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1,276 results for “Liver transplantation”
Data from Time since liver transplantation and immunosuppression withdrawal outcomes: a systematic review with individual patient data meta-analysis
<p>This record provides one CSV file containing anonymized individual patient data (IPD) of pre-withdrawal times (in days) of liver transplant recipients that underwent immunosuppression (IS) withdrawal. Collection and publication of anonymized data was approved by the Ethics Committee Northwest and Central Switzerland. Patients of 15 primary studies are stratified by successfully reaching the state of IS-free operational tolerance (OT) or by developing signs of immunological rejection (non-OT).</p>
Efficacy and Safety of Everolimus in Liver Transplant Recipients of Living Donor Liver Transplants
ClinicalTrials.gov study NCT01888432. IPD Sharing: UNDECIDED. Countries: 13. Publications: 1.
Raw data for the article: Successful Use of Heterologous CMV-Reactive T Lymphocyte to Treat Severe Refractory Cytomegalovirus (CMV) Infection in a Liver Transplanted Patient: Correlation of the Host Antiviral Immune Reconstitution with CMV Viral Load and CMV miRNome
<p>Cytomegalovirus (CMV) infection is the most significant viral infection in hosts with compromised immune systems as solid organ transplant patients. Despite significant progress being made in the prevention of CMV disease in these patients, further therapeutic strategies for CMV disease and for the CMV reactivation prevention are needed. Here, we describe the outcome of the infusion of in vitro expanded CMV-reactive T-cells, taken from a healthy CMV-seropositive donor, in a liver-transplanted recipient with a refractory recurrent CMV. In this particular case, adoptive transfer of allogenic CMV-reactive T-lymphocytes resulted in the clearance of CMV infection and resolution of the pathological manifestations of the patient. In the study we also investigated circulating miRNAs, both cellular and viral, as potential biomarkers during the course of CMV infection. The results indicate that the infusion of allogenic CMV-reactive T-cells can be an effective strategy to treat CMV infection recurrence when the generation of autologous virus specific T cell clones is not possible.</p>
Raw Data for the article: Liver Transplantation for Unresectable Intrahepatic Cholangiocarcinoma: The Role of Sequencing Genetic Profiling
<p>Intrahepatic cholangiocarcinoma (iCCA) is a rare and aggressive primary liver tumor, characterized by a range of different clinical manifestations and by increasing incidence and mortality rates even after curative treatment with radical resection. In recent years, growing attention has been devoted to this disease and some evidence supports liver transplantation (LT) as an appropriate treatment for intrahepatic cholangiocarcinoma; evolving work has also provided a framework for better understanding the genetic basis of this cancer. The aim of this study was to provide a clinical description of our series of patients complemented with Next-Generation Sequencing genomic profiling. From 1999 to 2021, 12 patients who underwent LT with either iCCA or a combined hepatocellular and cholangiocellular carcinoma (HCC-iCCA) were included in this study. Mutations were observed in gene activating signaling pathways known to be involved with iCCA tumorigenesis (KRAS/MAPK, P53, PI3K-Akt/mTOR, cAMP, WNT, epigenetic regulation and chromatin remodeling). Among several others, a strong association was observed between the Notch pathway and tumor size (point-biserial <em>rho<sub>pb</sub></em> = 0.93). Our results are suggestive of the benefit potentially derived from molecular analysis to improve our diagnostic capabilities and to devise new treatment protocols, and eventually ameliorate long-term survival of patients affected by iCCA or HCC-iCCA.</p>
Raw Data for the article: Liver transplantation for unresectable intrahepatic cholangiocarcinoma: an Italian experience
<p>Intrahepatic cholangiocarcinoma (iCCA) is an aggressive form of primary liver cancer treated exclusively with surgery.</p> <p>Its incidence in the western world is growing lately [<a href="https://link.springer.com/article/10.1007/s13304-021-01064-w#ref-CR1">1</a>] and the overall 5-year survival is poor due to late diagnosis, since patients rarely present a jaundice differently from patients affected by perihilar cholangiocarcinoma. Ideally liver resection and regional lymphadenectomy are the best treatments; however, these are unfortunately connotated by a 75% recurrence rate 5 years after surgery. Systemic chemotherapy offers a minimal response, as well as loco-regional therapy such as selective internal radiotherapy (SIRT), with a survival varying from 11 to 15 months between the two therapies</p>
Impact of CYP3A5 Genotypes on Tacrolimus Pharmacokinetics in Colombian Liver Transplant Patients
<p><strong><span>Impact of CYP3A5 Genotypes on Tacrolimus Pharmacokinetics in Colombian Liver Transplant Patients</span></strong></p>
Raw data fort the article: FLUOROSCOPY-GUIDED BILIARY PROCEDURES IN A PREGNANT, LIVER TRANSPLANT PATIENT: FETUS RADIATION PROTECTION
<p>We report three cases of clinically necessary, fluoroscopy-guided, percutaneous biliary procedures performed safely in a pregnant, liver transplant recipient using three different angiography suites. The uterine cumulative equivalent dose was 0.25 mSv, a value obtained by adding the doses of the three procedures described above, and which is relatively low when compared with the naturally occurring background radiation exposure for a 9-month pregnancy (~0.5-1 mSv). Our experience shows that staff knowledge, awareness and liaison promote the application of all dose reduction strategies possible while still achieving the clinical aim despite using different angiographic equipment.</p>
Raw Data for the article: Neurological Screening in Elderly Liver Transplantation Candidates: A Single Center
<p><strong>Background: </strong>Cerebral small vessels disease (cSVD) is an age-related disorder and risk factor for stroke and cognitive/motor impairments. Neurological complications (NCs) are among the causes of adverse outcomes in older liver transplant recipients. This study sought to determine whether cSVD predicts acute NCs in over 65-year-old liver transplant patients.</p> <p><strong>Methods: </strong>Data were collected, from a retrospective medical chart review, of 22 deceased donor liver transplant recipients aged 65 years or older with a pre-operative brain magnetic resonance imaging (MRI). We used the Fazekas score (0-3) as a quantitative measurement of the vascular lesion load seen in the MRI. We analyzed all post-operative acute NCs occurring during the hospital stay and any other non-NC.</p> <p><strong>Results: </strong>cSVD was recognized in all patients. Neurological complications (NCs) occurred in 18.1% of patients with toxic-metabolic encephalopathy the most frequent diagnosis (13.64%). More severe cSVD was associated with seizures (<em>p</em> = 0.0362), longer hospital stay (<em>p</em> 0.0299), and disability (<em>p</em> 0.0134). In our elderly cohort, hepatic encephalopathy (HE) (<em>p</em> 0.0287) and ascites (<em>p</em> 0.0270) were predictors of NCs after liver transplantation. Ascites and/or variceal bleeding and severity of liver disease were associated with adverse post-operative outcomes. The small sample size limited the statistical analysis power.</p> <p><strong>Conclusions: </strong>We present the preliminary data of a single-center retrospective study aimed at understanding the cSVD role on NCs and non-NCs after a liver transplantation in elderly patients. This would encourage a more appropriate multicenter prospective study that will definitely confirm if a neurological screening in old age liver transplant candidates is appropriate.</p>
Raw Data for the article: Clinical outcomes of transjugular intrahepatic portosystemic shunt with PTFE-covered stents after liver transplantation and technical results in split and whole liver graft recipients
<p><strong>Objectives: </strong>To assess the outcomes of transjugular intrahepatic portosystemic shunt (TIPS) creation using PTFE-covered stents in liver transplant (LT) recipients and to analyze the technical result of TIPS creation in split grafts (SG) compared with whole liver grafts (WG).</p> <p><strong>Methods and materials: </strong>Single-center, retrospective study, analyzing LT patients who underwent TIPS using PTFE-covered stents. Clinical and technical variables were analyzed.</p> <p><strong>Results: </strong>Between 2005 and 2021, TIPS was created using PTFE-covered stents in 48 LT patients at a median of 43 months (range, 0.5-192) after LT. TIPS indications were refractory ascites (RA) in 33 patients (69%), variceal bleeding (VB) in 9 patients (19%), others in 6 (12%). Ten patients (21%) received a SG. Technical success rate was 100% in both groups: in two WG recipients, (5%) a second attempt was required. An unconventional approach (combined transhepatic or transplenic access) was needed in 2 WG (5%) and 2 SG recipients (20%). Two procedure-related death occurred in the WG group. After a median follow-up of 22 months (range, 0,1-144), 16 patients (48%) in the RA group did not require post-TIPS paracentesis, in the VB group rebleeding occurred in 3 patients (33%). Fifteen patients (31%) underwent TIPS revision. Overt hepatic encephalopathy occurred in 14 patients (29%). Patient survival at 6 months, 1 year, and 3 years was 77%, 66%, and 43%, respectively.</p> <p><strong>Conclusions: </strong>The feasibility and safety of TIPS creation in SG are comparable to that of WG. TIPS creation using PTFE-covered stents represents a viable option to treat portal hypertensive complications in LT recipients.</p>
Raw Data for the article: Continuous Renal Replacement Therapy after Liver Transplantation: Peri-Operative Associated Factors and Impact on Survival
<p>Continuous renal replacement therapy (CRRT) following orthotopic liver transplantation (OLT) is usually started for multifactorial reasons, with variable incidence among series. This paper presents a single-center retrospective observational study on the early use (within one week) of CRRT after consecutive cadaveric OLT from January 2008 to December 2016. Preoperative patient characteristics and intraoperative data were collected, and patients were divided into two groups (CRRT and no CRRT) to explore the factors associated with the use of CRRT. Repeated measurements of postoperative creatinine were analyzed with generalized estimating equation (GEE) models. Among 528 OLT patients, 75 (14.2%) were treated with CRRT at least once in the first week. Patients treated with CRRT showed lower survival in a Kaplan-Meier curve (log-rank <em>p</em> value &lt; 0.01). Patients treated with CRRT had a more severe preoperative profile, with a significantly higher age, MELD, BUN, creatinine, and total bilirubin, as well as a longer surgery time and a higher number of transfusions of red blood cells, plasma, and platelets (all <em>p</em> values &lt; 0.05). In a stepwise multiple analysis, the following characteristics remained independently associated with the use of CRRT: the MELD score OR 1.12 (95% CL: 1.07-1.16), <em>p</em> value &lt; 0.001, and the preoperative value for blood urea nitrogen OR 1.016 (95% CL: 1.010-1.023), <em>p</em> value &lt; 0.001. The early use of CRRT after OLT occurred at a low rate in this large cohort; however, it was associated with worse outcomes. Apart from the preoperative severity, repeated intraoperative hypotension episodes, which were likely modifiable or preventable, were associated with the increased use of CRRT and higher postoperative creatinine.</p>
Raw Data for the article: How important is the role of iterative liver direct surgery in patients with hepatocellular carcinoma for a transplant center located in an area with a low rate of deceased donation?
<p><strong>Introduction: </strong>Hepatocellular carcinoma (HCC) accounts for nearly 90% of primary liver cancers, with estimates of over 1 million people affected by 2025. We aimed to explore the impacting role of an iterative surgical treatment approach in a cohort of HCC patients within the Milan criteria, associated with clinical risk factors for tumor recurrence (RHCC) after liver transplant (LT) and loco-regional therapies (LRT), as well as liver resection (LR) and/or microwave thermal ablation (MWTA).</p> <p><strong>Methods: </strong>We retrospectively analyzed our experience performed during an 8-year period between January 2013 and December 2021 in patients treated for HCC, focusing on describing the impact on preoperative end-stage liver disease severity, oncologic staging, tumor characteristics, and surgical treatments. The Cox model was used to evaluate variables that could predict relapse risks. Relapse risk curves were calculated according to the Kaplan-Meier method, and the log-rank test was used to compare them.</p> <p><strong>Results: </strong>There were 557 HCC patients treated with a first-line approach of LR and/or LRTs (<em>n</em> = 335) or LT (<em>n</em> = 222). The median age at initial transplantation was 59 versus 68 for those whose first surgical approach was LR and/or LRT. In univariate analysis with the Cox model, nodule size was the single predictor of recurrence of HCC in the posttreatment setting (HR: 1.61, 95% CI: 1.05-2.47, <em>p</em> = 0.030). For the LRT group, we have enlightened the following clinical characteristics as significantly associated with RHCC: hepatitis B virus infection (which has a protective role with HR: 0.34, 95% CI: 0.13-0.94, <em>p</em> = 0.038), number of HCC nodules (HR: 1.54, 95% CI: 1.22-1.94, <em>p</em> < 0.001), size of the largest nodule (HR: 1.06, 95% CI: 1.01-1.12, <em>p</em> = 0.023), serum bilirubin (HR: 1.57, 95% CI: 1.03-2.40, <em>p</em> = 0.038), and international normalized ratio (HR: 16.40, 95% CI: 2.30-118.0, <em>p</em> = 0.006). Among the overall 111 patients with RHCC in the LRT group, 33 were iteratively treated with further curative treatment (12 were treated with LR, two with MWTA, three with a combined LR-MWTA treatment, and 16 underwent LT). Only one of 18 recurrent patients previously treated with LT underwent LR. For these RHCC patients, multivariable analysis showed the protective roles of LT for primary RHCC after IDLS (HR: 0.06, 95% CI: 0.01-0.36, <em>p</em> = 0.002), of the time relapsed between the first and second IDLS treatments (HR: 0.97, 95% CI: 0.94-0.99, <em>p</em> = 0.044), and the impact of previous minimally invasive treatment (HR: 0.28, 95% CI: 0.08-1.00, <em>p</em> = 0.051).</p> <p><strong>Conclusion: </strong>The coexistence of RHCC with underlying cirrhosis increases the complexity of assessing the net health benefit of ILDS before LT. Minimally invasive surgical therapies and time to HCC relapse should be considered an outcome in randomized clinical trials because they have a relevant impact on tumor-free survival.</p>
Safety and Efficacy of Ledipasvir/Sofosbuvir Fixed Dose Combination Administered in Patients Infected With Chronic Genotype 1 or 4 HCV for Use in the Peri-Operative Liver Transplantation Setting
ClinicalTrials.gov study NCT02350569. IPD Sharing: YES. Countries: 1. Publications: 1.
Pre-Transplant Treatment to Prevent Recurrence of Hepatitis C After Liver Transplantation
ClinicalTrials.gov study NCT00135798. IPD Sharing: Not stated. Countries: 1. Publications: 5.
Safety Study of Liver Natural Killer Cell Therapy for Hepatoma Liver Transplantation
ClinicalTrials.gov study NCT01147380. IPD Sharing: NO. Countries: 1. Publications: 1.
Adjuvant Lenvatinib Prevents Recurrence of High-risk Patients With HBV-related HCC After Liver Transplantation
ClinicalTrials.gov study NCT04415567. IPD Sharing: YES. Countries: 1. Publications: 4.
Gradual Withdrawal of Immune System Suppressing Drugs in Patients Receiving a Liver Transplant
ClinicalTrials.gov study NCT00135694. IPD Sharing: Not stated. Countries: 1. Publications: 2.
Patisiran in Patients With Hereditary Transthyretin-mediated Amyloidosis (hATTR Amyloidosis) Disease Progression Post-Liver Transplant
ClinicalTrials.gov study NCT03862807. IPD Sharing: YES. Countries: 7. Publications: 3.
LIFT Intervention in Liver Transplant Candidates
ClinicalTrials.gov study NCT04836923. IPD Sharing: NO. Countries: 1. Publications: 1.
Mild Hypothermia and Acute Kidney Injury in Liver Transplantation
ClinicalTrials.gov study NCT03534141. IPD Sharing: NO. Countries: 1. Publications: 6.
Belatacept in Liver Transplant Recipients
ClinicalTrials.gov study NCT00555321. IPD Sharing: Not stated. Countries: 9. Publications: 1.
ScienceDex guides
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These curated guides explain access requirements, typical timelines, costs, and reuse considerations for widely used research datasets.
Allen Brain Atlas
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DANDI Archive for NWB datasets
DANDI is a BRAIN Initiative archive for publishing and sharing neurophysiology data, including electrophysiology, optophysiology, and behavioral data packaged as NWB and related standards.
International Brain Laboratory public data
The International Brain Laboratory public data releases expose standardized mouse decision-making experiments, including Neuropixels recordings, widefield calcium imaging, behavior, and session metadata accessed through the ONE API.
OpenNeuro
OpenNeuro is a free, open platform for sharing neuroimaging datasets, with public search, dataset pages, and download paths for web, S3, DataLad, and the OpenNeuro CLI.