescence (SAF) can detect advanced glycation end products (AGEs) that accumulate in tissues over time. AGEs reflect patients’ general health, and their pathological accumulation has been associated with various diseases. This study aimed to determine whether its measurements can correlate with the liver parenchyma quality. This prospective study included 186 patients who underwent liver resections. Liver fibrosis and/or steatosis > 10% were found in almost 30% of the patients. ROC analysis for SAF revealed the optimal cutoff point of 2.4 AU as an independent predictor for macrovesicular steatosis ≥ 10% with an AUC of 0.629 (95% CI 0.538−0.721, p = 0.006), 59.9% sensitivity, 62.4% specificity, and positive (PPV) and negative (NPV) predictive values of 45.7% and 74.1%, respectively. The optimal cutoff point for liver fibrosis was 2.3 AU with an AUC of 0.613 (95% CI 0.519−0.708, p = 0.018), 67.3% sensitivity, 55.2% specificity, and PPV and NPV of 37.1% and 81.2%, respectively. In the multivariable logistic regression model, SAF ≥ 2.4 AU (OR 2.16; 95% CI 1.05−4.43; p = 0.036) and BMI (OR 1.21; 95% CI 1.10−1.33, p < 0.001) were independent predictors of macrovesicular steatosis ≥ 10%. SAF may enhance the available non-invasive methods of detecting hepatic steatosis and fibrosis in patients prior to liver resection.
Collapse
Affiliation(s)
- Maciej Krasnodębski
- Department of General, Transplant, and Liver Surgery, Medical University of Warsaw, 02-097 Warsaw, Poland
- Correspondence: ; Tel.: +48-22-599-25-45
| | - Marcin Morawski
- Department of General, Transplant, and Liver Surgery, Medical University of Warsaw, 02-097 Warsaw, Poland
| | - Jan Borkowski
- Department of General, Transplant, and Liver Surgery, Medical University of Warsaw, 02-097 Warsaw, Poland
| | - Karolina Grąt
- Second Department of Clinical Radiology, Medical University of Warsaw, 02-097 Warsaw, Poland
| | - Jan Stypułkowski
- Department of General, Transplant, and Liver Surgery, Medical University of Warsaw, 02-097 Warsaw, Poland
| | - Michał Skalski
- Department of General, Transplant, and Liver Surgery, Medical University of Warsaw, 02-097 Warsaw, Poland
| | - Andriy Zhylko
- Department of General, Transplant, and Liver Surgery, Medical University of Warsaw, 02-097 Warsaw, Poland
| | - Marek Krawczyk
- Department of General, Transplant, and Liver Surgery, Medical University of Warsaw, 02-097 Warsaw, Poland
| | - Michał Grąt
- Department of General, Transplant, and Liver Surgery, Medical University of Warsaw, 02-097 Warsaw, Poland
| |
Collapse
|
15
|
Roeb E, Canbay A, Bantel H, Bojunga J, de Laffolie J, Demir M, Denzer UW, Geier A, Hofmann WP, Hudert C, Karlas T, Krawczyk M, Longerich T, Luedde T, Roden M, Schattenberg J, Sterneck M, Tannapfel A, Lorenz P, Tacke F. Aktualisierte S2k-Leitlinie nicht-alkoholische Fettlebererkrankung der Deutschen Gesellschaft für Gastroenterologie, Verdauungs- und Stoffwechselkrankheiten (DGVS) – April 2022 – AWMF-Registernummer: 021–025. Z Gastroenterol 2022; 60:1346-1421. [PMID: 36100202 DOI: 10.1055/a-1880-2283] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Affiliation(s)
- E Roeb
- Gastroenterologie, Medizinische Klinik II, Universitätsklinikum Gießen und Marburg, Gießen, Deutschland
| | - A Canbay
- Medizinische Klinik, Universitätsklinikum Knappschaftskrankenhaus Bochum, Bochum, Deutschland
| | - H Bantel
- Klinik für Gastroenterologie, Hepatologie und Endokrinologie, Medizinische Hochschule Hannover (MHH), Hannover, Deutschland
| | - J Bojunga
- Medizinische Klinik I Gastroent., Hepat., Pneum., Endokrin., Universitätsklinikum Frankfurt, Frankfurt, Deutschland
| | - J de Laffolie
- Allgemeinpädiatrie und Neonatologie, Zentrum für Kinderheilkunde und Jugendmedizin, Universitätsklinikum Gießen und Marburg, Gießen, Deutschland
| | - M Demir
- Medizinische Klinik mit Schwerpunkt Hepatologie und Gastroenterologie, Charité - Universitätsmedizin Berlin, Campus Virchow-Klinikum und Campus Charité Mitte, Berlin, Deutschland
| | - U W Denzer
- Klinik für Gastroenterologie und Endokrinologie, Universitätsklinikum Gießen und Marburg, Marburg, Deutschland
| | - A Geier
- Medizinische Klinik und Poliklinik II, Schwerpunkt Hepatologie, Universitätsklinikum Würzburg, Würzburg, Deutschland
| | - W P Hofmann
- Gastroenterologie am Bayerischen Platz - Medizinisches Versorgungszentrum, Berlin, Deutschland
| | - C Hudert
- Klinik für Pädiatrie m. S. Gastroenterologie, Nephrologie und Stoffwechselmedizin, Charité Campus Virchow-Klinikum - Universitätsmedizin Berlin, Berlin, Deutschland
| | - T Karlas
- Klinik und Poliklinik für Onkologie, Gastroenterologie, Hepatologie, Pneumologie und Infektiologie, Universitätsklinikum Leipzig, Leipzig, Deutschland
| | - M Krawczyk
- Klinik für Innere Medizin II, Gastroent., Hepat., Endokrin., Diabet., Ern.med., Universitätsklinikum des Saarlandes, Homburg, Deutschland
| | - T Longerich
- Pathologisches Institut, Universitätsklinikum Heidelberg, Heidelberg, Deutschland
| | - T Luedde
- Klinik für Gastroenterologie, Hepatologie und Infektiologie, Universitätsklinikum Düsseldorf, Düsseldorf, Deutschland
| | - M Roden
- Klinik für Endokrinologie und Diabetologie, Universitätsklinikum Düsseldorf, Düsseldorf, Deutschland
| | - J Schattenberg
- I. Medizinische Klinik und Poliklinik, Universitätsmedizin Mainz, Mainz, Deutschland
| | - M Sterneck
- Klinik für Hepatobiliäre Chirurgie und Transplantationschirurgie, Universitätsklinikum Hamburg, Hamburg, Deutschland
| | - A Tannapfel
- Institut für Pathologie, Ruhr-Universität Bochum, Bochum, Deutschland
| | - P Lorenz
- Deutsche Gesellschaft für Gastroenterologie, Verdauungs- und Stoffwechselkrankheiten (DGVS), Berlin, Deutschland
| | - F Tacke
- Medizinische Klinik mit Schwerpunkt Hepatologie und Gastroenterologie, Charité - Universitätsmedizin Berlin, Campus Virchow-Klinikum und Campus Charité Mitte, Berlin, Deutschland
| | | |
Collapse
|
16
|
Porsch F, Kiss M, Rajčić D, Papac-Milicevic N, Goederle L, Hladik A, Derdak S, Shaw L, Heintz L, Paternostro R, Farlik M, Knapp S, Krawczyk M, Trauner M, Bilban M, Wolf D, Binder C, Hendrikx T. Non-alcoholic steatohepatitis is reflected by levels of systemic soluble TREM2 and limited by the recruitment of TREM2-positive macrophages to areas of lipid-induced tissue damage. Atherosclerosis 2022. [DOI: 10.1016/j.atherosclerosis.2022.06.050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
17
|
Casper M, Reichert MC, Rissland J, Smola S, Lammert F, Krawczyk M. Pre-endoscopy SARS-CoV-2 testing strategy during COVID-19 pandemic: the care must go on. Eur J Med Res 2022; 27:41. [PMID: 35303954 PMCID: PMC8931568 DOI: 10.1186/s40001-022-00672-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2020] [Accepted: 03/07/2022] [Indexed: 11/24/2022] Open
Abstract
Background In response to the COVID-19 pandemic, endoscopic societies initially recommended reduction of endoscopic procedures. In particular non-urgent endoscopies should be postponed. However, this might lead to unnecessary delay in diagnosing gastrointestinal conditions. Methods Retrospectively we analysed the gastrointestinal endoscopies performed at the Central Endoscopy Unit of Saarland University Medical Center during seven weeks from 23 March to 10 May 2020 and present our real-world single-centre experience with an individualized rtPCR-based pre-endoscopy SARS-CoV-2 testing strategy. We also present our experience with this strategy in 2021. Results Altogether 359 gastrointestinal endoscopies were performed in the initial period. The testing strategy enabled us to conservatively handle endoscopy programme reduction (44% reduction as compared 2019) during the first wave of the COVID-19 pandemic. The results of COVID-19 rtPCR from nasopharyngeal swabs were available in 89% of patients prior to endoscopies. Apart from six patients with known COVID-19, all other tested patients were negative. The frequencies of endoscopic therapies and clinically significant findings did not differ between patients with or without SARS-CoV-2 tests. In 2021 we were able to unrestrictedly perform all requested endoscopic procedures (> 5000 procedures) by applying the rtPCR-based pre-endoscopy SARS-CoV-2 testing strategy, regardless of next waves of COVID-19. Only two out-patients (1893 out-patient procedures) were tested positive in the year 2021. Conclusion A structured pre-endoscopy SARS-CoV-2 testing strategy is feasible in the clinical routine of an endoscopy unit. rtPCR-based pre-endoscopy SARS-CoV-2 testing safely allowed unrestricted continuation of endoscopic procedures even in the presence of high incidence rates of COVID-19. Given the low frequency of positive tests, the absolute effect of pre-endoscopy testing on viral transmission may be low when FFP-2 masks are regularly used.
Collapse
Affiliation(s)
- M Casper
- Department of Medicine II - Gastroenterology, Hepatology and Endocrinology, Saarland University Medical Center, Saarland University, Kirrberger Straße 100, 66421, Homburg, Germany.
| | - M C Reichert
- Department of Medicine II - Gastroenterology, Hepatology and Endocrinology, Saarland University Medical Center, Saarland University, Kirrberger Straße 100, 66421, Homburg, Germany
| | - J Rissland
- Institute of Virology, Saarland University Medical Center, Saarland University, Homburg, Germany
| | - S Smola
- Institute of Virology, Saarland University Medical Center, Saarland University, Homburg, Germany
| | - F Lammert
- Department of Medicine II - Gastroenterology, Hepatology and Endocrinology, Saarland University Medical Center, Saarland University, Kirrberger Straße 100, 66421, Homburg, Germany.,Hannover Medical School, Hannover Health Sciences Campus, Hannover, Germany
| | - M Krawczyk
- Department of Medicine II - Gastroenterology, Hepatology and Endocrinology, Saarland University Medical Center, Saarland University, Kirrberger Straße 100, 66421, Homburg, Germany.,Laboratory of Metabolic Liver Diseases, Department of General, Transplant and Liver Surgery, Center for Preclinical Research, Medical University of Warsaw, Warsaw, Poland
| |
Collapse
|
18
|
Grąt M, Morawski M, Krasnodębski M, Borkowski J, Krawczyk P, Grąt K, Stypułkowski J, Maczkowski B, Figiel W, Lewandowski Z, Kobryń K, Patkowski W, Krawczyk M, Wróblewski T, Otto W, Paluszkiewicz R, Zieniewicz K. Incisional Surgical Site Infections After Mass and Layered Closure of Upper Abdominal Transverse Incisions: First Results of a Randomized Controlled Trial. Ann Surg 2021; 274:690-697. [PMID: 34353985 DOI: 10.1097/sla.0000000000005128] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To compare the early results of mass and layered closure of upper abdominal transverse incisions. SUMMARY OF BACKGROUND DATA Contrary to midline incisions, data on closure of transverse abdominal incisions are lacking. METHODS This is the first analysis of a randomized controlled trial primarily designed to compare mass with layered closure of transverse incisions with respect to incisional hernias. Patients undergoing laparotomy through upper abdominal transverse incisions were randomized to either mass or layered closure with continuous sutures. Incisional surgical site infection (incisional-SSI) was the primary end-point. Secondary end-points comprised suture-to-wound length ratio (SWLR), closure duration, and fascial dehiscence (clinicatrials.gov NCT03561727). RESULTS A total of 268 patients were randomized to either mass (n=134) or layered (n=134) closure. Incisional-SSIs occurred in 24 (17.9%) and 8 (6.0%) patients after mass and layered closure, respectively (P =0.004), with crude odds ratio (OR) of 0.29 [95% confidence interval (95% CI) 0.13-0.67; P =0.004]. Layered technique was independently associated with fewer incisional-SSIs (OR: 0.29; 95% CI 0.12-0.69; P =0.005). The number needed to treat, absolute, and relative risk reduction for layered technique in reducing incisional-SSIs were 8.4 patients, 11.9%, and 66.5%, respectively. Dehiscence occurred in one (0.8%) patient after layered closure and in two (1.5%) patients after mass closure (P >0.999). Median SWLR were 8.1 and 5.6 (P <0.001) with median closure times of 27.5 and 25.0 minutes (P =0.044) for layered and mass closures, respectively. CONCLUSIONS Layered closure of upper abdominal transverse incisions should be preferred due to lower risk of incisional-SSIs and higher SWLR, despite clinically irrelevant longer duration.
Collapse
Affiliation(s)
- Michał Grąt
- Department of General, Transplant and Liver Surgery, Warsaw, Poland
| | - Marcin Morawski
- Department of General, Transplant and Liver Surgery, Warsaw, Poland
| | | | - Jan Borkowski
- Department of General, Transplant and Liver Surgery, Warsaw, Poland
| | - Piotr Krawczyk
- Department of General, Transplant and Liver Surgery, Warsaw, Poland
| | - Karolina Grąt
- Second Department of Clinical Radiology, Warsaw, Poland
| | - Jan Stypułkowski
- Department of General, Transplant and Liver Surgery, Warsaw, Poland
| | | | - Wojciech Figiel
- Department of General, Transplant and Liver Surgery, Warsaw, Poland
| | - Zbigniew Lewandowski
- Department of Epidemiology and Biostatistics, Medical University of Warsaw, Warsaw, Poland
| | - Konrad Kobryń
- Department of General, Transplant and Liver Surgery, Warsaw, Poland
| | | | - Marek Krawczyk
- Department of General, Transplant and Liver Surgery, Warsaw, Poland
| | | | - Włodzimierz Otto
- Department of General, Transplant and Liver Surgery, Warsaw, Poland
| | | | | |
Collapse
|
19
|
Lamarca A, Santos-Laso A, Utpatel K, La Casta A, Stock S, Forner A, Adeva J, Folseraas T, Fabris L, Macias RI, Krawczyk M, Krawczyk M, Cardinale V, Braconi C, Alvaro D, Evert M, Banales JM, Valle JW. REPLY. Hepatology 2021; 74:2319-2321. [PMID: 33998692 DOI: 10.1002/hep.31904] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/08/2022]
Affiliation(s)
- Angela Lamarca
- Medical Oncology/Institute of Cancer Sciences, The Christie NHS Foundation Trust/University of Manchester, Manchester, United Kingdom
| | - Alvaro Santos-Laso
- Department of Liver and Gastrointestinal Diseases, Biodonostia Health Research Institute - Donostia University Hospital, University of the Basque Country (UPV/EHU), San Sebastian, Spain
| | - Kirsten Utpatel
- Institute of Pathology, University of Regensburg, Regensburg, Germany
| | - Adelaida La Casta
- Department of Liver and Gastrointestinal Diseases, Biodonostia Health Research Institute - Donostia University Hospital, University of the Basque Country (UPV/EHU), San Sebastian, Spain
| | - Simone Stock
- Institute of Pathology, University of Regensburg, Regensburg, Germany
| | - Alejandro Forner
- BCLC Group, Liver Unit, Hospital Clínic Barcelona, Barcelona, Spain.,National Institute for the Study of Liver and Gastrointestinal Diseases (CIBERehd), Carlos III National Health Institute, Madrid, Spain
| | - Jorge Adeva
- Department of Medical Oncology Hospital, Universitario 12 de Octubre, Madrid, Spain
| | - Trine Folseraas
- Section of Gastroenterology and the Norwegian PSC Research Center, Department of Transplantation Medicine, Oslo University Hospital, Oslo, Norway
| | - Luca Fabris
- Molecular Medicine, University of Padua, Padua, Italy
| | - Rocio Ir Macias
- National Institute for the Study of Liver and Gastrointestinal Diseases (CIBERehd), Carlos III National Health Institute, Madrid, Spain.,Experimental Hepatology and Drug Targeting (HEVEPHARM) Group, University of Salamanca, IBSAL, Salamanca, Spain
| | - Marcin Krawczyk
- Department of Medicine II, Saarland University Medical Centre, Saarland University, Homburg, Germany.,Laboratory of Metabolic Liver Diseases, Centre for Preclinical Research, Department of General, Transplant and Liver Surgery, Medical University of Warsaw, Warsaw, Poland
| | - Marek Krawczyk
- Department of General, Transplant and Liver Surgery, Medical University of Warsaw, Warsaw, Poland
| | | | - Chiara Braconi
- Medical Oncology, The University of Glasgow, Glasgow, United Kingdom
| | | | - Matthias Evert
- Institute of Pathology, University of Regensburg, Regensburg, Germany
| | - Jesus M Banales
- Department of Liver and Gastrointestinal Diseases, Biodonostia Health Research Institute - Donostia University Hospital, University of the Basque Country (UPV/EHU), San Sebastian, Spain.,National Institute for the Study of Liver and Gastrointestinal Diseases (CIBERehd), Carlos III National Health Institute, Madrid, Spain.,IKERBASQUE, Basque Foundation for Science, Bilbao, Spain
| | - Juan W Valle
- Medical Oncology/Institute of Cancer Sciences, The Christie NHS Foundation Trust/University of Manchester, Manchester, United Kingdom
| |
Collapse
|
20
|
Barman A, Gubbiotti G, Ladak S, Adeyeye AO, Krawczyk M, Gräfe J, Adelmann C, Cotofana S, Naeemi A, Vasyuchka VI, Hillebrands B, Nikitov SA, Yu H, Grundler D, Sadovnikov AV, Grachev AA, Sheshukova SE, Duquesne JY, Marangolo M, Csaba G, Porod W, Demidov VE, Urazhdin S, Demokritov SO, Albisetti E, Petti D, Bertacco R, Schultheiss H, Kruglyak VV, Poimanov VD, Sahoo S, Sinha J, Yang H, Münzenberg M, Moriyama T, Mizukami S, Landeros P, Gallardo RA, Carlotti G, Kim JV, Stamps RL, Camley RE, Rana B, Otani Y, Yu W, Yu T, Bauer GEW, Back C, Uhrig GS, Dobrovolskiy OV, Budinska B, Qin H, van Dijken S, Chumak AV, Khitun A, Nikonov DE, Young IA, Zingsem BW, Winklhofer M. The 2021 Magnonics Roadmap. J Phys Condens Matter 2021; 33:413001. [PMID: 33662946 DOI: 10.1088/1361-648x/abec1a] [Citation(s) in RCA: 50] [Impact Index Per Article: 16.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Accepted: 03/04/2021] [Indexed: 05/26/2023]
Abstract
Magnonics is a budding research field in nanomagnetism and nanoscience that addresses the use of spin waves (magnons) to transmit, store, and process information. The rapid advancements of this field during last one decade in terms of upsurge in research papers, review articles, citations, proposals of devices as well as introduction of new sub-topics prompted us to present the first roadmap on magnonics. This is a collection of 22 sections written by leading experts in this field who review and discuss the current status besides presenting their vision of future perspectives. Today, the principal challenges in applied magnonics are the excitation of sub-100 nm wavelength magnons, their manipulation on the nanoscale and the creation of sub-micrometre devices using low-Gilbert damping magnetic materials and its interconnections to standard electronics. To this end, magnonics offers lower energy consumption, easier integrability and compatibility with CMOS structure, reprogrammability, shorter wavelength, smaller device features, anisotropic properties, negative group velocity, non-reciprocity and efficient tunability by various external stimuli to name a few. Hence, despite being a young research field, magnonics has come a long way since its early inception. This roadmap asserts a milestone for future emerging research directions in magnonics, and hopefully, it will inspire a series of exciting new articles on the same topic in the coming years.
Collapse
Affiliation(s)
- Anjan Barman
- Department of Condensed Matter Physics and Material Sciences, S N Bose National Centre for Basic Sciences, Salt Lake, Kolkata 700106, India
| | - Gianluca Gubbiotti
- Istituto Officina dei Materiali del Consiglio nazionale delle Ricerche (IOM-CNR), Perugia, Italy
| | - S Ladak
- School of Physics and Astronomy, Cardiff University, United Kingdom
| | - A O Adeyeye
- Department of Physics, University of Durham, United Kingdom
| | - M Krawczyk
- Adam Mickiewicz University, Poznan, Poland
| | - J Gräfe
- Max Planck Institute for Intelligent Systems, Stuttgart, Germany
| | | | - S Cotofana
- Delft University of Technology, The Netherlands
| | - A Naeemi
- Georgia Institute of Technology, United States of America
| | - V I Vasyuchka
- Department of Physics and State Research Center OPTIMAS, Technische Universität Kaiserslautern (TUK), Kaiserslautern, Germany
| | - B Hillebrands
- Department of Physics and State Research Center OPTIMAS, Technische Universität Kaiserslautern (TUK), Kaiserslautern, Germany
| | - S A Nikitov
- Kotelnikov Institute of Radioengineering and Electronics, Moscow, Russia
| | - H Yu
- Fert Beijing Institute, BDBC, School of Microelectronics, Beijing Advanced Innovation Center for Big Data and Brian Computing, Beihang University, People's Republic of China
| | - D Grundler
- Laboratory of Nanoscale Magnetic Materials and Magnonics, Institute of Materials (IMX), Institute of Electrical and Micro Engineering, School of Engineering, École Polytechnique Fédérale de Lausanne (EPFL), Switzerland
| | - A V Sadovnikov
- Kotelnikov Institute of Radioengineering and Electronics, Moscow, Russia
- Laboratory 'Magnetic Metamaterials', Saratov State University, Saratov, Russia
| | - A A Grachev
- Kotelnikov Institute of Radioengineering and Electronics, Moscow, Russia
- Laboratory 'Magnetic Metamaterials', Saratov State University, Saratov, Russia
| | - S E Sheshukova
- Kotelnikov Institute of Radioengineering and Electronics, Moscow, Russia
- Laboratory 'Magnetic Metamaterials', Saratov State University, Saratov, Russia
| | - J-Y Duquesne
- Institut des NanoSciences de Paris, Sorbonne University, CNRS, Paris, France
| | - M Marangolo
- Institut des NanoSciences de Paris, Sorbonne University, CNRS, Paris, France
| | - G Csaba
- Pázmány University, Budapest, Hungary
| | - W Porod
- University of Notre Dame, IN, United States of America
| | - V E Demidov
- Institute for Applied Physics, University of Muenster, Muenster, Germany
| | - S Urazhdin
- Department of Physics, Emory University, Atlanta, United States of America
| | - S O Demokritov
- Institute for Applied Physics, University of Muenster, Muenster, Germany
| | | | - D Petti
- Polytechnic University of Milan, Italy
| | | | - H Schultheiss
- Helmholtz-Center Dresden-Rossendorf, Institute of Ion Beam Physics and Materials Research, Germany
- Technische Universität Dresden, Germany
| | | | | | - S Sahoo
- Department of Condensed Matter Physics and Material Sciences, S N Bose National Centre for Basic Sciences, Salt Lake, Kolkata 700106, India
| | - J Sinha
- Department of Physics and Nanotechnology, SRM Institute of Science and Technology, Kattankulathur, India
| | - H Yang
- Department of Electrical and Computer Engineering, National University of Singapore, Singapore
| | - M Münzenberg
- Institute of Physics, University of Greifswald, Greifswald, Germany
| | - T Moriyama
- Institute for Chemical Research, Kyoto University, Gokasho, Uji, Kyoto, Japan
- Centre for Spintronics Research Network, Japan
| | - S Mizukami
- Centre for Spintronics Research Network, Japan
- Advanced Institute for Materials Research (WPI-AIMR), Tohoku University, Sendai, Japan
| | - P Landeros
- Departamento de Física, Universidad Técnica Federico Santa María, Valparaíso, Chile
- Center for the Development of Nanoscience and Nanotechnology (CEDENNA), Santiago, Chile
| | - R A Gallardo
- Departamento de Física, Universidad Técnica Federico Santa María, Valparaíso, Chile
- Center for the Development of Nanoscience and Nanotechnology (CEDENNA), Santiago, Chile
| | - G Carlotti
- Dipartimento di Fisica e Geologia, University of Perugia, Perugia, Italy
- CNR Instituto Nanoscienze, Modena, Italy
| | - J-V Kim
- Centre for Nanosciences and Nanotechnology, CNRS, Université Paris-Saclay, Palaiseau, France
| | - R L Stamps
- Department of Physics and Astronomy, University of Manitoba, Canada
| | - R E Camley
- Center for Magnetism and Magnetic Nanostructures, University of Colorado, Colorado Springs, United States of America
| | | | - Y Otani
- RIKEN, Japan
- Institute for Solid State Physics (ISSP), University of Tokyo, Japan
| | - W Yu
- Institute for Materials Research, Tohoku University, Sendai, 980-8577, Japan
| | - T Yu
- Max Planck Institute for the Structure and Dynamics of Matter, Hamburg, Germany
| | - G E W Bauer
- Advanced Institute for Materials Research (WPI-AIMR), Tohoku University, Sendai, Japan
- Zernike Institute for Advanced Materials, Groningen University, The Netherlands
| | - C Back
- Technical University Munich, Germany
| | - G S Uhrig
- Technical University Dortmund, Germany
| | | | - B Budinska
- Faculty of Physics, University of Vienna, Vienna, Austria
| | - H Qin
- Department of Applied Physics, School of Science, Aalto University, Finland
| | - S van Dijken
- Department of Applied Physics, School of Science, Aalto University, Finland
| | - A V Chumak
- Faculty of Physics, University of Vienna, Vienna, Austria
| | - A Khitun
- University of California Riverside, United States of America
| | - D E Nikonov
- Components Research, Intel, Hillsboro, Oregon, United States of America
| | - I A Young
- Components Research, Intel, Hillsboro, Oregon, United States of America
| | - B W Zingsem
- The University of Duisburg-Essen, CENIDE, Germany
| | - M Winklhofer
- The Carl von Ossietzky University of Oldenburg, Germany
| |
Collapse
|
21
|
Lamarca A, Santos-Laso A, Utpatel K, La Casta A, Stock S, Forner A, Adeva J, Folseraas T, Fabris L, Macias RIR, Krawczyk M, Krawczyk M, Cardinale V, Braconi C, Alvaro D, Evert M, Banales JM, Valle JW. REPLY. Hepatology 2021; 74:1129-1131. [PMID: 33550618 DOI: 10.1002/hep.31740] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Affiliation(s)
- Angela Lamarca
- Medical Oncology/Institute of Cancer SciencesThe Christie NHS Foundation Trust/University of ManchesterManchesterUnited Kingdom
| | - Alvaro Santos-Laso
- Department of Liver and Gastrointestinal DiseasesBiodonostia Health Research Institute - Donostia University Hospital -, University of the Basque Country (UPV/EHU)San SebastianSpain
| | - Kirsten Utpatel
- Institute of PathologyUniversity of RegensburgRegensburgGermany
| | - Adelaida La Casta
- Department of Liver and Gastrointestinal DiseasesBiodonostia Health Research Institute - Donostia University Hospital -, University of the Basque Country (UPV/EHU)San SebastianSpain
| | - Simone Stock
- Institute of PathologyUniversity of RegensburgRegensburgGermany
| | - Alejandro Forner
- BCLC group, Liver UnitHospital Clínic BarcelonaBarcelonaSpain.,National Institute for the Study of Liver and Gastrointestinal Diseases (CIBERehd)III National Health InstituteCarlos, MadridSpain
| | - Jorge Adeva
- Department of Medical OncologyHospital Universitario 12 de OctubreMadridSpain
| | - Trine Folseraas
- Section of Gastroenterology and the Norwegian PSC Research Center, Department of Transplantation MedicineOslo University HospitalOsloNorway
| | - Luca Fabris
- Molecular MedicineUniversity of PaduaPaduaItaly
| | - Rocio I R Macias
- National Institute for the Study of Liver and Gastrointestinal Diseases (CIBERehd)III National Health InstituteCarlos, MadridSpain.,Experimental Hepatology and Drug Targeting (HEVEFARM) GroupUniversity of SalamancaIBSALSalamancaSpain
| | - Marcin Krawczyk
- Department of Medicine IISaarland University Medical CentreSaarland UniversityHomburgGermany.,Laboratory of Metabolic Liver Diseases, Centre for Preclinical Research, Department of General, Transplant and Liver SurgeryMedical University of WarsawWarsawPoland
| | - Marek Krawczyk
- Department of General, Transplant and Liver SurgeryMedical University of WarsawWarsawPoland
| | | | - Chiara Braconi
- Medical OncologyThe University of GlasgowGlasgowUnited Kingdom
| | | | - Matthias Evert
- Institute of PathologyUniversity of RegensburgRegensburgGermany
| | - Jesus M Banales
- Department of Liver and Gastrointestinal DiseasesBiodonostia Health Research Institute - Donostia University Hospital -, University of the Basque Country (UPV/EHU)San SebastianSpain.,National Institute for the Study of Liver and Gastrointestinal Diseases (CIBERehd)III National Health InstituteCarlos, MadridSpain.,IKERBASQUEBasque Foundation for ScienceBilbaoSpain
| | - Juan W Valle
- Medical Oncology/Institute of Cancer SciencesThe Christie NHS Foundation Trust/University of ManchesterManchesterUnited Kingdom
| |
Collapse
|
22
|
Lamarca A, Santos‐Laso A, Utpatel K, La Casta A, Stock S, Forner A, Adeva J, Folseraas T, Fabris L, Macias RI, Krawczyk M, Krawczyk M, Cardinale V, Braconi C, Alvaro D, Evert M, Banales JM, Valle JW. Liver Metastases of Intrahepatic Cholangiocarcinoma: Implications for an Updated Staging System. Hepatology 2021; 73:2311-2325. [PMID: 33073396 PMCID: PMC8252018 DOI: 10.1002/hep.31598] [Citation(s) in RCA: 33] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Revised: 08/04/2020] [Accepted: 09/20/2020] [Indexed: 12/11/2022]
Abstract
BACKGROUND AND AIMS Intrahepatic cholangiocarcinoma (iCCA) with liver metastases is perceived to have a poor prognosis, but the American Joint Committee on Cancer (AJCC) classifies them as early stage in the absence of lymph nodes or extrahepatic spread. APPROACH AND RESULTS Patients with iCCA from the European Network for the Study of Cholangiocarcinoma (ENS-CCA) and Surveillance, Epidemiology, and End Results (SEER) registries with survival/staging (AJCC v.7) data were eligible. Modified staging was used (mAJCC v.7): group A: stages I-III (excluding T2bN0); group B: stage IVa (excluding T2bN1M0); group C: liver metastases (T2bN0/1); and group D: stage IVb (extrahepatic metastases). Survival analysis (Kaplan-Meier and Cox regression) was performed in an ENS-CCA training cohort (TC) and findings internally (ENS-CCA iVC) and externally (SEER) validated. The aim was to assess whether liver metastases (group C) had a shorter survival compared to other early stages (group A) to propose a modified version of AJCC v.8 (mAJCC v.8). A total of 574 and 4,171 patients from the ENS-CCA and SEER registries were included. Following the new classification, 19.86% and 17.31% of patients from the ENS-CCA and SEER registries were reclassified into group C, respectively. In the ENS-CCA TC, multivariable Cox regression was adjusted for obesity (p = 0.026) and performance status (P < 0.001); patients in group C (HR, 2.53; 95% CI, 1.18-5.42; P = 0.017) had a higher risk of death (vs. group A). Findings were validated in the ENS-CCA iVC (HR, 2.93; 95% CI, 2.04-4.19; P < 0.001) and in the SEER registry (HR, 1.88; 95% CI, 1.68-2.09; P < 0.001). CONCLUSIONS iCCA with liver metastases has a worse outcome than other early stages of iCCA. Given that AJCC v.8 does not take this into consideration, a modification of AJCC v.8 (mAJCC v.8), including "liver metastases: multiple liver lesions, with or without vascular invasion" as an "M1a stage," is suggested.
Collapse
Affiliation(s)
- Angela Lamarca
- Medical Oncology/Institute of Cancer SciencesThe Christie NHS Foundation Trust/University of ManchesterManchesterUnited Kingdom
| | - Alvaro Santos‐Laso
- Department of Liver and Gastrointestinal DiseasesBiodonostia Health Research InstituteDonostia University HospitalUniversity of the Basque Country (UPV/EHU)San SebastianSpain
| | - Kirsten Utpatel
- Institute of PathologyUniversity of RegensburgRegensburgGermany
| | - Adelaida La Casta
- Department of Liver and Gastrointestinal DiseasesBiodonostia Health Research InstituteDonostia University HospitalUniversity of the Basque Country (UPV/EHU)San SebastianSpain
| | - Simone Stock
- Institute of PathologyUniversity of RegensburgRegensburgGermany
| | - Alejandro Forner
- BCLC group, Liver UnitHospital Clínic BarcelonaBarcelonaSpain
- National Institute for the Study of Liver and Gastrointestinal Diseases (CIBERehd)The National Institute of Health Carlos IIIMadridSpain
| | - Jorge Adeva
- Department of Medical OncologyHospital Universitario 12 de OctubreMadridSpain
| | - Trine Folseraas
- Section of Gastroenterology and the Norwegian PSC Research CenterDepartment of Transplantation MedicineOslo University HospitalOsloNorway
| | - Luca Fabris
- Department of Molecular MedicineUniversity of PaduaPaduaItaly
| | - Rocio I.R. Macias
- National Institute for the Study of Liver and Gastrointestinal Diseases (CIBERehd)The National Institute of Health Carlos IIIMadridSpain
- Experimental Hepatology and Drug Targeting (HEVEPHARM) groupUniversity of SalamancaIBSALSalamancaSpain
| | - Marcin Krawczyk
- Department of Medicine IISaarland University Medical CentreSaarland UniversityHomburgGermany
- Laboratory of Metabolic Liver DiseasesCentre for Preclinical ResearchDepartment of General, Transplant and Liver SurgeryMedical University of WarsawWarsawPoland
| | - Marek Krawczyk
- Department of General, Transplant and Liver SurgeryMedical University of WarsawWarsawPoland
| | | | - Chiara Braconi
- Medical OncologyThe University of GlasgowGlasgowUnited Kingdom
| | | | - Matthias Evert
- Institute of PathologyUniversity of RegensburgRegensburgGermany
| | - Jesus M. Banales
- Department of Liver and Gastrointestinal DiseasesBiodonostia Health Research InstituteDonostia University HospitalUniversity of the Basque Country (UPV/EHU)San SebastianSpain
- National Institute for the Study of Liver and Gastrointestinal Diseases (CIBERehd)The National Institute of Health Carlos IIIMadridSpain
- IKERBASQUEBasque Foundation for ScienceBilbaoSpain
| | - Juan W. Valle
- Medical Oncology/Institute of Cancer SciencesThe Christie NHS Foundation Trust/University of ManchesterManchesterUnited Kingdom
| | | |
Collapse
|
23
|
Krawczyk M, Ziarkiewicz-Wróblewska B, Wróblewski T, Podgórska J, Grzybowski J, Gierej B, Krawczyk P, Nyckowski P, Kornasiewicz O, Patkowski W, Remiszewski P, Zając K, Grąt M. PEComa-A Rare Liver Tumor. J Clin Med 2021; 10:jcm10081756. [PMID: 33919494 PMCID: PMC8072725 DOI: 10.3390/jcm10081756] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Revised: 04/09/2021] [Accepted: 04/14/2021] [Indexed: 12/16/2022] Open
Abstract
PEComa (perivascular epithelioid cell tumor) is a rare liver tumor. Decisions regarding patient management are currently based on a few small case series. The aim of this study was to report the clinicopathological features of PEComa in order to provide guidance for management, complemented by our own experience. This retrospective observational study included all patients with PEComa who underwent surgical treatment in two departments between 2002 and 2020. A total of 20 patients were diagnosed with PEComa following histopathological examination. The age of the patients ranged from 21 to 73 years. The majority of patients were women (85%). In most patients, the tumors were incidental. In diagnostic studies, PEComas with high arterial vascularization have been described. Liver resection was the treatment of choice. There was only one postoperative complication. During histopathological evaluation, tumors were composed mostly of epithelioid cells, rarely with spindle cell components, thick-walled vessels, and adipocytes in different proportions. Melanocytic markers (HMB45, MelanA) and at least one smooth muscle marker were expressed in all tumors. Features suggestive of malignancy were found in three cases. In conclusion, PEComa is a rare liver tumor that is usually diagnosed incidentally. In radiological studies, tumors with high arterial vascularization are observed. Liver resection is the treatment of choice.
Collapse
Affiliation(s)
- Marek Krawczyk
- Department of General, Transplant and Liver Surgery, Medical University Warsaw, 02-097 Warsaw, Poland; (M.K.); (T.W.); (P.K.); (O.K.); (W.P.); (P.R.); (K.Z.)
| | | | - Tadeusz Wróblewski
- Department of General, Transplant and Liver Surgery, Medical University Warsaw, 02-097 Warsaw, Poland; (M.K.); (T.W.); (P.K.); (O.K.); (W.P.); (P.R.); (K.Z.)
| | - Joanna Podgórska
- 2nd Department of Clinical Radiology, Medical University of Warsaw, 02-097 Warsaw, Poland;
| | - Jakub Grzybowski
- Department of Pathology, Medical University of Warsaw, 02-097 Warsaw, Poland; (B.Z.-W.); (J.G.); (B.G.)
| | - Beata Gierej
- Department of Pathology, Medical University of Warsaw, 02-097 Warsaw, Poland; (B.Z.-W.); (J.G.); (B.G.)
| | - Piotr Krawczyk
- Department of General, Transplant and Liver Surgery, Medical University Warsaw, 02-097 Warsaw, Poland; (M.K.); (T.W.); (P.K.); (O.K.); (W.P.); (P.R.); (K.Z.)
| | - Paweł Nyckowski
- Department of General, Gastroenterological and Oncological Surgery, Medical University Warsaw, 02-097 Warsaw, Poland;
| | - Oskar Kornasiewicz
- Department of General, Transplant and Liver Surgery, Medical University Warsaw, 02-097 Warsaw, Poland; (M.K.); (T.W.); (P.K.); (O.K.); (W.P.); (P.R.); (K.Z.)
| | - Waldemar Patkowski
- Department of General, Transplant and Liver Surgery, Medical University Warsaw, 02-097 Warsaw, Poland; (M.K.); (T.W.); (P.K.); (O.K.); (W.P.); (P.R.); (K.Z.)
| | - Piotr Remiszewski
- Department of General, Transplant and Liver Surgery, Medical University Warsaw, 02-097 Warsaw, Poland; (M.K.); (T.W.); (P.K.); (O.K.); (W.P.); (P.R.); (K.Z.)
| | - Krzysztof Zając
- Department of General, Transplant and Liver Surgery, Medical University Warsaw, 02-097 Warsaw, Poland; (M.K.); (T.W.); (P.K.); (O.K.); (W.P.); (P.R.); (K.Z.)
| | - Michał Grąt
- Department of General, Transplant and Liver Surgery, Medical University Warsaw, 02-097 Warsaw, Poland; (M.K.); (T.W.); (P.K.); (O.K.); (W.P.); (P.R.); (K.Z.)
- Correspondence: ; Tel.: +48-22-599-2545
| |
Collapse
|
24
|
Krawczyk M, Ziarkiewicz-Wróblewska B, Podgórska J, Grzybowski J, Gierej B, Krawczyk P, Grąt M, Kornasiewicz O, Skalski M, Wróblewski T. Intraductal papillary neoplasm of the bile duct - A comprehensive review. Adv Med Sci 2021; 66:138-147. [PMID: 33556909 DOI: 10.1016/j.advms.2021.01.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Revised: 11/14/2020] [Accepted: 01/21/2021] [Indexed: 02/09/2023]
Abstract
BACKGROUND Intraductal papillary neoplasm of the bile ducts is a rare tumor type. Management decisions are currently based upon a small case series. The authors have large own experience with IPNB. OBJECTIVE The review aims at reporting on clinicopathological features of IPNB in order to provide guidance for management. METHODS We searched PubMed, Medline, Microsoft Academic and Embase databases to identify studies of relevance. The analysis of own experience was also included. RESULTS We analyzed 59 retrospective series and 25 cases from authors' clinical experience. The main sign was jaundice and cholangitis, 33% and 48%, respectively. CT's were performed in 63-76% and MR in 40-56%. Intraductal mass was found in 31-32% and duct dilatation in 27-30%. Endoscopic Retrograde Cholangio-Pancreatography (ERCP) was performed in 48-62%. IPNB with invasive carcinoma was found in 35.7-60% and IPNB with intraepithelial neoplasia in 36-60%. Histopathological confirmation before surgery was rare. The main treatment of IPNB is resection, in our material, both, hepatectomy and hepatectomy plus bile duct resections were performed in 40% of patients. The percentage of postoperative complications was 20%. The 5-year survival rate of all IPNB's patients was 53.6%; in patients with associated invasive carcinoma - 22.2% and without invasive carcinoma - 100% (p = 0.001). CONCLUSIONS Early surgery is advisable for radiologically suspected IPNB. The results of treatment depend on histopathology. They are worse at intraductal invasive carcinoma than at neoplasm with neoplasia.
Collapse
|
25
|
Urban SK, Sänger H, Krawczyk M, Julich-Haertel H, Willms A, Ligocka J, Azkargorta M, Mocan T, Kahlert C, Kruk B, Jankowski K, Patkowski W, Krawczyk M, Zieniewicz K, Hołówko W, Krupa Ł, Rzucidło M, Gutkowski K, Wystrychowski W, Król R, Raszeja-Wyszomirska J, Słomka A, Schwab R, Wöhler A, Gonzalez-Carmona MA, Gehlert S, Sparchez Z, Banales JM, Strassburg CP, Lammert F, Milkiewicz P, Kornek M. Synergistic effects of extracellular vesicle phenotyping and AFP in hepatobiliary cancer differentiation. Liver Int 2020; 40:3103-3116. [PMID: 32614460 DOI: 10.1111/liv.14585] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2020] [Revised: 06/12/2020] [Accepted: 06/24/2020] [Indexed: 02/06/2023]
Abstract
BACKGROUND Biliary cancer, comprising cholangio- and gallbladder carcinomas, is associated with high mortality due to asymptomatic disease onset and resulting late diagnosis. Currently, no robust diagnostic biomarker is clinically available. Therefore, we explored the feasibility of extracellular vesicles (EVs) as a liquid biopsy tool for biliary cancer screening and hepatobiliary cancer differentiation. METHODS Serum EVs of biliary cancer, hepatocellular carcinoma, colorectal cancer and non-small cell lung cancer patients, as well as from healthy individuals, were isolated by sequential two-step centrifugation and presence of indicated EVs was evaluated by fluorescence activated cell sorting (FACS) analysis. RESULTS Two directly tumour-related antigen combinations (AnnV+ CD44v6+ and AnnV+ CD44v6+ CD133+ ) and two combinations related to progenitor cells from the tumour microenvironment (AnnV+ CD133+ gp38+ and AnnV+ EpCAM+ CD133+ gp38+ ) were associated with good diagnostic performances that could potentially be used for clinical assessment of biliary cancer and differentiation from other cancer entities. With 91% sensitivity and 69% specificity AnnV+ CD44v6+ EVs showed the most promising results for differentiating biliary cancers from HCC. Moreover using a combined approach of EV levels of the four populations with serum AFP values, we obtained a perfect separation of biliary cancer and HCC with sensitivity, specificity, positive and negative predictive value all reaching 100% respectively. CONCLUSIONS EV phenotyping, especially if combined with serum AFP, represents a minimally invasive, accurate liquid biopsy tool that could improve cancer screening and differential diagnosis of hepatobiliary malignancies.
Collapse
Affiliation(s)
- Sabine K Urban
- Department of Internal Medicine I, University Medical Center Bonn, Bonn, Germany.,Department of Medicine II, Saarland University Medical Center, Saarland University, Homburg, Germany
| | - Hanna Sänger
- Department of Medicine II, Saarland University Medical Center, Saarland University, Homburg, Germany.,Institute of Experimental Immunology, Rheinische Friedrich-Wilhelms-Universität, Bonn, Germany
| | - Marcin Krawczyk
- Department of Medicine II, Saarland University Medical Center, Saarland University, Homburg, Germany.,Laboratory of Metabolic Liver Diseases, Centre for Preclinical Research, Department of General, Transplant and Liver Surgery, Medical University of Warsaw, Warsaw, Poland
| | - Henrike Julich-Haertel
- Department of Medicine II, Saarland University Medical Center, Saarland University, Homburg, Germany
| | - Arnulf Willms
- Department of General, Visceral and Thoracic Surgery, German Armed Forces Central Hospital, Koblenz, Germany
| | - Joanna Ligocka
- Department of General, Transplant and Liver Surgery, Medical University of Warsaw, Warsaw, Poland
| | - Mikel Azkargorta
- Proteomics Platform, Bizkaia Science and Technology Park, Derio, Spain
| | - Tudor Mocan
- Octavian Fodor Institute for Gastroenterology and Hepatology, Iuliu Haţieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Christoph Kahlert
- Department of Visceral, Thoracic and Vascular Surgery, University Hospital Carl Gustav Carus, Technische Universität Dresden, Germany
| | - Beata Kruk
- Laboratory of Metabolic Liver Diseases, Centre for Preclinical Research, Department of General, Transplant and Liver Surgery, Medical University of Warsaw, Warsaw, Poland
| | - Krzysztof Jankowski
- Department of Internal Medicine and Cardiology, Medical University of Warsaw, Warsaw, Poland
| | - Waldemar Patkowski
- Department of General, Transplant and Liver Surgery, Medical University of Warsaw, Warsaw, Poland
| | - Marek Krawczyk
- Department of General, Transplant and Liver Surgery, Medical University of Warsaw, Warsaw, Poland
| | - Krzysztof Zieniewicz
- Department of General, Transplant and Liver Surgery, Medical University of Warsaw, Warsaw, Poland
| | - Wacław Hołówko
- Department of General, Transplant and Liver Surgery, Medical University of Warsaw, Warsaw, Poland
| | - Łukasz Krupa
- Department of Gastroenterology and Hepatology with Internal Disease Unit, Specialist District Hospital in Rzeszow, Rzeszow, Poland
| | - Mateusz Rzucidło
- Department of Gastroenterology and Hepatology with Internal Disease Unit, Specialist District Hospital in Rzeszow, Rzeszow, Poland
| | - Krzysztof Gutkowski
- Department of Gastroenterology and Hepatology with Internal Disease Unit, Specialist District Hospital in Rzeszow, Rzeszow, Poland
| | - Wojciech Wystrychowski
- Department of General, Vascular and Transplant Surgery, School of Medicine in Katowice, Medical University of Silesia, Katowice, Poland
| | - Robert Król
- Department of General, Vascular and Transplant Surgery, School of Medicine in Katowice, Medical University of Silesia, Katowice, Poland
| | - Joanna Raszeja-Wyszomirska
- Liver and Internal Medicine Unit, Department of General, Transplant and Liver Surgery, Medical University of Warsaw, Warsaw, Poland
| | - Artur Słomka
- Department of Pathophysiology, Nicolaus Copernicus University in Toruń, Ludwik Rydygier Collegium Medicum in Bydgoszcz, Poland
| | - Robert Schwab
- Department of General, Visceral and Thoracic Surgery, German Armed Forces Central Hospital, Koblenz, Germany
| | - Aliona Wöhler
- Department of General, Visceral and Thoracic Surgery, German Armed Forces Central Hospital, Koblenz, Germany
| | | | - Sebastian Gehlert
- Department for Biosciences of Sports, Institute of Sports Science, University of Hildesheim, Hildesheim, Germany
| | - Zeno Sparchez
- Octavian Fodor Institute for Gastroenterology and Hepatology, Iuliu Haţieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Jesus M Banales
- Department of Liver and Gastrointestinal Diseases, Biodonostia Health Research Institute - Donostia University Hospital, University of the Basque Country (UPV/EHU), San Sebastian, Spain
| | | | - Frank Lammert
- Department of Medicine II, Saarland University Medical Center, Saarland University, Homburg, Germany
| | - Piotr Milkiewicz
- Liver and Internal Medicine Unit, Department of General, Transplant and Liver Surgery, Medical University of Warsaw, Warsaw, Poland.,Translational Medicine Group, Pomeranian Medical University, Szczecin, Poland
| | - Miroslaw Kornek
- Department of Internal Medicine I, University Medical Center Bonn, Bonn, Germany.,Department of Medicine II, Saarland University Medical Center, Saarland University, Homburg, Germany
| |
Collapse
|
26
|
Grąt M, Grąt K, Krawczyk M, Lewandowski Z, Krasnodębski M, Masior Ł, Patkowski W, Zieniewicz K. Post-hoc analysis of a randomized controlled trial on the impact of pre-transplant use of probiotics on outcomes after liver transplantation. Sci Rep 2020; 10:19944. [PMID: 33204004 PMCID: PMC7672052 DOI: 10.1038/s41598-020-76994-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2019] [Accepted: 11/04/2020] [Indexed: 01/14/2023] Open
Abstract
Perioperative use of probiotics serves as efficient prophylaxis against postoperative infections after liver transplantation, yet data on long-term effects of pre-transplant probiotic intake is lacking.
The aim of this study was to assess the effects of pre-transplant probiotic administration on long-term results of liver transplantation. This was secondary analysis of a randomized trial. Patients were randomized to receive either 4-strain probiotic or placebo before liver transplantation. Five year graft survival was set as the primary end-point. Secondary end-points comprised serum bilirubin and C-reactive protein (CRP) concentration, international normalized ratio (INR), serum transaminases and gamma-glutamyl transferase (GGT) activity. Study group comprised 44 patients, of whom 21 received probiotics and 23 received placebo with 5-year graft survival of 81.0% and 87.0%, respectively (p = 0.591). Patients in the probiotic arm exhibited lower INR (p = 0.001) and CRP (p = 0.030) over the first 6 post-transplant months. In the absence of hepatitis B or C virus infection, pre-transplant administration of probiotics also reduced aspartate transaminase activity (p = 0.032). In the intervention arm, patients receiving probiotics for under and over 30 days had 5-year graft survival rates of 100% and 66.7%, respectively (p = 0.061). Duration of probiotic intake > 30 days was additionally associated with increased INR (p = 0.031), GGT (p = 0.032) and a tendency towards increased bilirubin (p = 0.074) over first 6 post-transplant months. Pre-transplant administration of probiotics has mild positive influence on 6-month allograft function, yet should not exceed 30 days due to potential negative effects on long-term outcomes. (ClinicalTrials.gov Identifier: NCT01735591).
Collapse
Affiliation(s)
- M Grąt
- Department of General, Transplant and Liver Surgery, Medical University of Warsaw, Warsaw, Poland
| | - K Grąt
- Second Department of Clinical Radiology, Medical University of Warsaw, Banacha 1A, 02-097, Warsaw, Poland.
| | - M Krawczyk
- Department of General, Transplant and Liver Surgery, Medical University of Warsaw, Warsaw, Poland
| | - Z Lewandowski
- Department of Epidemiology and Biostatistics, Medical University of Warsaw, Warsaw, Poland
| | - M Krasnodębski
- Department of General, Transplant and Liver Surgery, Medical University of Warsaw, Warsaw, Poland
| | - Ł Masior
- Second Department of General, Vascular and Oncological Surgery, Medical University of Warsaw, Warsaw, Poland
| | - W Patkowski
- Department of General, Transplant and Liver Surgery, Medical University of Warsaw, Warsaw, Poland
| | - K Zieniewicz
- Department of General, Transplant and Liver Surgery, Medical University of Warsaw, Warsaw, Poland
| |
Collapse
|
27
|
Viganò L, Torzilli G, Aldrighetti L, Ferrero A, Troisi R, Figueras J, Cherqui D, Adam R, Kokudo N, Hasegawa K, Guglielmi A, Majno P, Toso C, Krawczyk M, Abu Hilal M, Pinna AD, Cescon M, Giuliante F, De Santibanes E, Costa-Maia J, Pawlik T, Urbani L, Zugna D. Stratification of Major Hepatectomies According to Their Outcome: Analysis of 2212 Consecutive Open Resections in Patients Without Cirrhosis. Ann Surg 2020; 272:827-833. [PMID: 32925253 DOI: 10.1097/sla.0000000000004338] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
OBJECTIVE To stratify major hepatectomies (MajHs) according to their outcomes. SUMMARY OF BACKGROUND DATA MajHs are associated with non-negligible operative risks, but they include a wide range of procedures. Detailed depiction of the outcomes of different MajHs is the basis for a new classification of liver resections. METHODS We retrospectively considered patients that underwent hepatectomy in 17 high-volume centers. Patients with an associated digestive/biliary resection were excluded. We analyzed open MajHs in non-cirrhotic patients. MajHs were classified according to the Brisbane nomenclature. Right hepatectomies (RHs) were reference standards. Outcomes were adjusted for potential confounders, including indication, liver function, preoperative portal vein embolization, and enrolling center. RESULTS We analyzed a series of 2212 patients. In comparison with RH, left hepatectomy had lower mortality [0.6% vs 2.2%, odds ratio (OR) = 0.25], severe morbidity (11.7% vs 14.4%, OR = 0.62), and liver failure rates (2.1% vs 11.6%, OR = 0.16). Left hepatectomy+Sg1 and mesohepatectomy+/-Sg1 had outcomes similar to RH, except for higher bile leak rate (31.3% and 13.5% vs 6.7%, OR = 4.36 and OR = 2.29). RH + Sg1 had slightly worse outcomes than RH. Right and left trisectionectomies had higher mortality (5.0% and 7.3% vs 2.2%, OR = 2.07 and OR = 2.71) and liver failure rates than RH (19.0% and 22.0% vs 11.6%, OR = 2.03 and OR = 2.21). Left trisectionectomy had even higher severe morbidity (25.6% vs 14.4%, OR = 2.07) and bile leak rates (14.6% vs 6.7%, OR = 2.31). CONCLUSIONS The term "major hepatectomy" includes resections having heterogeneous outcome. Different MajHs can be stratified according to their mortality, severe morbidity, liver failure, and bile leak rates.
Collapse
Affiliation(s)
- Luca Viganò
- Division of Hepatobiliary and General Surgery, Department of Surgery, Humanitas Clinical and Research Center - IRCCS, Rozzano - Milan, Italy.,Humanitas University, Department of Biomedical Sciences, Pieve Emanuele - Milan, Italy
| | - Guido Torzilli
- Division of Hepatobiliary and General Surgery, Department of Surgery, Humanitas Clinical and Research Center - IRCCS, Rozzano - Milan, Italy.,Humanitas University, Department of Biomedical Sciences, Pieve Emanuele - Milan, Italy
| | | | | | | | | | | | - René Adam
- Paul Brousse Hospital, Villejuif, France
| | | | | | | | - Pietro Majno
- University Hospital of Geneva, Geneva, Switzerland.,Ospedale Regionale di Lugano, Lugano, Switzerland
| | | | | | | | | | | | | | | | | | - Timothy Pawlik
- The Ohio State University Wexner Medical Center, Columbus, Ohio
| | - Lucio Urbani
- Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy
| | - Daniela Zugna
- Department of Medical Sciences, Cancer Epidemiology Unit, University of Torino and CPO-Piemonte, Torino, Italy
| | | |
Collapse
|
28
|
Izdebski R, Sitkiewicz M, Urbanowicz P, Krawczyk M, Brisse S, Gniadkowski M. Genomic background of the Klebsiella pneumoniae NDM-1 outbreak in Poland, 2012-18. J Antimicrob Chemother 2020; 75:3156-3162. [PMID: 32790858 DOI: 10.1093/jac/dkaa339] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Accepted: 07/01/2020] [Indexed: 12/28/2022] Open
Abstract
OBJECTIVES To characterize genomes of Klebsiella pneumoniae ST11 NDM-1 responsible for a countrywide outbreak in Poland and compare them phylogenetically with other Polish and international ST11 strains. METHODS Seventy-one carbapenemase-producing K. pneumoniae ST11 isolates from Poland, including 66 representatives of the NDM-1 epidemic from 2012-18, were sequenced using Illumina MiSeq. Additionally, three outbreak isolates were also sequenced using MinION. The clonality and phylogenetic analysis was done by core-genome MLST and SNP approaches. Resistomes, virulomes, K/O antigens and plasmid replicons were screened for. The detailed plasmid analysis was based on full assemblies using Oxford Nanopore Technologies data. RESULTS Chromosomes of the outbreak isolates formed an essentially homogeneous cluster (though accumulating SNPs gradually with time), differing remarkably from other Polish NDM-1/-5-, KPC-2- or OXA-48-producing K. pneumoniae ST11 strains. The cluster belonged to a clade with 72 additional isolates identified worldwide, including closely related NDM-1 producers from several countries, including organisms from Bulgaria and Greece. All these had KL24 and O2v1 antigens and the chromosomal yersiniabactin locus YbST230 residing in the ICEKp11 element. The specific blaNDM-1-carrying Tn125 transposon derivative, named Tn125A, was located in IncFII/pKPX-1- and/or IncR-like plasmids; however, the IncRs rearranged extensively during the outbreak, contributing to highly dynamic plasmid profiles and resistomes. CONCLUSIONS The K. pneumoniae ST11 NDM-1 genotype that has been expanding in Poland since 2012 is largely monoclonal and represents a novel international high-risk lineage that is also spreading in other countries.
Collapse
Affiliation(s)
- R Izdebski
- Department of Molecular Microbiology, National Medicines Institute, Warsaw, Poland
| | - M Sitkiewicz
- IT Department, National Medicines Institute, Warsaw, Poland
| | - P Urbanowicz
- Department of Molecular Microbiology, National Medicines Institute, Warsaw, Poland
| | | | - S Brisse
- Biodiversity and Epidemiology of Bacterial Pathogens, Institut Pasteur, Paris, France
| | - M Gniadkowski
- Department of Molecular Microbiology, National Medicines Institute, Warsaw, Poland
| |
Collapse
|
29
|
Masior Ł, Grąt M, Grąt K, Krasnodębski M, Wronka KM, Stypułkowski J, Patkowski W, Frączek M, Krawczyk M, Zieniewicz K. Importance of Intraoperative Transfusions of Packed Red Blood Cells and Fresh Frozen Plasma in Liver Transplantation for Hepatocellular Cancer. Ann Transplant 2020; 25:e923665. [PMID: 33079923 PMCID: PMC7552880 DOI: 10.12659/aot.923665] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND The impact of packed red blood cells (PRBCs) and fresh frozen plasma (FFP) transfusions in patients with hepatocellular cancer (HCC) undergoing liver transplantation has rarely been evaluated. The aim of the current study was to assess the impact of intraoperative transfusions on posttransplant outcomes. MATERIAL AND METHODS This retrospective cohort study was based on 229 HCC transplant recipients. The primary outcome measure was 5-year recurrence-free survival. Secondary outcome measures comprised overall and long-term survival at 5 years and 90-day mortality. Cox proportional hazard models and logistic regression were used to assess risk factors. RESULTS After adjustment for potential confounders, no association was found with respect to tumor recurrence for PRBCs (P=0.368) or FFP (P=0.081) transfusions. Similarly, PRBC transfusion (P=0.623) and FFP transfusion (P=0.460) had no impact on survival between 90 days and 5 years. PRBC transfusion increased the risk of 90-day mortality (P=0.005), while FFP transfusion was associated with a lower risk (P=0.036). CONCLUSIONS Intraoperative transfusions of blood products does not impair recurrence-free and long-term survival of patients with HCC undergoing liver transplantation. Intraoperative PRBC transfusion increases the risk of early mortality, whereas adequate supplementation of FFP plays a protective role.
Collapse
Affiliation(s)
- Łukasz Masior
- Department of General, Transplant and Liver Surgery, Medical University of Warsaw, Warsaw, Poland.,Department of General, Vascular and Oncological Surgery, Medical University of Warsaw, Warsaw, Poland
| | - Michał Grąt
- Department of General, Transplant and Liver Surgery, Medical University of Warsaw, Warsaw, Poland
| | - Karolina Grąt
- Second Department of Clinical Radiology, Medical University of Warsaw, Warsaw, Poland
| | - Maciej Krasnodębski
- Department of General, Transplant and Liver Surgery, Medical University of Warsaw, Warsaw, Poland
| | - Karolina M Wronka
- Hepatology and Internal Medicine Unit, Department of General, Transplant and Liver Surgery, Medical University of Warsaw, Warsaw, Poland
| | - Jan Stypułkowski
- Department of General, Transplant and Liver Surgery, Medical University of Warsaw, Warsaw, Poland
| | - Waldemar Patkowski
- Department of General, Transplant and Liver Surgery, Medical University of Warsaw, Warsaw, Poland
| | - Mariusz Frączek
- Department of General, Vascular and Oncological Surgery, Medical University of Warsaw, Warsaw, Poland
| | - Marek Krawczyk
- Department of General, Transplant and Liver Surgery, Medical University of Warsaw, Warsaw, Poland
| | - Krzysztof Zieniewicz
- Department of General, Transplant and Liver Surgery, Medical University of Warsaw, Warsaw, Poland
| |
Collapse
|
30
|
Tsaparas P, Machairas N, Ardiles V, Krawczyk M, Patrono D, Baccarani U, Cillo U, Aandahl EM, Cotsoglou C, Espinoza JL, Claría RS, Kostakis ID, Foss A, Mazzaferro V, de Santibañes E, Sotiropoulos GC. Liver transplantation as last-resort treatment for patients with bile duct injuries following cholecystectomy: a multicenter analysis. Ann Gastroenterol 2020; 34:111-118. [PMID: 33414630 PMCID: PMC7774661 DOI: 10.20524/aog.2020.0541] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Accepted: 07/20/2020] [Indexed: 11/22/2022] Open
Abstract
Background Liver transplantation (LT) has been used as a last resort in patients with end-stage liver disease due to bile duct injuries (BDI) following cholecystectomy. Our study aimed to identify and evaluate factors that cause or contribute to an extended liver disease that requires LT as ultimate solution, after BDI during cholecystectomy. Methods Data from 8 high-volume LT centers relating to patients who underwent LT after suffering BDI during cholecystectomy were prospectively collected and retrospectively analyzed. Results Thirty-four patients (16 men, 18 women) with a median age of 45 (range 22-69) years were included in this study. Thirty of them (88.2%) underwent LT because of liver failure, most commonly as a result of secondary biliary cirrhosis. The median time interval between BDI and LT was 63 (range 0-336) months. There were 23 cases (67.6%) of postoperative morbidity, 6 cases (17.6%) of post-transplant 30-day mortality, and 10 deaths (29.4%) in total after LT. There was a higher probability that patients with concomitant vascular injury (hazard ratio 10.69, P=0.039) would be referred sooner for LT. Overall survival following LT at 1, 3, 5 and 10 years was 82.4%, 76.5%, 73.5% and 70.6%, respectively. Conclusion LT for selected patients with otherwise unmanageable BDI following cholecystectomy yields acceptable long-term outcomes.
Collapse
Affiliation(s)
- Peter Tsaparas
- 2 Department of Propaedeutic Surgery, Laiko General Hospital, National and Kapodistrian University of Athens, Athens, Greece (Peter Tsaparas, Nikolaos Machairas, Ioannis D. Kostakis, Georgios C. Sotiropoulos)
| | - Nikolaos Machairas
- 2 Department of Propaedeutic Surgery, Laiko General Hospital, National and Kapodistrian University of Athens, Athens, Greece (Peter Tsaparas, Nikolaos Machairas, Ioannis D. Kostakis, Georgios C. Sotiropoulos)
| | - Victoria Ardiles
- Division of Hepatobiliary Surgery, Liver Transplant Unit, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina (Victoria Ardiles, Johana Leiva Espinoza, Rodrigo Sanchez Claría, Eduardo de Santibañes)
| | - Marek Krawczyk
- Department of General, Transplant and Liver Surgery, Medical University of Warsaw, Poland (Marek Krawczyk)
| | - Damiano Patrono
- General Surgery 2U, Liver Transplant Center, A.O.U. Città della Salute e della Scienza di Torino, University of Torino, Turin, Italy (Damiano Patrono)
| | - Umberto Baccarani
- Liver Transplant Unit, Department of Medicine, University of Udine, Udine, Italy (Umberto Baccarani)
| | - Umberto Cillo
- Hepatobiliary and Liver Transplant Unit, University of Padova School of Medicine, Padova, Italy (Umberto Cillo)
| | - Einar Martin Aandahl
- Surgical Department, Section of Transplant Surgery, Oslo University Hospital, Oslo, Norway (Einar Martin Aandahl, Aksel Foss)
| | - Christian Cotsoglou
- Department of Gastrointestinal Surgery and Liver Transplantation, Fondazione IRCCS Istituto Nazionale Tumori, University of Milan, Milan, Italy (Christian Cotsoglou)
| | - Johana Leiva Espinoza
- Division of Hepatobiliary Surgery, Liver Transplant Unit, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina (Victoria Ardiles, Johana Leiva Espinoza, Rodrigo Sanchez Claría, Eduardo de Santibañes)
| | - Rodrigo Sanchez Claría
- Division of Hepatobiliary Surgery, Liver Transplant Unit, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina (Victoria Ardiles, Johana Leiva Espinoza, Rodrigo Sanchez Claría, Eduardo de Santibañes)
| | - Ioannis D Kostakis
- 2 Department of Propaedeutic Surgery, Laiko General Hospital, National and Kapodistrian University of Athens, Athens, Greece (Peter Tsaparas, Nikolaos Machairas, Ioannis D. Kostakis, Georgios C. Sotiropoulos)
| | - Aksel Foss
- Surgical Department, Section of Transplant Surgery, Oslo University Hospital, Oslo, Norway (Einar Martin Aandahl, Aksel Foss)
| | - Vincenzo Mazzaferro
- Department of Gastrointestinal Surgery and Liver Transplantation, Fondazione IRCCS Istituto Nazionale Tumori, University of Milan, Milan, Italy (Christian Cotsoglou)
| | - Eduardo de Santibañes
- Division of Hepatobiliary Surgery, Liver Transplant Unit, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina (Victoria Ardiles, Johana Leiva Espinoza, Rodrigo Sanchez Claría, Eduardo de Santibañes)
| | - Georgios C Sotiropoulos
- 2 Department of Propaedeutic Surgery, Laiko General Hospital, National and Kapodistrian University of Athens, Athens, Greece (Peter Tsaparas, Nikolaos Machairas, Ioannis D. Kostakis, Georgios C. Sotiropoulos).,Department of General Visceral and Transplantation Surgery, University Hospital Essen, Germany (Georgios C. Sotiropoulos)
| |
Collapse
|
31
|
Krawczyk M, Ozimek M, Pociecha M, Draga P, Zadarko E, Barabasz Z. Selected morphofunctional characteristics and their correlations with performance of female and male speed climbers. Sci Sports 2020. [DOI: 10.1016/j.scispo.2019.11.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
|
32
|
Kościelska M, Matuszkiewicz-Rowińska J, Zieniewicz K, Krawczyk M, Giercuszkiewicz D, Sierdziński J, Żebrowski P, Malyszko J. P0627INTRAOPERATIVE DIALYSIS DURING LIVER TRANSPLANTATION IS SAFE AND BENEFICIAL. Nephrol Dial Transplant 2020. [DOI: 10.1093/ndt/gfaa142.p0627] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background and Aims
Orthotopic liver transplantation (OLt) is a technically complex surgical procedure associated with a major risk of hemodynamic instability and metabolic derangement, especially in patients with coexisting renal dysfunction. It remains uncertain if intraoperative renal replacement therapy (ioRRT) during OLt could be beneficial and in which subset of patients.
Method
A retrospective observational study of all adult patients undergoing intraoperative renal replacement therapy during OLt in our center from January 2010 till December 2018. IoRRT consisted of dialysis performed with the use of mobile Genius® single-pass batch dialysis system.
Results
1319 OLts were conducted during the study period and 129 patients (9,8%) were treated with intraoperative dialysis. Seven patients with incomplete documentation were excluded from the study. The mean age of the cohort was 47,8±14,7 years, and 73 (60%) of patients were men. The mean calculated MELD score was 33,7±12,5. 41 procedures (33,6%) were retransplantations and 7 patients underwent simultaneous liver and kidney transplantation. 18 (14,7%) recipients had fulminant liver failure. 66 (54,1%) of patients were admitted to Intensive Care Unit before transplantation. The mean preoperative serum creatinine level was 2,95±1,15 mg/dl and 95 (78%) patients were undergoing renal replacement therapy or had creatinine level ≥2 mg/dl preoperatively. Others required emergent ioRRT due to intraoperative complications and development of significant hyperkalemia or acidosis. The mean preoperative serum potassium concentration was 4,23±0,68 mmol/l and the mean bicarbonate level was 19,8±4,5 mmol/l. Intraoperative dialysis was performed without anticoagulation. The mean surgical time was 400±90,6 minutes and the mean ioRRT duration remained 308 ±109 minutes. Dialysis circuit clotting occurred in 9 (7,3%) cases. There were no other adverse events of ioRRT. Achieved mean arterial bicarbonate and potassium levels after graft reperfusion were 18,5±3,6 and 3,8±0,95 mmol/l, respectively. In 111 cases dialysis was initiated at least 15 minutes before reperfusion. 13% of this subgroup (16 pts) experienced post-reperfusion syndrome (defined as a decrease in the mean arterial pressure of more than 30% of the baseline, occurring within first 5 minutes after the reperfusion of the graft and lasting at least 1 minute).
Conclusion
Our data suggests that intraoperative dialysis in severely ill patients with high MELD score is safe and effective. Lower than expected post-reperfusion syndrome occurrence needs to be confirmed in a study designed with appropriate control group.
Collapse
Affiliation(s)
- Małgorzata Kościelska
- Medical University of Warsaw, Department of Nephrology, Dialysis and Internal Diseases, Warsaw, Poland
| | | | - Krzysztof Zieniewicz
- Medical University of Warsaw, Department of General, Liver and Transplantation Surgery, Warsaw, Poland
| | - Marek Krawczyk
- Medical University of Warsaw, Department of General, Liver and Transplantation Surgery, Warsaw, Poland
| | - Dorota Giercuszkiewicz
- Medical University of Warsaw, Department of Anaesthesiology and Intensive Care, Warsaw, Poland
| | - Janusz Sierdziński
- Medical University of Warsaw, Department of Medical Informatics and Telemedicine, Warsaw, Poland
| | - Paweł Żebrowski
- Medical University of Warsaw, Department of Nephrology, Dialysis and Internal Diseases, Warsaw, Poland
| | - Jolanta Malyszko
- Medical University of Warsaw, Department of Nephrology, Dialysis and Internal Diseases, Warsaw, Poland
| |
Collapse
|
33
|
Smyk W, Weber SN, Hall R, Gruenhage F, Lammert F, Krawczyk M. Genetic variant c.711A>T in the hepatobiliary phospholipid transporter ABCB4 is associated with significant liver fibrosis. J Physiol Pharmacol 2020; 71. [PMID: 32991311 DOI: 10.26402/jpp.2020.3.02] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Accepted: 06/30/2020] [Indexed: 11/03/2022]
Abstract
Liver fibrosis is the common consequence of chronic liver diseases (CLD). Recently liver stiffness measurements (LSM) ≥ 9.1 kPa, as determined by transient elastography (TE), were demonstrated to predict significant fibrosis (stages ≥ F2) in a population-based setting. The PNPLA3 (adiponutrin) p.I148M polymorphism enhances the risk of liver injury. The aim of our study was to investigate the association between the procholestatic ABCB4 polymorphism c.711A>T and LSM ≥ 9.1 kPa in humans as well as the interaction between ABCB4 and PNPLA3 in a mouse model of chronic cholestasis. Prospectively, we recruited 712 patients with CLD (278 women, age 50 ± 13 years) with available TE results; liver biopsy results were available in 165 individuals. The ABCB4 c.711 genotype was determined by PCR-based assays. PNPLA3 expression and liver injury were studied in Abcb4-/- mice and wild-type controls. Overall, median LSM in our cohort was 6.7 kPa, and 226 individuals had LSM ≥ 9.1 kPa. Carriers of the ABCB4 variant c.711A presented more frequently with LSM ≥ 9.1 kPa (OR = 1.33, P = 0.020) and FIB-4 score ≥ 2.67 (OR = 1.38, P = 0.040). The presence of the risk allele was associated (P = 0.002) with FIB-4. In a multivariate model, the ABCB4 variant (OR = 1.43, P = 0.047) as well as BMI (P = 0.043, OR = 1.04) and age (OR = 1.02, P < 0.010) were independent risk factors for fibrosis stage ≥ F2. Abcb4 deficiency in mice led to enhanced liver injury, coupled with a decrease (P = 0.020) of hepatic PNPLA3 expression. To conclude, the procholestatic variant ABCB4 c.711A>T might represent a new genetic risk factor for clinically significant liver fibrosis. Lower expression of PNPLA3 in fibrotic Abcb4-/- livers points to the interaction between phospholipid metabolism and PNPLA3 in progressive liver injury.
Collapse
MESH Headings
- ATP Binding Cassette Transporter, Subfamily B/genetics
- ATP Binding Cassette Transporter, Subfamily B/metabolism
- Adolescent
- Adult
- Aged
- Aged, 80 and over
- Animals
- Case-Control Studies
- Female
- Genetic Association Studies
- Genetic Predisposition to Disease
- Humans
- Liver/metabolism
- Liver/pathology
- Liver Cirrhosis/diagnosis
- Liver Cirrhosis/genetics
- Liver Cirrhosis/metabolism
- Liver Cirrhosis, Experimental/genetics
- Liver Cirrhosis, Experimental/metabolism
- Liver Cirrhosis, Experimental/pathology
- Male
- Mice, Knockout
- Middle Aged
- Phenotype
- Phospholipases A2, Calcium-Independent/genetics
- Phospholipases A2, Calcium-Independent/metabolism
- Phospholipids/metabolism
- Polymorphism, Single Nucleotide
- Risk Assessment
- Risk Factors
- Young Adult
- ATP-Binding Cassette Sub-Family B Member 4
Collapse
Affiliation(s)
- W Smyk
- Department of Medicine II Saarland university Medical Center, Saarland university, Homburg, Germany
- Liver and Internal Medicine unit, Department of General, Transplant and Liver Surgery, Medical university of Warsaw, Warsaw, Poland
| | - S N Weber
- Department of Medicine II Saarland university Medical Center, Saarland university, Homburg, Germany
| | - R Hall
- Department of Medicine II Saarland university Medical Center, Saarland university, Homburg, Germany
| | - F Gruenhage
- Department of Medicine II Saarland university Medical Center, Saarland university, Homburg, Germany
| | - F Lammert
- Department of Medicine II Saarland university Medical Center, Saarland university, Homburg, Germany
| | - M Krawczyk
- Department of Medicine II Saarland university Medical Center, Saarland university, Homburg, Germany.
- Laboratory of Metabolic Liver Diseases, Department of General, Transplant and Liver Surgery, Laboratory of Metabolic Liver Diseases, Centre for Preclinical Research, Medical university of Warsaw, Warsaw, Poland
| |
Collapse
|
34
|
Kościelska M, Matuszkiewicz-Rowińska J, Zieniewicz K, Krawczyk M, Giercuszkiewicz D, Sierdziński J, Żebrowski P, Małyszko J. Intraoperative Dialysis During Liver Transplantation. Transplant Proc 2020; 52:2454-2458. [PMID: 32448654 DOI: 10.1016/j.transproceed.2020.01.129] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2019] [Accepted: 01/26/2020] [Indexed: 11/28/2022]
Abstract
BACKGROUND Orthotopic liver transplantation (LT) is a technically complex surgical procedure associated with a major risk of hemodynamic instability and metabolic derangement, especially in patients with coexisting renal dysfunction. Some centers have applied intraoperative renal replacement therapy (ioRRT) to support patients with preoperative renal failure and prevent critical complications. Although there is a strong theoretical rationale for this treatment, there remains a paucity of definite data demonstrating its benefits. METHODS This was a retrospective observational study of all adult patients undergoing intraoperative dialysis in our center from January 2010 till December 2016. RESULTS The study group consisted of 88 patients with a mean MELD score of 31.4. Six patients underwent simultaneous liver and kidney transplantation. Forty-four (50%) recipients were admitted to the intensive care unit before transplantation, and 19 (21.6%) needed mechanical ventilation. Twenty-eight (31.8%) of the procedures were retransplantations, and 40 (45.4%) patients had been undergoing renal replacement therapy before LT. The mean preoperative serum creatinine was 2.82 ± 1.13 mg/dL. The majority of patients (54.5%) was operated on using the veno-venous bypass technique. The mean arterial blood pH and potassium levels after reperfusion were 7.2 ± 0.12 and 4.04 ± 0.95 mmol/L, respectively. Postreperfusion syndrome (PRS) occurred in 11 (13.9%) patients in whom dialysis started at least 15 minutes before reperfusion. Dialysis circuit clotting occurred in 9.1% of cases. There were no other adverse events of ioRRT. CONCLUSION Our data suggests that intraoperative dialysis in severely ill patients with a high MELD score is safe and effective. Lower than expected PRS occurrence needs to be confirmed in a study with a control group.
Collapse
Affiliation(s)
- Małgorzata Kościelska
- Department of Nephrology, Dialysis, and Internal Diseases, Medical University of Warsaw, Warsaw, Poland.
| | | | - Krzysztof Zieniewicz
- Department of General, Liver, and Transplantation Surgery, Medical University of Warsaw, Warsaw, Poland
| | - Marek Krawczyk
- Department of General, Liver, and Transplantation Surgery, Medical University of Warsaw, Warsaw, Poland
| | - Dorota Giercuszkiewicz
- Department of Anesthesiology and Intensive Care, Medical University of Warsaw, Warsaw, Poland
| | - Janusz Sierdziński
- Department of Medical Informatics and Telemedicine, Medical University of Warsaw, Warsaw, Poland
| | - Paweł Żebrowski
- Department of Nephrology, Dialysis, and Internal Diseases, Medical University of Warsaw, Warsaw, Poland
| | - Jolanta Małyszko
- Department of Nephrology, Dialysis, and Internal Diseases, Medical University of Warsaw, Warsaw, Poland
| |
Collapse
|
35
|
Lamarca A, Santos A, Utpatel K, La Casta A, Stock S, Forner A, Adeva Alfonso J, Folseraas T, Fabris L, Macias R, Krawczyk M, Krawczyk M, Cardinale V, Braconi C, Alvaro D, Evert M, Bañales J, Valle J. Liver metastases (LM) from intrahepatic cholangiocarcinoma (iCCA): Outcomes from the European Network for the study of cholangiocarcinoma (ENS-CCA) registry and implications on current American Joint Committee on Cancer (AJCC) staging. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz247.058] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
|
36
|
Grąt M, Krawczyk M, Stypułkowski J, Morawski M, Krasnodębski M, Wasilewicz M, Lewandowski Z, Grąt K, Patkowski W, Zieniewicz K. Prognostic Relevance of a Complete Pathologic Response in Liver Transplantation for Hepatocellular Carcinoma. Ann Surg Oncol 2019; 26:4556-4565. [PMID: 31520204 PMCID: PMC6863942 DOI: 10.1245/s10434-019-07811-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2019] [Indexed: 12/19/2022]
Abstract
BACKGROUND A complete pathologic response (CPR) after neoadjuvant treatment is reported to be associated with an exceptionally low risk of recurrence after liver transplantation for hepatocellular carcinoma (HCC). This study aimed to evaluate the prognostic role of CPR in liver transplantation for HCC. METHODS This retrospective cohort study was based on 222 HCC transplant recipients. Incidence of recurrence and survival at 5 years were the primary and secondary outcome measures, respectively. Competing risk analyses were applied to evaluate recurrence incidence and its predictors. Propensity score matching was performed to compare the outcomes for patients after neoadjuvant treatment with and without CPR. RESULTS Neoadjuvant treatment was performed for 127 patients, 32 of whom achieved CPR (25.2%). Comparison of baseline characteristics showed that the patients with CPR were at lowest baseline recurrence risk, followed by treatment-naïve patients and patients without CPR. Adjusted for potential confounders, CPR did not have any significant effects on tumor recurrence. No significant net reclassification improvement was noted after addition of CPR to existing criteria. Neoadjuvant treatment without CPR was associated with increased risk of recurrence in subgroups within the Milan criteria (p = 0.016), with alpha-fetoprotein concentration (AFP) model not exceeding 2 points (p = 0.021) and within the Warsaw criteria (p = 0.007) compared with treatment-naïve patients who were at risk similar to those with CPR. The 5-year incidences of recurrence in propensity score-matched patients with and without CPR were respectively 14.0% and 15.9% (p = 0.661), with corresponding survival rates of 73.2% and 67.4%, respectively (p = 0.329). CONCLUSIONS The findings showed that CPR is not independently associated with long-term outcomes after liver transplantation for HCC.
Collapse
Affiliation(s)
- Michał Grąt
- Department of General, Transplant and Liver Surgery, Medical University of Warsaw, Warsaw, Poland.
| | - Marek Krawczyk
- Department of General, Transplant and Liver Surgery, Medical University of Warsaw, Warsaw, Poland
| | - Jan Stypułkowski
- Department of General, Transplant and Liver Surgery, Medical University of Warsaw, Warsaw, Poland
| | - Marcin Morawski
- Department of General, Transplant and Liver Surgery, Medical University of Warsaw, Warsaw, Poland
| | - Maciej Krasnodębski
- Department of General, Transplant and Liver Surgery, Medical University of Warsaw, Warsaw, Poland
| | - Michał Wasilewicz
- Hepatology and Internal Medicine Unit, Department of General, Transplant and Liver Surgery, Medical University of Warsaw, Warsaw, Poland
| | - Zbigniew Lewandowski
- Department of Epidemiology and Biostatistics, Medical University of Warsaw, Warsaw, Poland
| | - Karolina Grąt
- Second Department of Clinical Radiology, Medical University of Warsaw, Warsaw, Poland
| | - Waldemar Patkowski
- Department of General, Transplant and Liver Surgery, Medical University of Warsaw, Warsaw, Poland
| | - Krzysztof Zieniewicz
- Department of General, Transplant and Liver Surgery, Medical University of Warsaw, Warsaw, Poland
| |
Collapse
|
37
|
Zelent M, Mailyan M, Vashistha V, Gruszecki P, Gorobets OY, Gorobets YI, Krawczyk M. Spin wave collimation using a flat metasurface. Nanoscale 2019; 11:9743-9748. [PMID: 31066382 DOI: 10.1039/c8nr10484k] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
In this paper, we show that the phase shift of spin waves propagating in the plane of the film can be controlled by a metasurface formed by an ultra-narrow non-magnetic spacer separating edges of the two thin ferromagnetic films. For this purpose, we exploit the strength of the exchange coupling of the RKKY type between the films which allows tuning the phase of the transmitted spin waves in the wide range of angles [-π/2; π/2]. We combined the phase-shift dependency along the interface with the lens equation to demonstrate numerically the metalens for spin waves.
Collapse
Affiliation(s)
- M Zelent
- Faculty of Physics, Adam Mickiewicz University in Poznan, ul. Uniwersytetu Poznańskiego 2, Poznań, 61-614, Poland.
| | | | | | | | | | | | | |
Collapse
|
38
|
Wronka KM, Grąt M, Stypułkowski J, Bik E, Patkowski W, Krawczyk M, Zieniewicz K. Relevance of Preoperative Hyperbilirubinemia in Patients Undergoing Hepatobiliary Resection for Hilar Cholangiocarcinoma. J Clin Med 2019; 8:jcm8040458. [PMID: 30959757 PMCID: PMC6517893 DOI: 10.3390/jcm8040458] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2019] [Revised: 03/22/2019] [Accepted: 04/02/2019] [Indexed: 12/12/2022] Open
Abstract
Preoperative hyperbilirubinemia is known to increase the risk of mortality and morbidity in patients undergoing resection for hilar cholangiocarcinoma. The aim of this study was to characterize the associations between the preoperative bilirubin concentration and the risk of postoperative mortality and severe complications to guide decision-making regarding preoperative biliary drainage. Eighty-one patients undergoing liver and bile duct resection for hilar cholangiocarcinoma between 2005 and 2015 were analyzed retrospectively. Postoperative mortality and severe complications, defined as a Clavien⁻Dindo grade of ≥III, were the primary and secondary outcome measures, respectively. The severe postoperative complications and mortality rates were 28.4% (23/81) and 11.1% (9/81), respectively. Patients with preoperative biliary drainage had significantly lower bilirubin concentrations (p = 0.028) than did those without. The preoperative bilirubin concentration was a risk factor of postoperative mortality (p = 0.003), with an optimal cut-off of 6.20 mg/dL (c-statistic = 0.829). The preoperative bilirubin concentration was a risk factor of severe morbidity (p = 0.018), with an optimal cut-off of 2.48 mg/dL (c-statistic = 0.662). These results indicate that preoperative hyperbilirubinemia is a major risk factor of negative early postoperative outcomes of patients who undergo surgical treatment for hilar cholangiocarcinoma and may aid in decision-making with respect to preoperative biliary drainage.
Collapse
Affiliation(s)
- Karolina Maria Wronka
- Liver and Internal Medicine Unit, Department of General, Transplant and Liver Surgery, Medical University of Warsaw, 1A Banacha Street, 02-097 Warsaw, Poland.
| | - Michał Grąt
- Department of General, Transplant and Liver Surgery, Medical University of Warsaw, 1A Banacha Street, 02-097 Warsaw, Poland.
| | - Jan Stypułkowski
- Department of General, Transplant and Liver Surgery, Medical University of Warsaw, 1A Banacha Street, 02-097 Warsaw, Poland.
| | - Emil Bik
- Department of General, Transplant and Liver Surgery, Medical University of Warsaw, 1A Banacha Street, 02-097 Warsaw, Poland.
| | - Waldemar Patkowski
- Department of General, Transplant and Liver Surgery, Medical University of Warsaw, 1A Banacha Street, 02-097 Warsaw, Poland.
| | - Marek Krawczyk
- Department of General, Transplant and Liver Surgery, Medical University of Warsaw, 1A Banacha Street, 02-097 Warsaw, Poland.
| | - Krzysztof Zieniewicz
- Department of General, Transplant and Liver Surgery, Medical University of Warsaw, 1A Banacha Street, 02-097 Warsaw, Poland.
| |
Collapse
|
39
|
Galas M, Glówczyńska R, Lewandowski Z, Cacko A, Raszeja-Wyszomirska J, Milkiewicz P, Krawczyk M, Zieniewicz K, Opolski G. Etiology of Liver Disease and Cardiovascular Abnormalities in Patients on a Liver Transplantation Waiting List. Ann Transplant 2019; 24:162-167. [PMID: 30898994 PMCID: PMC6442494 DOI: 10.12659/aot.913061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND The classical cardiovascular risk factors and changes in the circulatory system secondary to end-stage liver disease (ESLD) are associated with an increased risk of cardiac abnormalities (CAs) in patients waiting for liver transplantation (LTx). The aim of this study was to assess the relationship between the etiology of liver disease and the presence of CAs in patients qualified for LTx. MATERIAL AND METHODS The study enrolled patients qualified to LTx due to ESLD at the Clinical Hospital of the Medical University of Warsaw between 2013 and 2016. Out of 396 patients: 65, 157, 117, and 57 had ESLD due to the alcoholic liver disease (ALD), viral infections (VIR), autoimmune disorders (AUTO), and different etiologies (OTHER), respectively. RESULTS An increased frequency of hypertension and diabetes mellitus were observed in ALD and VIR groups, while for hyperlipidemia, the highest rates were observed in ALD and AUTO groups. Significant differences in CAs rates were observed for resting tachycardia, prolonged QT interval, bradycardia, and left ventricular diastolic dysfunction. After adjustment for age, MELD, and Child-Pugh scores, hyperlipidemia (26% vs. 7-15%, p<0.048) was most frequently observed in the AUTO group, while poor aerobic capacity (49% vs. 21-34%, p<0.009) dominated in the OTHER group. CONCLUSIONS The frequency of hyperlipidemia, and poor aerobic capacity were directly related to the etiology of liver disease, while the remaining associations resulted from effects of age, MELD, and Child-Pugh score.
Collapse
Affiliation(s)
- Michalina Galas
- 1st Department of Cardiology, Medical University of Warsaw, Warsaw, Poland
| | - Renata Glówczyńska
- 1st Department of Cardiology, Medical University of Warsaw, Warsaw, Poland
| | - Zbigniew Lewandowski
- Department of Epidemiology and Biostatistics, Medical University of Warsaw, Warsaw, Poland
| | - Andrzej Cacko
- Department of Medical Informatics and Telemedicine, Medical University of Warsaw, Warsaw, Poland
| | - Joanna Raszeja-Wyszomirska
- Liver and Internal Medicine Unit, Department of General, Transplant and Liver Surgery, Medical University of Warsaw, Warsaw, Poland
| | - Piotr Milkiewicz
- Liver and Internal Medicine Unit, Department of General, Transplant and Liver Surgery, Medical University of Warsaw, Warsaw, Poland
| | - Marek Krawczyk
- Department of General, Transplant, and Liver Surgery, Medical University of Warsaw, Warsaw, Poland
| | - Krzysztof Zieniewicz
- Department of General, Transplant, and Liver Surgery, Medical University of Warsaw, Warsaw, Poland
| | - Grzegorz Opolski
- 1st Department of Cardiology, Medical University of Warsaw, Warsaw, Poland
| |
Collapse
|
40
|
Janik MK, Księżopolska A, Kostrzewa K, Kobryń K, Moskwa M, Raszeja-Wyszomirska J, Kornasiewicz O, Patkowski W, Milkiewicz P, Krawczyk M, Zieniewicz K. Long-Term Health-Related Quality of Life in Living Liver Donors. Ann Transplant 2019; 24:45-51. [PMID: 30666044 PMCID: PMC6352752 DOI: 10.12659/aot.911109] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND In living donor liver transplantation (LDLT), 2 patients undergo surgery, and the advantages and disadvantages for both patients should be considered. This study evaluated the long-term quality of life in living liver donors, and its impact on their activities of daily living focusing on mood and mental health. MATERIAL AND METHODS In total, 101 living liver donors (69 female and 32 male patients, median age of 36.8 years) were surveyed at a median time of 61.8 months after liver donation (range 7-169 months). The generic Short Form Health Survey (SF-36), the Patient Health Questionnaire 9 (PHQ-9), and the Questionnaire of Physical Activity (IPAQ) were used. The results of SF-36 were compared to a matched control group (n=72) using the Wilcoxon test; the SF-36, the PHQ-9, and the IPAQ scores were analyzed using Spearman's rank correlation. Linear regression model was used to check for dependencies between variables of interest. The IPAQ results were compared between the study group and the general Polish population. RESULTS There were no significant differences in the SF-36 domains between the study group and control group except body pain, which was higher in the living liver donor group (P<0.05). In 30.6% of patients, the PHQ-9 survey revealed mood disturbances. The PHQ-9 scores were higher in female-donors (P<0.05). Both summary scores of the SF-36 correlated to the PHQ-9 (P<0.001). In 89.1% of patients, physical activity was below the population norm and was lower in female donors than in male donors (P<0.01). CONCLUSIONS LDLT had no impact on donors' physical and mental health. Physical activity of living liver donors was lower than that of the general population. The SF-36 and the IPAQ measures seem to be reliable in the care of living liver donors. The PHQ-9 survey results and the inclination to depression of female living liver donors requires further study.
Collapse
Affiliation(s)
- Maciej K Janik
- Liver and Internal Medicine Unit, Department of General, Transplant and Liver Surgery, Medical University of Warsaw, Warsaw, Poland
| | - Aleksandra Księżopolska
- Liver and Internal Medicine Unit, Department of General, Transplant and Liver Surgery, Medical University of Warsaw, Warsaw, Poland
| | | | - Konrad Kobryń
- Department of General, Transplant and Liver Surgery, Medical University of Warsaw, Warsaw, Poland
| | - Maciej Moskwa
- 2nd Department of Psychiatry, Medical University of Warsaw, Warsaw, Poland
| | - Joanna Raszeja-Wyszomirska
- Liver and Internal Medicine Unit, Department of General, Transplant and Liver Surgery, Medical University of Warsaw, Warsaw, Poland
| | - Oskar Kornasiewicz
- Department of General, Transplant and Liver Surgery, Medical University of Warsaw, Warsaw, Poland
| | - Waldemar Patkowski
- Department of General, Transplant and Liver Surgery, Medical University of Warsaw, Warsaw, Poland
| | - Piotr Milkiewicz
- Liver and Internal Medicine Unit, Department of General, Transplant and Liver Surgery, Medical University of Warsaw, Warsaw, Poland
| | - Marek Krawczyk
- Department of General, Transplant and Liver Surgery, Medical University of Warsaw, Warsaw, Poland
| | - Krzysztof Zieniewicz
- Department of General, Transplant and Liver Surgery, Medical University of Warsaw, Warsaw, Poland
| |
Collapse
|
41
|
Szczubiał M, Dabrowski R, Łopuszyński W, Bochniarz M, Krawczyk M. Changes in serum neopterin and C-reactive protein concentrations in female dogs with mammary gland tumours. Pol J Vet Sci 2019; 21:691-696. [PMID: 30605283 DOI: 10.24425/124307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
The aim of this study was to measure serum neopterin and C-reactive protein (CRP) concen- trations in female dogs with mammary tumours and evaluate the association between the values of these indicators and some clinical characteristics of the tumour. Fifty three female dogs were used for this study, including 43 dogs with mammary gland tumours (10 benign and 33 malignant) and 10 healthy controls. The concentrations of neopterin and CRP were determined using the ELISA technique and commercial ELISA kits. The mean serum neopterin concentration in fe- male dogs with mammary tumours was lower than in healthy dogs, but significant difference was not found. Similarly, there were no significant differences in neopterin concentrations in female dogs based on tumour size, tumour ulceration and metastasis. The mean CRP concentration was significantly higher (p⟨0.05) in dogs with malignant tumours compared to dogs with benign tu- mours and control. Furthermore, serum CRP concentration was significantly higher (p⟨0.05) in dogs with metastatic malignant tumours compared to dogs with non-metastatic mammary tu- mours. The CRP concentration was significantly lower (p⟨0.05) in dogs with tumours less than 3 cm compared to those with larger tumours, and significantly higher in dogs with ulcerated tu- mours compared to those without ulceration. Our findings suggest that the neoplastic process in the mammary gland does not cause significant changes in serum neopterin concentrations in dogs. Higher concentrations of serum CRP in dogs with advanced stages of malignant tumours may suggest that CRP could be a potential prognostic marker in canine malignant mammary tu- mours, but this hypothesis needs further study.
Collapse
Affiliation(s)
- M Szczubiał
- Department and Clinic of Animal Reproduction, Faculty of Veterinary Medicine, University of Life Sciences, Głęboka 30, 20-612 Lublin, Poland
| | - R Dabrowski
- Department and Clinic of Animal Reproduction, Faculty of Veterinary Medicine, University of Life Sciences, Głęboka 30, 20-612 Lublin, Poland
| | - W Łopuszyński
- Department of Pathological Anatomy, Faculty of Veterinary Medicine, University of Life Sciences, Głęboka 30, 20-612 Lublin, Poland
| | - M Bochniarz
- Department and Clinic of Animal Reproduction, Faculty of Veterinary Medicine, University of Life Sciences, Głęboka 30, 20-612 Lublin, Poland
| | - M Krawczyk
- Department and Clinic of Animal Reproduction, Faculty of Veterinary Medicine, University of Life Sciences, Głęboka 30, 20-612 Lublin, Poland
| |
Collapse
|
42
|
Budhram A, Liu Y, Krawczyk M, Chan TLH, Burneo JG, Hosseini-Moghaddam SM, Shoesmith C. High-dose corticosteroids for acute cytomegalovirus-associated transverse myelitis in the immunocompetent patient: a case report and systematic review. J Neurovirol 2019; 25:405-409. [PMID: 30610740 DOI: 10.1007/s13365-018-0717-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2018] [Accepted: 12/18/2018] [Indexed: 11/25/2022]
Abstract
We present an immunocompetent patient with transverse myelitis (TM) during acute cytomegalovirus (CMV) infection, as evidenced by a reactive serum CMV IgM and CMV viremia. The patient had an excellent outcome after receiving only high-dose methylprednisolone. Given concerns that practitioners may have around the use of immunosuppressive therapy for this potentially infectious myelopathy, we systematically reviewed the literature to assess outcomes after administration of high-dose corticosteroids to this population. Despite severe disease at clinical nadir with inability to ambulate, immunocompetent patients with acute CMV-associated TM who received high-dose corticosteroids had good clinical outcomes 1 month to 1 year after presentation.
Collapse
Affiliation(s)
- A Budhram
- Department of Clinical Neurological Sciences, Division of Neurology, University Hospital, Western University, 339 Windermere Rd, London, ON, N6A 5A5, Canada.
| | - Y Liu
- Department of Medicine, Division of General Internal Medicine, Western University, London, Ontario, N6A 5A5, Canada
| | - M Krawczyk
- Department of Clinical Neurological Sciences, Division of Neurology, University Hospital, Western University, 339 Windermere Rd, London, ON, N6A 5A5, Canada
| | - T L H Chan
- Department of Clinical Neurological Sciences, Division of Neurology, University Hospital, Western University, 339 Windermere Rd, London, ON, N6A 5A5, Canada
| | - J G Burneo
- Department of Clinical Neurological Sciences, Division of Neurology, University Hospital, Western University, 339 Windermere Rd, London, ON, N6A 5A5, Canada
| | - S M Hosseini-Moghaddam
- Department of Medicine, Division of Infectious Diseases, Western University, London, Ontario, N6A 5A5, Canada
| | - C Shoesmith
- Department of Clinical Neurological Sciences, Division of Neurology, University Hospital, Western University, 339 Windermere Rd, London, ON, N6A 5A5, Canada
| |
Collapse
|
43
|
Raszeja-Wyszomirska J, Glowczynska R, Kostrzewa K, Janik M, Zygmunt M, Zborowska H, Krawczyk M, Niewinski G, Galas M, Krawczyk M, Zieniewicz K, Milkiewicz P, Opolski G. Evaluation of Liver Graft Recipient Workup in Predicting of Early Cardiovascular Events During Liver Transplantation: A Single-Center Experience. Transplant Proc 2018; 50:1997-2001. [PMID: 30177096 DOI: 10.1016/j.transproceed.2018.02.161] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2017] [Accepted: 02/06/2018] [Indexed: 02/07/2023]
Abstract
BACKGROUND Cardiovascular events (CVE) contribute to serious complications and death after liver transplantation (LT). Troponin I (TnI) level >0.07 mg/L and prior cardiac disease are known to be the independent predictors for posttransplant CVE. We evaluated single-center cardiac workup to predict early cardiovascular morbidity and mortality after LT. PATIENTS AND METHODS We recruited 105 consecutive liver transplant recipients (male/female, 59/46; mean age, 51.66 ± 11.67 years). The cardiological assessment at evaluation for LT included medical history, electrocardiogram, echocardiography, Holter monitoring, and exercise test. We collected data regarding CVE including hypotonia with catecholamine usage, arrhythmia, sudden cardiac death, pulmonary edema, and myocardial infarction within 7 days after LT. RESULTS CVE during LT occurred in 42 recipients (40%) and after LT in 9 patients (8.57%). Proposed cutoff level of TnI >0.07 mg/L did not correlate with CVE during operation (P = .73) or after LT (P = .47). CVE during LT was associated with arterial hypertension in medical history (P <.001), right ventricular systolic pressure (P< .05), and clinical scores: Child-Pugh (P = .04), Model for End-Stage Liver Disease (MELD) (P = .04), MELD incorporating serum sodium (P<.03), and integrated MELD score (P = .01). CVE after LT correlated only with arrhythmia (P<.001) and catecholamine usage (P < .05) perioperatively. Of interest, catecholamine usage during LT was associated with prolonged stay at the intensive care unit (P < .05). CONCLUSION The single-center algorithm with noninvasive cardiac procedures without TnI assessment is optimal in evaluation before LT; however, medical history and severity of the liver disease are crucial for short-term cardiovascular morbidity after LT.
Collapse
Affiliation(s)
- J Raszeja-Wyszomirska
- Liver and Internal Medicine Unit, Department of General, Transplant, and Liver Surgery, Medical University of Warsaw, Warsaw, Poland
| | - R Glowczynska
- 1st Department of Cardiology, Medical University of Warsaw, Warsaw, Poland.
| | | | - M Janik
- Liver and Internal Medicine Unit, Department of General, Transplant, and Liver Surgery, Medical University of Warsaw, Warsaw, Poland
| | - M Zygmunt
- Liver and Internal Medicine Unit, Department of General, Transplant, and Liver Surgery, Medical University of Warsaw, Warsaw, Poland
| | - H Zborowska
- Central Laboratory, Public Central Teaching Clinical Hospital, Warsaw, Poland
| | - M Krawczyk
- Department of Medicine II, Saarland University Medical Center, Homburg, Germany; Laboratory of Metabolic Liver Diseases, Center for Preclinical Research, Department of General, Transplant and Liver Surgery, Medical University of Warsaw, Warsaw, Poland
| | - G Niewinski
- II Department of Anaesthesiology and Intensive Care, Medical University of Warsaw, Warsaw, Poland
| | - M Galas
- 1st Department of Cardiology, Medical University of Warsaw, Warsaw, Poland
| | - M Krawczyk
- Department of General, Transplant and Liver Surgery, Medical University of Warsaw, Warsaw, Poland
| | - K Zieniewicz
- Department of General, Transplant and Liver Surgery, Medical University of Warsaw, Warsaw, Poland
| | - P Milkiewicz
- Liver and Internal Medicine Unit, Department of General, Transplant, and Liver Surgery, Medical University of Warsaw, Warsaw, Poland
| | - G Opolski
- 1st Department of Cardiology, Medical University of Warsaw, Warsaw, Poland
| |
Collapse
|
44
|
Główczyńska R, Galas M, Ołdakowska-Jedynak U, Peller M, Tomaniak M, Raszeja-Wyszomirska J, Milkiewicz P, Krawczyk M, Zieniewicz K, Opolski G. Pretransplant QT Interval: The Relationship with Severity and Etiology of Liver Disease and Prognostic Value After Liver Transplantation. Ann Transplant 2018; 23:622-630. [PMID: 30177675 PMCID: PMC6248058 DOI: 10.12659/aot.908769] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2017] [Accepted: 04/09/2018] [Indexed: 01/16/2023] Open
Abstract
BACKGROUND Prolonged QT interval is an integral part of the definition of cirrhotic cardiomyopathy. The aim of this study was to analyze the relationship between QT corrected (QTc) and the etiology and the severity of liver disease in relation to the complications of cirrhosis in candidates for orthotropic liver transplantation (OLTx). MATERIAL AND METHODS From 360 consecutive patients with end-stage liver disease (ESLD) consulted by a designated cardiologist, 160 patients underwent OLTx. The QTc was calculated according to 3 formulas in 151 ECG tracings with good quality. The severity of liver disease was assessed according to Child-Pugh classification and model for end-stage liver disease (MELD). This was a single-center study with register-based follow-up design. RESULTS Prolonged QTc over 440 ms was found in 51 subjects (33.8%), but none had prolonged QTc >500 ms. QTc corrected by Fridericia (F) formula was more suitable for patients with ESLD. We found no correlation between QTc interval and severity of liver disease. The QTc interval was higher in patients with alcoholic cirrhosis when compared to patients with viral hepatitis and ESLD of other etiologies. We observed a higher QTc interval in patients with gastroesophageal varices and encephalopathy. We did not notice any significant difference in the effect of the QTc interval on survival. CONCLUSIONS QTc interval might be associated with etiology and complication of ESLD. The prolonged QT interval is not associated with higher all-cause mortality after OLTx.
Collapse
Affiliation(s)
| | - Michalina Galas
- Department of Cardiology, Medical University of Warsaw, Warsaw, Poland
| | - Urszula Ołdakowska-Jedynak
- Liver and Internal Medicine Unit, Department of General, Transplant, and Liver Surgery, Medical University of Warsaw, Warsaw, Poland
| | - Michał Peller
- Department of Cardiology, Medical University of Warsaw, Warsaw, Poland
| | - Mariusz Tomaniak
- Department of Cardiology, Medical University of Warsaw, Warsaw, Poland
| | - Joanna Raszeja-Wyszomirska
- Liver and Internal Medicine Unit, Department of General, Transplant, and Liver Surgery, Medical University of Warsaw, Warsaw, Poland
| | - Piotr Milkiewicz
- Liver and Internal Medicine Unit, Department of General, Transplant, and Liver Surgery, Medical University of Warsaw, Warsaw, Poland
| | - Marek Krawczyk
- Department of General, Transplant, and Liver Surgery, Medical University of Warsaw, Warsaw, Poland
| | - Krzysztof Zieniewicz
- Department of General, Transplant, and Liver Surgery, Medical University of Warsaw, Warsaw, Poland
| | - Grzegorz Opolski
- Department of Cardiology, Medical University of Warsaw, Warsaw, Poland
| |
Collapse
|
45
|
Główczyńska R, Raszeja-Wyszomirska J, Janik M, Kostrzewa K, Zygmunt M, Zborowska H, Krawczyk M, Galas M, Niewińsk G, Krawczyk M, Zieniewicz K, Milkiewicz P, Opolski G. Troponin I Is Not a Predictor of Early Cardiovascular Morbidity in Liver Transplant Recipients. Transplant Proc 2018; 50:2022-2026. [DOI: 10.1016/j.transproceed.2018.02.136] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2017] [Accepted: 02/06/2018] [Indexed: 01/06/2023]
|
46
|
Główczyńska R, Galas M, Witkowska A, Ołdakowska-Jedynak U, Raszeja-Wyszomirska J, Krasuski K, Milkiewicz P, Krawczyk M, Zieniewicz K, Opolski G. The Pre-Transplant Profile of Cardiovascular Risk Factors and Its Impact on Long-Term Mortality After Liver Transplantation. Ann Transplant 2018; 23:591-597. [PMID: 30127335 PMCID: PMC6248299 DOI: 10.12659/aot.908771] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Cardiovascular disease (CVD) is an important aggravating factor for orthotopic liver transplantation (OLT) outcomes. CVD still seems to be one of the most common cause of death in the long-term post-transplant period. Nevertheless, there are some limited data regarding the optimal strategy of risk assessment during OLT candidate evaluation. MATERIAL AND METHODS Routine pre-transplant cardiac workup in 360 patients with end stage liver disease (ESLD) included electrocardiogram, echocardiography, and exercise stress testing. The aim of this retrospective study was an analysis of the impact of cardiovascular risk profile on overall mortality in the 2-year follow-up of 160 patients who underwent liver transplantation. RESULTS Cardiovascular risk factors or a history of CVD were found in 23.1% of patients who received transplants. The cardiovascular risk factors most common in our group of transplant recipients with ESLD were: diabetes (26.3%), hypertension (25.6%), and hepatopulmonary syndrome (23.1%). Only 3.8% of patients had a positive exercise test. Coronary angiography revealed at least 50% stenosis in some epicardial arteries in 1.9% of patients. The risk of death in long-term follow-up of liver transplant recipients was most strongly associated with 3 cardiac variables: history of coronary artery disease (CAD), angiographically confirmed coronary stenosis, and reduced ejection fraction (EF). CONCLUSIONS Our study identified pre-transplant CAD with its consequences as a factor associated with increased risk of negative post-transplant outcomes.
Collapse
Affiliation(s)
- Renata Główczyńska
- 1st Department of Cardiology, Medical University of Warsaw, Warsaw, Poland
| | - Michalina Galas
- 1st Department of Cardiology, Medical University of Warsaw, Warsaw, Poland
| | - Anna Witkowska
- 1st Department of Cardiology, Medical University of Warsaw, Warsaw, Poland
| | - Urszula Ołdakowska-Jedynak
- Liver and Internal Medicine Unit, Department of General, Transplant and Liver Surgery, Medical University of Warsaw, Warsaw, Poland
| | - Joanna Raszeja-Wyszomirska
- Liver and Internal Medicine Unit, Department of General, Transplant and Liver Surgery, Medical University of Warsaw, Warsaw, Poland
| | - Krzysztof Krasuski
- Department of Medical Informatics and Telemedicine, Medical University of Warsaw, Warsaw, Poland
| | - Piotr Milkiewicz
- Liver and Internal Medicine Unit, Department of General, Transplant and Liver Surgery, Medical University of Warsaw, Warsaw, Poland
| | - Marek Krawczyk
- Department of General, Transplant and Liver Surgery, Medical University of Warsaw, Warsaw, Poland
| | - Krzysztof Zieniewicz
- Department of General, Transplant and Liver Surgery, Medical University of Warsaw, Warsaw, Poland
| | - Grzegorz Opolski
- 1st Department of Cardiology, Medical University of Warsaw, Warsaw, Poland
| |
Collapse
|
47
|
Krawczyk M, Gawęda B, Kośnik A, Rejowski S, Remiszewski P, Krawczyk M, Milkiewicz P, Raszeja-Wyszomirska J. Successful DAA-Based Treatment of Hcv-Related Fibrosing Cholestatic Hepatitis After Liver Transplantation Due to a Fulminant Liver Failure. Am J Gastroenterol 2018; 113:1062-1063. [PMID: 29925910 DOI: 10.1038/s41395-018-0078-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2018] [Accepted: 03/03/2018] [Indexed: 12/11/2022]
Affiliation(s)
- Marcin Krawczyk
- Department of Medicine II, Saarland University Medical Center, Homburg, Germany. Laboratory of Metabolic Liver Diseases, Center for Preclinical Research, Department of General, Transplant and Liver Surgery, Medical University of Warsaw, Warsaw, Poland. Liver and Internal Medicine Unit, Department of General Transplant and Liver Surgery, Medical University of Warsaw, Warsaw, Poland. Department of General Transplant and Liver Surgery, Medical University of Warsaw, Warsaw, Poland. Translational Medicine Group, Pomeranian Medical University, Szczecin, Poland.,Department of Medicine II, Saarland University Medical Center, Homburg, Germany. Laboratory of Metabolic Liver Diseases, Center for Preclinical Research, Department of General, Transplant and Liver Surgery, Medical University of Warsaw, Warsaw, Poland. Liver and Internal Medicine Unit, Department of General Transplant and Liver Surgery, Medical University of Warsaw, Warsaw, Poland. Department of General Transplant and Liver Surgery, Medical University of Warsaw, Warsaw, Poland. Translational Medicine Group, Pomeranian Medical University, Szczecin, Poland
| | - Bartłomiej Gawęda
- Department of Medicine II, Saarland University Medical Center, Homburg, Germany. Laboratory of Metabolic Liver Diseases, Center for Preclinical Research, Department of General, Transplant and Liver Surgery, Medical University of Warsaw, Warsaw, Poland. Liver and Internal Medicine Unit, Department of General Transplant and Liver Surgery, Medical University of Warsaw, Warsaw, Poland. Department of General Transplant and Liver Surgery, Medical University of Warsaw, Warsaw, Poland. Translational Medicine Group, Pomeranian Medical University, Szczecin, Poland
| | - Artur Kośnik
- Department of Medicine II, Saarland University Medical Center, Homburg, Germany. Laboratory of Metabolic Liver Diseases, Center for Preclinical Research, Department of General, Transplant and Liver Surgery, Medical University of Warsaw, Warsaw, Poland. Liver and Internal Medicine Unit, Department of General Transplant and Liver Surgery, Medical University of Warsaw, Warsaw, Poland. Department of General Transplant and Liver Surgery, Medical University of Warsaw, Warsaw, Poland. Translational Medicine Group, Pomeranian Medical University, Szczecin, Poland
| | - Sławomir Rejowski
- Department of Medicine II, Saarland University Medical Center, Homburg, Germany. Laboratory of Metabolic Liver Diseases, Center for Preclinical Research, Department of General, Transplant and Liver Surgery, Medical University of Warsaw, Warsaw, Poland. Liver and Internal Medicine Unit, Department of General Transplant and Liver Surgery, Medical University of Warsaw, Warsaw, Poland. Department of General Transplant and Liver Surgery, Medical University of Warsaw, Warsaw, Poland. Translational Medicine Group, Pomeranian Medical University, Szczecin, Poland
| | - Piotr Remiszewski
- Department of Medicine II, Saarland University Medical Center, Homburg, Germany. Laboratory of Metabolic Liver Diseases, Center for Preclinical Research, Department of General, Transplant and Liver Surgery, Medical University of Warsaw, Warsaw, Poland. Liver and Internal Medicine Unit, Department of General Transplant and Liver Surgery, Medical University of Warsaw, Warsaw, Poland. Department of General Transplant and Liver Surgery, Medical University of Warsaw, Warsaw, Poland. Translational Medicine Group, Pomeranian Medical University, Szczecin, Poland
| | - Marek Krawczyk
- Department of Medicine II, Saarland University Medical Center, Homburg, Germany. Laboratory of Metabolic Liver Diseases, Center for Preclinical Research, Department of General, Transplant and Liver Surgery, Medical University of Warsaw, Warsaw, Poland. Liver and Internal Medicine Unit, Department of General Transplant and Liver Surgery, Medical University of Warsaw, Warsaw, Poland. Department of General Transplant and Liver Surgery, Medical University of Warsaw, Warsaw, Poland. Translational Medicine Group, Pomeranian Medical University, Szczecin, Poland
| | - Piotr Milkiewicz
- Department of Medicine II, Saarland University Medical Center, Homburg, Germany. Laboratory of Metabolic Liver Diseases, Center for Preclinical Research, Department of General, Transplant and Liver Surgery, Medical University of Warsaw, Warsaw, Poland. Liver and Internal Medicine Unit, Department of General Transplant and Liver Surgery, Medical University of Warsaw, Warsaw, Poland. Department of General Transplant and Liver Surgery, Medical University of Warsaw, Warsaw, Poland. Translational Medicine Group, Pomeranian Medical University, Szczecin, Poland.,Department of Medicine II, Saarland University Medical Center, Homburg, Germany. Laboratory of Metabolic Liver Diseases, Center for Preclinical Research, Department of General, Transplant and Liver Surgery, Medical University of Warsaw, Warsaw, Poland. Liver and Internal Medicine Unit, Department of General Transplant and Liver Surgery, Medical University of Warsaw, Warsaw, Poland. Department of General Transplant and Liver Surgery, Medical University of Warsaw, Warsaw, Poland. Translational Medicine Group, Pomeranian Medical University, Szczecin, Poland
| | - Joanna Raszeja-Wyszomirska
- Department of Medicine II, Saarland University Medical Center, Homburg, Germany. Laboratory of Metabolic Liver Diseases, Center for Preclinical Research, Department of General, Transplant and Liver Surgery, Medical University of Warsaw, Warsaw, Poland. Liver and Internal Medicine Unit, Department of General Transplant and Liver Surgery, Medical University of Warsaw, Warsaw, Poland. Department of General Transplant and Liver Surgery, Medical University of Warsaw, Warsaw, Poland. Translational Medicine Group, Pomeranian Medical University, Szczecin, Poland
| |
Collapse
|
48
|
Abstract
Experimental research on liver transplantation was introduced in Poland by Waldemar Olszewski with his team. It was in 1972. Not until 15 years later, in 1987, did Stanisław Zieliński in Szczecin and Marian Pardela in Katowice make an attempt of transplanting liver in humans. In 1989, the attempt was made by Jacek Pawlak and Marek Krawczyk in Warsaw. The first successful liver transplantation in Poland was performed by Piotr Kaliciński at the Children's Memorial Health Institute, Warsaw. Also, in early 1990s the attempts were made by Jerzy Polański in Warsaw and Piotr Szyber in Wrocław. In the next years, liver transplantations were connected with three centers in Szczecin and were associated with the following persons: Roman Kostryka, Maciej Wójcicki and Samir Zeaira. In Warsaw, 1994, Jacek Pawlak, Bogdan Michałowicz and Krzysztof Zieniewicz performed another successful liver transplantation. The program started to develop rapidly and is still up and running. In 2000, Wojciech Rowiński and Marek Pacholczyk created another liver transplant center in Warsaw, while in 2005 Lech Cierpka and Robert Król did the same in Katowice. In the following years, liver transplantation was initiated by Maciej Słupski in Bydgoszcz (2017) and Zbigniew Śledziński in Gdańsk (2018). In the developing liver transplant centers, an exceptional contribution was made by Paweł Nyckowski, Jacek Pawlak, Krzysztof Zieniewicz, Waldemar Patkowski, Tadeusz Wróblewski, Rafał Paluszkiewicz, Marek Pacholczyk, Andrzej Chmura, Maciej Kosieradzki and Marek Krawczyk - all employees of the Medical University of Warsaw. In Wrocław, Dariusz Patrzałek and Paweł Chudoba were very active in the field of liver transplantations. In 1996, the Organizing-Coordinating Center for Transplantation POLTRANSPLANT was brought to life. It was directed by Janusz Wałaszewski, then by Roman Danielewicz and Artur Kamiński. In 1999, Piotr Kaliciński and Marek Krawczyk started the program for liver fragment harvesting and transplantation from living donors. Until the end of 2016, 4186 liver transplantations including 314 liver transplants from living donors were performed in Poland. Currently, the active centers are three centers from Warsaw, namely Pediatric Surgery and Transplantation Surgery, Children's Memorial Health Institute; Department of General, Transplant and Liver Surgery, Medical University of Warsaw; Department of General and Transplant Surgery, Medical University of Warsaw. Other active centers include Department of General and Transplant Surgery, Provincial Hospital in Szczecin, Department of General, Vascular and Transplant Surgery, Medical University of Silesia, Katowice, Department of Vascular, General and Transplant Surgery in Wrocław. Liver transplant programs have also been initiated at the Department of Liver and General Surgery, Bydgoszcz, and Department of General, Endocrine and Transplant Surgery, Medical University of Gdańsk.
Collapse
Affiliation(s)
- Marek Krawczyk
- Department of General, Transplant and Liver Surgery, Medical University of Warsaw, Poland
| |
Collapse
|
49
|
Willms A, Müller C, Julich H, Klein N, Schwab R, Güsgen C, Richardsen I, Schaaf S, Krawczyk M, Krawczyk M, Lammert F, Schuppan D, Lukacs-Kornek V, Kornek M. Tumour-associated circulating microparticles: A novel liquid biopsy tool for screening and therapy monitoring of colorectal carcinoma and other epithelial neoplasia. Oncotarget 2017; 7:30867-75. [PMID: 27127176 PMCID: PMC5058724 DOI: 10.18632/oncotarget.9018] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2016] [Accepted: 04/02/2016] [Indexed: 02/05/2023] Open
Abstract
Up to date, novel tools for low-cost, minimal invasive cancer surveillance, cancer screening and treatment monitoring are in urgent need. Physicians consider the so-called liquid biopsy as a possible future tool successfully achieving these ultimate goals. Here, we aimed to identify circulating tumour-associated MPs (taMPs) that could aid in diagnosing minimal-invasively the presence and follow up treatment in non-small cell lung carcinoma (NSCLC), colorectal carcinoma (CRC) and pancreas carcinoma (PaCa). Tumour-associated MPs (taMPs) were quantified after isolation by centrifugation followed by flow cytometry analysis from the serum of cancer patients with CRC (n = 52), NSCLC (n = 40) and PaCa (n = 11). Healthy subjects (n = 55) or patients with struma nodosa (thyroid nodules) (n = 43) served as negative controls. In all three types of tumour entities, the presence of tumour was associated with an increase of circulating EpCAM+ and EpCAM+CD147+ taMPs. The presence of CD147+EpCAM+ taMPs were specific to tumour-bearing patients thus allowing the specific distinction of malignancies from patients with thyroid nodules. Increased level of EpCAM single positive MPs were, in turn, also detected in patients with thyroid nodules. Importantly, EpCAM+CD147+ taMPs correlated with the measured tumour-volume in CRC patients. EpCAM+ taMPs decreased at 7 days after curative R0 tumour resection suggesting a close dependence with tumour presence. AUROC values (up to 0.85 and 0.90), sensitivity/specificity scores, and positive/negative predictive values indicated a high diagnostic accuracy of EpCAM+CD147+ taMPs. Taken together, EpCAM+CD147+ double positive taMPs could potentially serve as novel promising clinical parameter for cancer screening, diagnosis, surveillance and therapy monitoring.
Collapse
Affiliation(s)
- Arnulf Willms
- Department of General, Visceral and Thoracic Surgery, German Armed Forces Central Hospital, Koblenz, Germany
| | - Clara Müller
- Department of Medicine II, Saarland University Medical Center, Homburg/Saar, Germany
| | - Henrike Julich
- Department of Medicine II, Saarland University Medical Center, Homburg/Saar, Germany
| | - Niklas Klein
- Department of Medicine II, Saarland University Medical Center, Homburg/Saar, Germany
| | - Robert Schwab
- Department of General, Visceral and Thoracic Surgery, German Armed Forces Central Hospital, Koblenz, Germany
| | - Christoph Güsgen
- Department of General, Visceral and Thoracic Surgery, German Armed Forces Central Hospital, Koblenz, Germany
| | - Ines Richardsen
- Department of General, Visceral and Thoracic Surgery, German Armed Forces Central Hospital, Koblenz, Germany
| | - Sebastian Schaaf
- Department of General, Visceral and Thoracic Surgery, German Armed Forces Central Hospital, Koblenz, Germany
| | - Marcin Krawczyk
- Department of Medicine II, Saarland University Medical Center, Homburg/Saar, Germany.,Laboratory of Metabolic Liver Diseases, Department of General, Transplant and Liver Surgery, Medical University of Warsaw, Warsaw, Poland
| | - Marek Krawczyk
- Department of General, Transplant and Liver Surgery, Medical University of Warsaw, Warsaw, Poland
| | - Frank Lammert
- Department of Medicine II, Saarland University Medical Center, Homburg/Saar, Germany
| | - Detlef Schuppan
- Institute of Translational Immunology and Research Center for Immune Therapy, Institute of Translational Immunology, University Medical Center, Johannes Gutenberg University, Mainz, Germany
| | | | - Miroslaw Kornek
- Department of General, Visceral and Thoracic Surgery, German Armed Forces Central Hospital, Koblenz, Germany.,Department of Medicine II, Saarland University Medical Center, Homburg/Saar, Germany
| |
Collapse
|
50
|
Krawczyk M, Ligocka J, Ligocki M, Raszeja-Wyszomirska J, Milkiewicz M, Szparecki G, Ilczuk T, Górnicka B, Zieniewicz K, Krawczyk M, Lammert F, Milkiewicz P. Does transient elastography correlate with liver fibrosis in patients with PSC? Laennec score-based analysis of explanted livers. Scand J Gastroenterol 2017; 52:1407-1412. [PMID: 28851259 DOI: 10.1080/00365521.2017.1370009] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND AND AIMS Previous studies demonstrated a close correlation between transient elastography (TE) and liver histology in chronic liver diseases. Data on the accuracy of TE in primary sclerosing cholangitis (PSC) remains scarce. Here, we investigated the association between TE, serum marker of liver injury and histology of explanted livers in PSC patients. METHODS Thirty patients were prospectively recruited. TE (Fibroscan®) and blood sampling were performed during evaluation for liver transplantation (LT); the second blood sampling was performed on the day of LT. Fibrosis of explanted livers according to the seven-point Laennec staging system and liver collagen contents were measured. RESULTS TE correlated with Laennec stages of fibrosis (p = .001), collagen contents (p < .001) and with diameter of thickest septa (p = .034) in explanted livers. It also correlated with serum indices of liver injury, namely AST, bilirubin as well as FIB-4 and APRI scores (all p < .05). In a multivariate model, only liver fibrosis, according to either Laennec score (p = .035) or collagen contents (p = .005), was significantly associated with TE. Finally, patients with cirrhosis had increased liver stiffness (p = .002) and the TE cut-off of 13.7 kPa showed the best predictive value (AUC = .90, 95% CI: 0.80-1.00, p < .001) for detecting cirrhosis. CONCLUSIONS TE correlates with liver fibrosis and markers of liver injury in patients with PSC. However, liver fibrosis seems to be the strongest predictor of liver stiffness assessed with TE. Hence, we postulate that TE is a reliable tool for non-invasive monitoring of PSC.
Collapse
Affiliation(s)
- Marcin Krawczyk
- a Department of Medicine II , Saarland University Medical Center , Homburg , Germany.,b Laboratory of Metabolic Liver Diseases, Centre for Preclinical Research, Department of General, Transplant and Liver Surgery , Medical University of Warsaw , Warsaw , Poland
| | - Joanna Ligocka
- c Department of General, Transplant and Liver Surgery , Medical University of Warsaw , Warsaw , Poland
| | - Mariusz Ligocki
- d Liver and Internal Medicine Unit, Department of General, Transplant and Liver Surgery , Medical University of Warsaw , Warsaw , Poland
| | - Joanna Raszeja-Wyszomirska
- d Liver and Internal Medicine Unit, Department of General, Transplant and Liver Surgery , Medical University of Warsaw , Warsaw , Poland
| | | | - Grzegorz Szparecki
- f Department of Pathology , Medical University of Warsaw , Warsaw , Poland
| | - Tomasz Ilczuk
- f Department of Pathology , Medical University of Warsaw , Warsaw , Poland
| | - Barbara Górnicka
- f Department of Pathology , Medical University of Warsaw , Warsaw , Poland
| | - Krzysztof Zieniewicz
- c Department of General, Transplant and Liver Surgery , Medical University of Warsaw , Warsaw , Poland
| | - Marek Krawczyk
- c Department of General, Transplant and Liver Surgery , Medical University of Warsaw , Warsaw , Poland
| | - Frank Lammert
- a Department of Medicine II , Saarland University Medical Center , Homburg , Germany
| | - Piotr Milkiewicz
- d Liver and Internal Medicine Unit, Department of General, Transplant and Liver Surgery , Medical University of Warsaw , Warsaw , Poland.,g Translational Medicine Group , Pomeranian Medical University , Szczecin , Poland
| |
Collapse
|