Tumors after Liver Transplantation

Sve dulje preživljenje nakon transplantacije jetre povezano je s porastom kasnih komplikacija. Najčešći uzrok mortaliteta godinama nakon transplantacije jetre su de novo maligne bolesti i recidivi malignih bolesti. Najčešće de novo maligne bolesti nakon transplantacije jetre su maligni tumori kože, posttransplantacijska limfoproliferativna bolest, maligni tumori pluća i maligni tumori gastrointestinalnog sustava. Kako bismo prevenirali i u ranom stadiju dijagnosticirali malignu bolest kod pacijenta kojem je transplantirana jetra, potrebno je educirati pacijenta, provoditi redovite kontrolne preglede te odabrati imunosupresivnu terapiju prilagođenu pacijentu. U slučaju dijagnosticirane maligne bolesti kod pacijenta s transplantiranom jetrom potrebno je provoditi odgovarajuće liječenje čime značajno utječemo na produljenje preživljenja i poboljšanje kvalitete života pacijenata nakon transplantacije jetre.More prolonged survival after liver transplantation is associated with an increase in late complications after liver transplantation. The most common causes of death years after liver transplantation are de novo malignant diseases and recurrences of malignant diseases. The most common de novo malignant diseases after liver transplantation are malignant skin tumors, post-transplantation lymphoproliferative disease, lung tumors, and gastrointestinal tumors. In order to prevent and diagnose malignant disease in liver transplant patients at an early stage, it is necessary to educate patients, carry out regular check-ups, reduce immunosuppressive therapy, and adapt it to the patient. In the case of a diagnosed de novo malignant disease in liver transplant patients at an early stage, it is necessary to educate patients, carry out regular check-ups, reduce immunosuppressive therapy, and adapt it to a patient. In the case of a diagnosed de novo malignant disease in patients after liver transplant, it is necessary to carry out adequate treatment. In this way, we can prolong patients’ survival after liver transplantation and improve their quality of life

NOTCH3 rs1043996 Polymorphism Is Associated with the Occurrence of Alcoholic Liver Cirrhosis Independently of PNPLA3 and TM6SF2 Polymorphisms

Alcoholic liver cirrhosis (ALC) is the most common indication for liver transplantation (LT) in Croatia and presents a risk factor for the development of hepatocellular carcinoma (HCC). However, genetic susceptibility has not yet been systematically studied. We aimed to investigate the contribution of the risk polymorphisms PNPLA3 rs738409, EGF rs4444903, TM6SF2 rs58542926, MTHFR rs1801133, previously identified in other populations and, additionally, the contribution of Notch-related polymorphisms (NOTCH1 rs3124591, NOTCH3 rs1043996 and rs1044116, NOTCH4 rs422951). The study included 401 patients. The ALC group consisted of 260 LT candidates, 128 of whom had histopathologically confirmed HCC, and 132 of whom were without HCC. The control group included 141 patients without liver disease. Genotyping was performed by PCR using Taqman assays. The patients’ susceptibility to ALC was significantly associated with PNPLA3 rs738409, TM6SF2 rs58542926, and NOTCH3 rs1043996 polymorphisms. These polymorphisms remained significantly associated with ALC occurrence in a logistic regression model, even after additional model adjustment for sex and age. Cirrhotic patients with the PNPLA3 GG genotype demonstrated higher activity of ALT aminotransferases than patients with CC or CG genotypes. The susceptibility to the development of HCC in ALC was significantly associated with PNPLA3 rs738409 and EGF rs4444903 polymorphisms, and logistic regression confirmed these polymorphisms as independent predictors

Parvovirus B19 status in liver, kidney and pancreas transplant candidates: A single center experience

Background: Parvovirus B19 (B19V) is associated with a wide range of clinical manifestations. The major presentation is erythema infectiosum. However, a persistent infection may cause pure red cell aplasia and chronic anemia in immunocompromized patients. The B19V seroprevalence varies with age and geographical location. Aim: To determine the B19V serological status and DNAemia in kidney, liver, and pancreas transplant candidates. Methods: Patients who underwent kidney, liver, or simultaneous kidney and pancreas/liver transplantation between January 2021 and May 2022 were included in the study. The serum samples were collected before transplantation. For detection of B19V DNA, a LightMix Kit B19V EC (TIB MOLBIOL, Berlin, Germany) was used. B19V IgM and IgG antibodies were detected using a commercial ELISA test (Euroimmun, Lübeck, Germany). Results: One hundred and thirty-one transplant candidates were included in the study, 71.0% male, with an average age of 53.27 years ± 12.71 years. There were 68.7% liver, 27.5% kidney, 3.0% simul taneous pancreas/kidney transplant (SPKT), and 0.8% simultaneous liver/kidney transplant recipients. No patients had detectable B19V DNA. B19V IgG seroprevalence was 77.1%. No acute or recent infections were detected (IgM antibodies). There was no difference in the mean age of seronegative and seropositive patients (51.8 years ± 12.9 years vs 53.7 years ± 12.7 years, t = -0.603; P = 0.548). Although seropositivity was lower in patients aged less than 30 years (66.6%) compared to the patients aged 30-59 years and > 60 years (80.4% and 78.1%, respectively), this difference was not significant. In addition, there was no difference in seropositivity between male and female transplant candidates, 76.3% and 78.9% (χ 2 = 0.104; P = 0.748). The seroprevalence did not differ among organ recipients, with 77.8%, 80.6%, and 50.0% for liver, kidney, and SPKT, respectively, (χ 2 = 5.297; P = 0.151). No significant difference was found in the seroprevalence in kidney transplant patients according to dialysis modality. Seroprevalence was 71.1% in hemodialysis patients, and 100% in peritoneal dialysis patients (χ 2 = 0.799; P = 0.372). Conclusion: The B19V seroprevalence is expectedly high among kidney, liver, and pancreas transplant candidates, but there are still 22.9% of seronegative individuals who remain at risk for primary disease and severe manifestations. Further research should elucidate the necessity of B19V screening in peri-transplant management