BACKGROUND: The established procedure for ABO-incompatible liver transplantation(ABO-I LT) was too complicated to be used in case of emergency. We developed a protocol consisting of rituximab and intravenous immunoglo...BACKGROUND: The established procedure for ABO-incompatible liver transplantation(ABO-I LT) was too complicated to be used in case of emergency. We developed a protocol consisting of rituximab and intravenous immunoglobulin(IVIG) for ABO-I LT in patients with acute liver failure(ALF).METHODS: The data from 101 patients who had undergone liver transplantation(LT) for ALF were retrospectively analyzed.The patients were divided into two groups: ABO-compatible liver transplantation group(ABO-C LT, n=66) and ABO-I LT group(n=35). All the patients in the ABO-I LT group received a single dose of rituximab(375 mg/m2) and IVIG(0.4 g/kg per day) at the beginning of the operation. IVIG was administered for 10 consecutive days after LT. Plasma exchange, splenectomy and graft local infusion were omitted in the protocol.Quadruple immunosuppressive therapy including basiliximab,corticosteroids, tacrolimus and mycophenolatemofetil was used to reinforce immunosuppression.RESULTS: The 3-year cumulative patient survival rates in the ABO-I LT and ABO-C LT groups were 83.1% and 86.3%,respectively(P>0.05), and the graft survival rates were 80.0%and 86.3%, respectively(P>0.05). Two patients(5.7%) suffered from antibody-mediated rejection in the ABO-I LT group.Other complications such as acute cellular rejection, biliary complication and infection displayed no significant differences between the two groups.CONCLUSIONS: The simplified treatment consisting of rituximab and IVIG prevented antibody-mediated rejection for LT of blood-type incompatible patients. With this treatment, the patients did not need plasma exchange, splenectomy and graft local infusion. This treatment was safe and efficient for LT of the patients with ALF.展开更多
Background: Previous studies have emphasized the need to reduce tacrolimus(TAC) trough levels in the early post-liver transplantation(LT) period. However, whether late-period TAC trough levels influence the long-term ...Background: Previous studies have emphasized the need to reduce tacrolimus(TAC) trough levels in the early post-liver transplantation(LT) period. However, whether late-period TAC trough levels influence the long-term outcomes of liver recipients is not clear.Methods: We enrolled 155 adult liver recipients survived more than 3 years after living donor liver transplantation because of non-malignant liver diseases. The maintenance immunosuppressive regimens were TAC monotherapy and combined therapy with mycophenolate mofetil. Patients were divided into three groups according to their late-period TAC trough levels: < 3 ng/m L group, 3–5 ng/m L group, and>5 ng/m L group. The complications and adverse effects of TAC were analyzed.Results: Each group showed similar rejection, graft loss and mortality. Patients achieved the < 5 ng/m L state in less than 4 years had fewer new-onset diabetes, hyperlipidemia, de novo malignancies, and hepatitis B virus recurrence; the complications of renal dysfunction and hypertension rates were the same among these 3 groups.Conclusions: Collectively, our findings indicated that lower TAC trough levels in the late period of liver transplantation are safe, improve the long-term outcomes.展开更多
AIM To investigate the underlying mechanisms of the protective role of remote ischemic perconditioning(RIPerC) in rat liver transplantation. METHODS Sprague-Dawley rats were subjected to sham, orthotopic liver transpl...AIM To investigate the underlying mechanisms of the protective role of remote ischemic perconditioning(RIPerC) in rat liver transplantation. METHODS Sprague-Dawley rats were subjected to sham, orthotopic liver transplantation(OLT), ischemic postconditioning(IPostC) or RIPerC. After 3 h reperfusion, blood samples were taken for measurement of alanine aminotransferase, aspartate aminotransferase, creatinine(Cr) and creatinine kinase-myocardial band(CK-MB). The liver lobes were harvested for the following measurements: reactive oxygen species(ROS), H2O2, mitochondrial membrane potential(ΔΨm) and total nitric oxide(NO). These measurements were determined using an ROS/H2O2, JC1 and Total NOx Assay Kit, respectively. Endothelial NO synthase(e NOS) was analyzed by reverse transcription-polymerase chain reaction(RTPCR) and western blotting, and peroxynitrite was semiquantified by western blotting of 3-nitrotyrosine. RESULTS Compared with the OLT group, the grafts subjected to RIPerC showed significantly improved liver and remote organ functions(P < 0.05). ROS(P < 0.001) including H2O2(P < 0.05) were largely elevated in the OLT group as compared with the sham group, and RIPerC(P < 0.05) reversed this trend. The collapse of ΔΨm induced by OLT ischemia/reperfusion(I/R) injury was significantly attenuated in the RIPerC group(P < 0.001). A marked increase of NO content and phosphoserine eN OS, both in protein and mR NA levels, was observed in liver graft of the RIPer C group as compared with the OLT group(P < 0.05). I/R-induced 3-nitrotyrosine content was significantly reduced in the RIPerC group as compared with the OLT group(P < 0.05). There were no significant differences between the RIPerC and IPostC groups for all the results except Cr. The Cr level was lower in the RIPerC group than in the IPostC group(P < 0.01).CONCLUSION Liver graft protection by RIPerC is similar to or better than that of IPostC, and involves inhibition of oxidative stress and up-regulation of the PI3K/Akt/e NOS/NO pathway.展开更多
AIM:To investigate the significance of pre-transplant neutrophil-lymphocyte ratio(NLR) in determining the prognosis of liver transplant(LT) recipients with acuteon-chronic liver failure(ACLF).METHODS:Data were collect...AIM:To investigate the significance of pre-transplant neutrophil-lymphocyte ratio(NLR) in determining the prognosis of liver transplant(LT) recipients with acuteon-chronic liver failure(ACLF).METHODS:Data were collected from the liver transplantation data bank.The NLR values and other conventional inflammatory markers were evaluated for their ability to predict the prognosis of 153 patients with ACLF after LT.The NLR cut-off value was based on a receiver operating characteristic curve analysis.A Kaplan-Meier curve analysis and univariate and multivariate Cox regression models were used to define the independent risk factors for poor outcomes.RESULTS:The optimal NLR cut-off value was 4.6.Out of 153 patients,83(54.2%) had an NLR ≥ 4.6.The 1-,3-,and 5-year overall survival rates were 94.3%,92.5% and 92.5%,respectively,in the normal NLR group and 74.7%,71.8% and 69.8%,respectively,in patients with high NLRs(P < 0.001).Furthermore,there was a significant difference in infectious complications after LT between the high and normal NLR groups.There were no significant differences for other complications.In the multivariate Cox regression model,a high NLR was defined as a significant predictor of poor outcomes for LT.CONCLUSION:A high NLR is a convenient and available predictor for prognosis of LT patients and can potentially optimize the current criteria for LT in ACLF.展开更多
Background:Accumulating data have suggested that long non-coding RNAs(lncRNAs)play important roles in regulating tumor cell growth.This study was designed to investigate the role of SNHG16 in hep-atocellular carcinoma...Background:Accumulating data have suggested that long non-coding RNAs(lncRNAs)play important roles in regulating tumor cell growth.This study was designed to investigate the role of SNHG16 in hep-atocellular carcinoma(HCC).Methods:SNHG16 expression was detected with real-time polymerase chain reaction(PCR).The cut-offvalue of SNHG16 for tumor-free survival(TFS)was determined with receiver operating characteristic curve analysis.Small interfering RNA was used to inhibit the expression of SNHG16 in HCC cell lines.The biologic behavior of HCC cell was determined with cell viability assay and Transwell assay in vitro.The potential predictive value of SNHG16 on prognosis was analyzed by Kaplan-Meier curves and Cox proportional hazards regression model.Results:SNHG16 expression was upregulated in tumor tissues and HCC cell lines.High expression of SNHG16 was associated with tumor recurrence and poor prognosis after surgery.Multivariate analysis revealed that SNHG16 was an independent prognostic factor for poor recurrence-free survival.Moreover,inhibition of SNHG16 in HepG2,Hep3B,and BEL-7402 cells significantly reduced cell invasiveness and proliferation.Mechanistic analyses indicated that the ECM-receptor interaction pathway was remarkably activated by SNHG16.Conclusions:SNHG16 might be a promising biomarker for predicting tumor recurrence in HCC patients after surgery and a potential therapeutic target for HCC.展开更多
Anti-virus prophylactic therapy may be not necessary for the prevention of hepatitis B virus(HBV) recurrence after HBV-related liver transplantation(LT).However,studies on completely stopping the hepatitis B immune gl...Anti-virus prophylactic therapy may be not necessary for the prevention of hepatitis B virus(HBV) recurrence after HBV-related liver transplantation(LT).However,studies on completely stopping the hepatitis B immune globulin(HBIG) and nucleos(t)ide analogs(NUC) after LT are few.The aim of the current study was to evaluate the safety of antivirus prophylaxis withdrawal in liver recipients whose serum hepatitis B e antigen(HBe Ag) and HBV DNA are negative.We analyzed 190 patients undergone LT for HBV-related liver disease from 2006 to 2012 and found that 10 patients completely stopped the HBIG and NUC due to poor compliance.These patients were liver biopsied and checked monthly with serum HBV markers,HBV DNA and liver function.Among the 10 patients,9 did not show the signs of HBV recurrence after a mean follow-up of 51.6 months(range 20-73) after withdrawal of the HBIG and NUC.The average time from LT to the withdrawal of the anti-virus drug was 23.8(13-42) months; one patient showed hepatitis B surface antigen-positive and detectable HBV DNA after stopping anti-virus drugs and this patient was successfully treated with entecavir.Our data suggested that complete withdrawal of anti-virus prophylaxis was safe and feasible for patients whose serum HBe Ag and HBV DNA were negative at the time of LT.展开更多
Background: Lower mean platelet volume(MPV) is an indicator of platelet activity in the setting of tumor development. This study was to assess the relationship between preoperative MPV and survival outcomes of patient...Background: Lower mean platelet volume(MPV) is an indicator of platelet activity in the setting of tumor development. This study was to assess the relationship between preoperative MPV and survival outcomes of patients with hepatocellular carcinoma(HCC) following liver transplantation(LT). Methods: The demographic and clinical characteristics of 304 HCC patients following LT were retrieved from an LT database. All the patients were divided into the normal and lower MPV groups according to the median MPV. The factors were first analyzed using a Kaplan–Meier survival analysis, then the factors with P < 0.10 were selected for multivariate Cox regression analysis and were used to define the independent risk factors for poor prognosis. Results: The 1-, 3-, and 5-year tumor free survival was 95.34%, 74.67% and 69.29% in the normal MPV group, respectively, and 95.40%, 59.97% and 42.94% in the lower MPV group, respectively( P < 0.01). No significant difference was observed in post-LT complications between the normal and lower MPV groups. Portal vein tumor thrombosis(PVTT)[hazard ratio(HR = 2.24;95% confidence interval: 1.46–3.43;P < 0.01) and lower MPV(HR = 1.58;95% confidence interval: 1.05–2.36;P = 0.03) were identified as independent prognostic risk factors for recipient survival. Conclusion: Preoperative lower MPV is a risk indicator of HCC patients survival outcomes after LT.展开更多
To the Editor:Liver transplantation (LT) is an effective therapeutic method for end-stage liver diseases. Although rejection is commonly mild or moderate in LT compared with other solid organs transplantation, it is s...To the Editor:Liver transplantation (LT) is an effective therapeutic method for end-stage liver diseases. Although rejection is commonly mild or moderate in LT compared with other solid organs transplantation, it is still requiring a life-long immunosuppressive therapy. Meanwhile, LT is less sensitive to rejection than other organs transplantation due to liver immune privilege which even allows the success of LT with positive across mismatches of blood group and complete major histocompatibility complex.[1, 2] During the early period of transplantation,clinical operational tolerance (COT) could be achieved on account of the genetic identity between recipient and donor.[3] Over the last decades, there is solid evident supporting that approximately 20% of LT recipients could develop COT, defined as maintaining normal graft function beyond one year completely without administering any immunosuppressive drugs.[4]展开更多
Background:Nonalcoholic fatty liver disease(NAFLD)is closely associated with obesity.However,this association could be influenced by the coexisting metabolic abnormalities.This study aimed to investigate the role of o...Background:Nonalcoholic fatty liver disease(NAFLD)is closely associated with obesity.However,this association could be influenced by the coexisting metabolic abnormalities.This study aimed to investigate the role of obesity and metabolic abnormalities in NAFLD among elderly Chinese.Methods:A cross-sectional study was performed among elderly residents who took their annual health checkups during 2016 in Keqiao District,Shaoxing,China.Results:A total of 3359 elderly adults were retrospectively included in this study.The overall prevalence of NAFLD was 28.7%.The prevalence of NAFLD were 7.14%,27.92%,34.80%,and 61.02%in participants with metabolically healthy normal weight(MHNW),metabolically abnormal normal weight(MANW),metabolically healthy obese(MHO),and metabolically abnormal obese(MAO),respectively.NAFLD patients in MHO group had more unfavorable metabolic profiles than those in MHNW group.Logistic regression analysis showed that sex,body mass index(BMI),fasting blood glucose,and serum uric acid were the risk factors of NAFLD.Conclusions:Both obesity and metabolic health were significantly associated with NAFLD in elderly Chinese.Screening for obesity and other metabolic abnormalities should be routinely performed for early risk stratification of NAFLD.展开更多
基金supported by grants from the National Natural Science Foundation of China(81373160,81272675 and81100321)Innovative research group National Natural Science Foundation of China(81121002)
文摘BACKGROUND: The established procedure for ABO-incompatible liver transplantation(ABO-I LT) was too complicated to be used in case of emergency. We developed a protocol consisting of rituximab and intravenous immunoglobulin(IVIG) for ABO-I LT in patients with acute liver failure(ALF).METHODS: The data from 101 patients who had undergone liver transplantation(LT) for ALF were retrospectively analyzed.The patients were divided into two groups: ABO-compatible liver transplantation group(ABO-C LT, n=66) and ABO-I LT group(n=35). All the patients in the ABO-I LT group received a single dose of rituximab(375 mg/m2) and IVIG(0.4 g/kg per day) at the beginning of the operation. IVIG was administered for 10 consecutive days after LT. Plasma exchange, splenectomy and graft local infusion were omitted in the protocol.Quadruple immunosuppressive therapy including basiliximab,corticosteroids, tacrolimus and mycophenolatemofetil was used to reinforce immunosuppression.RESULTS: The 3-year cumulative patient survival rates in the ABO-I LT and ABO-C LT groups were 83.1% and 86.3%,respectively(P>0.05), and the graft survival rates were 80.0%and 86.3%, respectively(P>0.05). Two patients(5.7%) suffered from antibody-mediated rejection in the ABO-I LT group.Other complications such as acute cellular rejection, biliary complication and infection displayed no significant differences between the two groups.CONCLUSIONS: The simplified treatment consisting of rituximab and IVIG prevented antibody-mediated rejection for LT of blood-type incompatible patients. With this treatment, the patients did not need plasma exchange, splenectomy and graft local infusion. This treatment was safe and efficient for LT of the patients with ALF.
基金supported by grants from Zhejiang Provincial Natural Science Foundation(LQ15H030003 and LY18H030002)the Public Welfare Project of Zhejiang Province(2016C37025)the Fundamental Research Funds for the Central Universities(2017FZA7009)
文摘Background: Previous studies have emphasized the need to reduce tacrolimus(TAC) trough levels in the early post-liver transplantation(LT) period. However, whether late-period TAC trough levels influence the long-term outcomes of liver recipients is not clear.Methods: We enrolled 155 adult liver recipients survived more than 3 years after living donor liver transplantation because of non-malignant liver diseases. The maintenance immunosuppressive regimens were TAC monotherapy and combined therapy with mycophenolate mofetil. Patients were divided into three groups according to their late-period TAC trough levels: < 3 ng/m L group, 3–5 ng/m L group, and>5 ng/m L group. The complications and adverse effects of TAC were analyzed.Results: Each group showed similar rejection, graft loss and mortality. Patients achieved the < 5 ng/m L state in less than 4 years had fewer new-onset diabetes, hyperlipidemia, de novo malignancies, and hepatitis B virus recurrence; the complications of renal dysfunction and hypertension rates were the same among these 3 groups.Conclusions: Collectively, our findings indicated that lower TAC trough levels in the late period of liver transplantation are safe, improve the long-term outcomes.
基金Supported by National Natural Science Foundation of China,No.81421062the Science and Technology Bureau of Zhejiang Province,China,No.2016C33145+1 种基金the National Natural Science Foundation of China,No.81470891the 863 National High Technology Research and Development Program of China for young scientist No.2015AA020923
文摘AIM To investigate the underlying mechanisms of the protective role of remote ischemic perconditioning(RIPerC) in rat liver transplantation. METHODS Sprague-Dawley rats were subjected to sham, orthotopic liver transplantation(OLT), ischemic postconditioning(IPostC) or RIPerC. After 3 h reperfusion, blood samples were taken for measurement of alanine aminotransferase, aspartate aminotransferase, creatinine(Cr) and creatinine kinase-myocardial band(CK-MB). The liver lobes were harvested for the following measurements: reactive oxygen species(ROS), H2O2, mitochondrial membrane potential(ΔΨm) and total nitric oxide(NO). These measurements were determined using an ROS/H2O2, JC1 and Total NOx Assay Kit, respectively. Endothelial NO synthase(e NOS) was analyzed by reverse transcription-polymerase chain reaction(RTPCR) and western blotting, and peroxynitrite was semiquantified by western blotting of 3-nitrotyrosine. RESULTS Compared with the OLT group, the grafts subjected to RIPerC showed significantly improved liver and remote organ functions(P < 0.05). ROS(P < 0.001) including H2O2(P < 0.05) were largely elevated in the OLT group as compared with the sham group, and RIPerC(P < 0.05) reversed this trend. The collapse of ΔΨm induced by OLT ischemia/reperfusion(I/R) injury was significantly attenuated in the RIPerC group(P < 0.001). A marked increase of NO content and phosphoserine eN OS, both in protein and mR NA levels, was observed in liver graft of the RIPer C group as compared with the OLT group(P < 0.05). I/R-induced 3-nitrotyrosine content was significantly reduced in the RIPerC group as compared with the OLT group(P < 0.05). There were no significant differences between the RIPerC and IPostC groups for all the results except Cr. The Cr level was lower in the RIPerC group than in the IPostC group(P < 0.01).CONCLUSION Liver graft protection by RIPerC is similar to or better than that of IPostC, and involves inhibition of oxidative stress and up-regulation of the PI3K/Akt/e NOS/NO pathway.
基金Supported by National Natural Science Foundation of China for Innovative Research Group,No.81121002grants from Scientific Research Project of Education Department of Zhejiang Province,No.Y201223762
文摘AIM:To investigate the significance of pre-transplant neutrophil-lymphocyte ratio(NLR) in determining the prognosis of liver transplant(LT) recipients with acuteon-chronic liver failure(ACLF).METHODS:Data were collected from the liver transplantation data bank.The NLR values and other conventional inflammatory markers were evaluated for their ability to predict the prognosis of 153 patients with ACLF after LT.The NLR cut-off value was based on a receiver operating characteristic curve analysis.A Kaplan-Meier curve analysis and univariate and multivariate Cox regression models were used to define the independent risk factors for poor outcomes.RESULTS:The optimal NLR cut-off value was 4.6.Out of 153 patients,83(54.2%) had an NLR ≥ 4.6.The 1-,3-,and 5-year overall survival rates were 94.3%,92.5% and 92.5%,respectively,in the normal NLR group and 74.7%,71.8% and 69.8%,respectively,in patients with high NLRs(P < 0.001).Furthermore,there was a significant difference in infectious complications after LT between the high and normal NLR groups.There were no significant differences for other complications.In the multivariate Cox regression model,a high NLR was defined as a significant predictor of poor outcomes for LT.CONCLUSION:A high NLR is a convenient and available predictor for prognosis of LT patients and can potentially optimize the current criteria for LT in ACLF.
基金supported by grants from Science and Tech-nology Projects of Medicine and Health in Zhejiang Province(2020383364)Natural Science Foundation of Zhejiang Province(LY21H160055).
文摘Background:Accumulating data have suggested that long non-coding RNAs(lncRNAs)play important roles in regulating tumor cell growth.This study was designed to investigate the role of SNHG16 in hep-atocellular carcinoma(HCC).Methods:SNHG16 expression was detected with real-time polymerase chain reaction(PCR).The cut-offvalue of SNHG16 for tumor-free survival(TFS)was determined with receiver operating characteristic curve analysis.Small interfering RNA was used to inhibit the expression of SNHG16 in HCC cell lines.The biologic behavior of HCC cell was determined with cell viability assay and Transwell assay in vitro.The potential predictive value of SNHG16 on prognosis was analyzed by Kaplan-Meier curves and Cox proportional hazards regression model.Results:SNHG16 expression was upregulated in tumor tissues and HCC cell lines.High expression of SNHG16 was associated with tumor recurrence and poor prognosis after surgery.Multivariate analysis revealed that SNHG16 was an independent prognostic factor for poor recurrence-free survival.Moreover,inhibition of SNHG16 in HepG2,Hep3B,and BEL-7402 cells significantly reduced cell invasiveness and proliferation.Mechanistic analyses indicated that the ECM-receptor interaction pathway was remarkably activated by SNHG16.Conclusions:SNHG16 might be a promising biomarker for predicting tumor recurrence in HCC patients after surgery and a potential therapeutic target for HCC.
基金supported by grants from the National Natural Science Foundation of China(81373160 and 81400673)Zhejiang Provincial Natural Science Foundation of China(LQ15H030003 and LY14H160022)
文摘Anti-virus prophylactic therapy may be not necessary for the prevention of hepatitis B virus(HBV) recurrence after HBV-related liver transplantation(LT).However,studies on completely stopping the hepatitis B immune globulin(HBIG) and nucleos(t)ide analogs(NUC) after LT are few.The aim of the current study was to evaluate the safety of antivirus prophylaxis withdrawal in liver recipients whose serum hepatitis B e antigen(HBe Ag) and HBV DNA are negative.We analyzed 190 patients undergone LT for HBV-related liver disease from 2006 to 2012 and found that 10 patients completely stopped the HBIG and NUC due to poor compliance.These patients were liver biopsied and checked monthly with serum HBV markers,HBV DNA and liver function.Among the 10 patients,9 did not show the signs of HBV recurrence after a mean follow-up of 51.6 months(range 20-73) after withdrawal of the HBIG and NUC.The average time from LT to the withdrawal of the anti-virus drug was 23.8(13-42) months; one patient showed hepatitis B surface antigen-positive and detectable HBV DNA after stopping anti-virus drugs and this patient was successfully treated with entecavir.Our data suggested that complete withdrawal of anti-virus prophylaxis was safe and feasible for patients whose serum HBe Ag and HBV DNA were negative at the time of LT.
基金supported by grants from the Natural Science Foundation of Zhejiang Province(Y17H160118,LY18H030002 and LQ15H030003)the Fundamental Research Funds for the Cen-tral University(2018FZA7002)
文摘Background: Lower mean platelet volume(MPV) is an indicator of platelet activity in the setting of tumor development. This study was to assess the relationship between preoperative MPV and survival outcomes of patients with hepatocellular carcinoma(HCC) following liver transplantation(LT). Methods: The demographic and clinical characteristics of 304 HCC patients following LT were retrieved from an LT database. All the patients were divided into the normal and lower MPV groups according to the median MPV. The factors were first analyzed using a Kaplan–Meier survival analysis, then the factors with P < 0.10 were selected for multivariate Cox regression analysis and were used to define the independent risk factors for poor prognosis. Results: The 1-, 3-, and 5-year tumor free survival was 95.34%, 74.67% and 69.29% in the normal MPV group, respectively, and 95.40%, 59.97% and 42.94% in the lower MPV group, respectively( P < 0.01). No significant difference was observed in post-LT complications between the normal and lower MPV groups. Portal vein tumor thrombosis(PVTT)[hazard ratio(HR = 2.24;95% confidence interval: 1.46–3.43;P < 0.01) and lower MPV(HR = 1.58;95% confidence interval: 1.05–2.36;P = 0.03) were identified as independent prognostic risk factors for recipient survival. Conclusion: Preoperative lower MPV is a risk indicator of HCC patients survival outcomes after LT.
基金supported by grants from National Natural Science Foundation of China(81373160)Major Program of National Natural Science Foundation of China(91542205)Zhejiang Provincial Natural Science Foundation of China(LQ15H030003)
文摘To the Editor:Liver transplantation (LT) is an effective therapeutic method for end-stage liver diseases. Although rejection is commonly mild or moderate in LT compared with other solid organs transplantation, it is still requiring a life-long immunosuppressive therapy. Meanwhile, LT is less sensitive to rejection than other organs transplantation due to liver immune privilege which even allows the success of LT with positive across mismatches of blood group and complete major histocompatibility complex.[1, 2] During the early period of transplantation,clinical operational tolerance (COT) could be achieved on account of the genetic identity between recipient and donor.[3] Over the last decades, there is solid evident supporting that approximately 20% of LT recipients could develop COT, defined as maintaining normal graft function beyond one year completely without administering any immunosuppressive drugs.[4]
基金supported by grants from the Key Research De-velopment Program of Zhejiang Province(2018C03018)Major Science and Technology Projects of Medicine and Health in Zhe-jiang Province(WKJ-ZJ-1923+1 种基金2020383364)National Key R and D Program of China(2017YFCO114102)。
文摘Background:Nonalcoholic fatty liver disease(NAFLD)is closely associated with obesity.However,this association could be influenced by the coexisting metabolic abnormalities.This study aimed to investigate the role of obesity and metabolic abnormalities in NAFLD among elderly Chinese.Methods:A cross-sectional study was performed among elderly residents who took their annual health checkups during 2016 in Keqiao District,Shaoxing,China.Results:A total of 3359 elderly adults were retrospectively included in this study.The overall prevalence of NAFLD was 28.7%.The prevalence of NAFLD were 7.14%,27.92%,34.80%,and 61.02%in participants with metabolically healthy normal weight(MHNW),metabolically abnormal normal weight(MANW),metabolically healthy obese(MHO),and metabolically abnormal obese(MAO),respectively.NAFLD patients in MHO group had more unfavorable metabolic profiles than those in MHNW group.Logistic regression analysis showed that sex,body mass index(BMI),fasting blood glucose,and serum uric acid were the risk factors of NAFLD.Conclusions:Both obesity and metabolic health were significantly associated with NAFLD in elderly Chinese.Screening for obesity and other metabolic abnormalities should be routinely performed for early risk stratification of NAFLD.
