Patient sex in the setting of liver transplant in alcoholic liver disease

© Baskent University 2018. This manuscript version is made available under the CC-BY-NC-ND 4.0 license http://creativecommons.org/licenses/by-nc-nd/4.0/ This document is the Published version of a Published Work that appeared in final form in Experimental and Clinical Transplantation. To access the final edited and published work see https://doi.org/10.6002/ect.2017.0302Objectives: The aim of this study was to analyze alcoholic cirrhosis in women who were to undergo liver transplant, including their biochemical and clinical characteristics, main complications, survival rates, and main causes of death compared with men with alcoholic cirrhosis. Materials and Methods: Our study included 400 patients with alcoholic cirrhosis, which we divided according to sex and viral infections. Biochemical parameters and the presence and degree of ascites and encephalopathy, liver function status, and liver rejection and survivalrates were analyzed from 1 to 10 years and the main cause of death at 10 years. Results: Patients with nonviral alcoholic cirrhosis and liver transplant had significantly better survival rates (84.1%) at 1 year versus those with viral alcoholic cirrhosis (74.5%; P = .036). Men with nonviral alcoholic cirrhosis (14%) and women with hepatitis C virus (29%) had the lowest short-term survival rates. In long-term survival analysis, the lowest rate was observed in women with nonviral alcoholic cirrhosis (26.1%), and the highest rate was observed in women with hepatitis C virus (42.9%). Liver graft failure was one of the main causes of death in male patients (19.5%). Conclusions: Women with alcoholic cirrhosis showed a higher rate of ascites and encephalopathy but lower liver graft rejection than men with alcoholic cirrhosis. Survival rates were similar between men and women, although slightly lowerin women who had hepatitis C virus

The peritoneal macrophage inflammatory profile in cirrhosis depends on the alcoholic or hepatitis C viral etiology and is related to ERK phosphorylation

BACKGROUND: The development of ascites in cirrhotic patients generally heralds a deterioration in their clinical status. A differential gene expression profile between alcohol- and hepatitis C virus (HCV)-related cirrhosis has been described from liver biopsies, especially those associated with innate immune responses. The aim of this work was to identify functional differences in the inflammatory profile of monocyte-derived macrophages from ascites in cirrhotic patients of different etiologies in an attempt to extrapolate studies from liver biopsies to immune cells in ascites. To this end 45 patients with cirrhosis and non-infected ascites, distributed according to disease etiology, HCV (n = 15) or alcohol (n = 30) were studied. Cytokines and the cell content in ascites were assessed by ELISA and flow cytometry, respectively. Cytokines and ERK phosphorylation in peritoneal monocyte-derived macrophages isolated and stimulated in vitro were also determined. RESULTS: A different pattern of leukocyte migration to the peritoneal cavity and differences in the primed status of macrophages in cirrhosis were observed depending on the viral or alcoholic etiology. Whereas no differences in peripheral blood cell subpopulations could be observed, T lymphocyte, monocyte and polymorphonuclear cell populations in ascites were more abundant in the HCV than the alcohol etiology. HCV-related cirrhosis etiology was associated with a decreased inflammatory profile in ascites compared with the alcoholic etiology. Higher levels of IL-10 and lower levels of IL-6 and IL-12 were observed in ascitic fluid from the HCV group. Isolated peritoneal monocyte-derived macrophages maintained their primed status in vitro throughout the 24 h culture period. The level of ERK1/2 phosphorylation was higher in ALC peritoneal macrophages at baseline than in HCV patients, although the addition of LPS induced a greater increase in ERK1/2 phosphorylation in HCV than in ALC patients. CONCLUSIONS: The macrophage inflammatory status is higher in ascites of alcohol-related cirrhotic patients than in HCV-related patients, which could be related with differences in bacterial translocation episodes or regulatory T cell populations. These findings should contribute to identifying potential prognostic and/or therapeutic targets for chronic liver diseases of different etiology

Genetic parameters for Photobacterium damselae subsp. piscicida resistance, immunological markers and body weight in gilthead seabream (Sparus aurata)

A challenge test for Photobacterium damselae subsp. piscicida (Phdp) resistance was carried out in two juvenile populations of gilthead seabream (Sparus aurata L.): F2_ATL and F0_MED. At 250 days post-hatching (dph), a fish plasma sample was collected to measure humoral immune markers (peroxidase activity, bactericidal activity, and IgM immunoglobulin levels), and at 272 dph fish were weighed and inoculated with bacteria Phdp. From that time onwards, surviving fish were recorded for nine days, and days to death was registered. Heritabilities for body weight and Phdp survival were moderate, although for days to death the heritability was low. Regarding humoral immune markers, for peroxidase activity it was moderate, and for IgM levels and for bactericidal activity it was low. Genetic correlations for body weight with Phdp survival and days to death were high and positive, while with peroxidase activity and IgM levels they tended to be positive, although these estimates were not accurate. Regarding genetic correlations between Phdp survival and humoral immune markers, they were very high, positive with peroxidase activity, and negative with IgM levels and bactericidal activity. Some humoral immune markers, particularly peroxidase activity, along with performance traits such as body weight and absence of deformities, are proposed to be included in a selective breeding program to raise fish that are capable of coping with diseasesThis project has received funding from the European Maritime and Fisheries Fund (EMFF) through the PROGENSA III project (Mejora de la Competitividad del Sector de la Dorada a Través de la Selección Genética, JACUMAR program), This study was also funded by Fondo Europeo Marítimo y de Pesca (FEMP) code PR.FEM.PPA201700.14. R.P. was supported by Universidad Politécnica de Cartagena Research Grant; A.V. was funded by a research scholarship fellow (Mejora de la Competitividad del Sector de la Dorada a Través de la Selección Genética, specialization scholarship); AV. was funded by a pre-doctoral research fellow (20,716/FPI/18. Fundación Séneca. Cofinanciado por grupo Andromeda. Región de Murcia (Spain)). Thanks to Javier Lopez Ales and M.A. Castaño Remeseiro for laboratory assistance

Mapping and Assessment of forest Ecosystem and Their Services. Applications and guidance for decision making in the framework of MAES

The aim of this report is to illustrate by means of a series of case studies the implementation of mapping and assessment of forest ecosystem services in different contexts and geographical levels. Methodological aspects, data issues, approaches, limitations, gaps and further steps for improvement are analysed for providing good practices and decision making guidance. The EU initiative on Mapping and Assessment of Ecosystems and their Services (MAES), with the support of all Member States, contributes to improve the knowledge on ecosytem services. MAES is one of the building-block initiatives supporting the EU Biodiversity Strategy to 2000

Mapping and assessment of forest ecosystems and their services - Applications and guidance for decision making in the framework of MAES

The aim of this report is to illustrate by means of a series of case studies the implementation of mapping and assessment of forest ecosystem services in different contexts and geographical levels. Methodological aspects, data issues, approaches, limitations, gaps and further steps for improvement are analysed for providing good practices and decision making guidance. The EU initiative on Mapping and Assessment of the state of Ecosystems and their Services (MAES), with the support of all Member States, contributes to improve the knowledge on ecosystem services. MAES is one of the building-block initiatives supporting the EU Biodiversity Strategy to 2020.JRC.H.3-Forest Resources and Climat

Multidisciplinary Assessment of Nature-Based Strategies to Address Groundwater Overexploitation and Drought Risk in Medina Del Campo Groundwater Body

[EN] Five decades of intensive groundwater exploitation have brought important economic, social and environmental changes in Medina del Campo Groundwater Body (MCGWB). Declining piezometric levels have worsened water quality, increased the costs of water supply and abstraction, and drained connected wetlands and rivers. This chapter presents the different methods and tools developed to assess the impacts and effectiveness for adaptation to droughts of the selected NAS strategies in biophysical, economic and social terms. It follows the methodologies presented in Chaps. 4, 5 and 6. It also summarizes the approaches for integrating all these assessments, as well as the main conclusions and lessons learnt. Important progress has been achieved on understanding and modelling the aquifer-system dynamics and functioning. First, geological and geophysical data analysis, debugging and integration have provided a basis for constructing a set of geological models of the MCGWB. Second, water balance components need to be updated through a deeper analysis of the recharge and groundwater abstractions (pumping). Third, a trend analysis of critical groundwater-related ecosystem services (GRES) and piezometric levels points at groundwater abstraction reductions as the most effective measure for a widespread recovery of the groundwater levels and storage. Fifth, the proposed managed artificial recharge would have limited effects on the recovery of the surface water bodies and no effect on the groundwater bodies. Sixth, the environmental reconstruction from a sedimentary record of the main wetland bed (Lagunas Reales) provides a reference knowledge base to understand the system response to human and climate changes. Finally, different barriers for design and implementation of NAS strategies have been identified and evaluated. Particularly, the lack of effective interaction mechanisms among the different actors involved/interested in the process could play a key role in the future.Peer reviewe

Experiencia del hospital "Virgen de la Arrixaca" en transplante ortotópico de hígado en adultos / Manuel Miras López ; directores Pascual Parrilla Paricio, Pablo Ramírez Romero.

Tesis-Universidad de Murcia.MEDICINA ESPINARDO. DEPOSITO. MU-Tesis 264.Consulte la tesis en: BCA. GENERAL. ARCHIVO UNIVERSITARIO. T.M.-780

Killer Cell Immunoglobulin-like Receptors (KIR) and Human Leucocyte Antigen C (HLA-C) Increase the Risk of Long-Term Chronic Liver Graft Rejection

Chronic liver rejection (CR) represents a complex clinical situation because many patients do not respond to increased immunosuppression. Killer cell immunoglobulin-like receptors/Class I Human Leukocyte Antigens (KIR/HLA-I) interactions allow for predicting Natural Killer (NK) cell alloreactivity and influence the acute rejection of liver allograft. However, its meaning in CR liver graft remains controversial. KIR and HLA genotypes were studied in 513 liver transplants using sequence-specific oligonucleotides (PCR-SSO) methods. KIRs, human leucocyte antigen C (HLA-C) genotypes, KIR gene mismatches, and the KIR/HLA-ligand were analyzed and compared in overall transplants with CR (n = 35) and no-chronic rejection (NCR = 478). Activating KIR (aKIR) genes in recipients (rKIR2DS2+ and rKIR2DS3+) increased CR compared with NCR groups (p = 0.013 and p = 0.038). The inhibitory KIR (iKIR) genes in recipients rKIR2DL2+ significantly increased the CR rate compared with their absence (9.1% vs. 3.7%, p = 0.020). KIR2DL3 significantly increases CR (13.1% vs. 5.2%; p = 0.008). There was no influence on NCR. CR was observed in HLA-I mismatches (MM). The absence of donor (d) HLA-C2 ligand (dC2−) ligand increases CR concerning their presence (13.1% vs. 5.6%; p = 0.018). A significant increase of CR was observed in rKIR2DL3+/dC1− (p = 0.015), rKIR2DS4/dC1− (p = 0.014) and rKIR2DL3+/rKIR2DS4+/dC1− (p = 0.006). Long-term patient survival was significantly lower in rKIR2DS1+rKIR2DS4+/dC1− at 5–10 years post-transplant. This study shows the influence of rKIR/dHLA-C combinations and aKIR gene-gene mismatches in increasing CR and KIR2DS1+/C1-ligands and the influence of KIR2DS4+/C1-ligands in long-term graft survival