Liver transplantation

Purpose of review: Long-term survival of liver transplant recipients is threatened by increased rates of de-novo malignancy and recurrence of hepatocellular carcinoma (HCC), both events tightly related to immunosuppression. Recent findings: There is accumulating evidence linking increased exposure to immunosuppressants and carcinogenesis, particularly concerning calcineurin inhibitors (CNIs), azathioprine and antilymphocyte agents. A recent study including 219 HCC transplanted patients showed that HCC recurrence rates were halved if a minimization of CNIs was applied within the first month after liver transplant. With mammalian target of rapamycin (mTOR) inhibitors as approved immunosuppressants for liver transplant patients, pooled data from several retrospective studies have suggested their possible benefit for reducing HCC recurrence. Summary: Randomized controlled trials with sufficiently long follow-up are needed to evaluate the influence of different immunosuppression protocols in preventing malignancy after LT. Currently, early minimization of CNIs with or without mTOR inhibitors or mycophenolate seems a rational strategy for patients with risk factors for de-novo malignancy or recurrence of HCC after liver transplant. A deeper understanding of the immunological pathways of rejection and cancer would allow for designing more specific and safer drugs, and thus to prevent cancer after liver transplant

Inclusion of [H3PW12O40] and [H4SiW12O40] into a silica gel matrix via "sol-gel" methodology

Indexación: Web of Science; Scopus.Here we report the inclusion of two Keggin Polyoxometalates (POMs), [H3PW12O40] and [H4SiW12O40], into silica gels by integrating them during the preparation of the SiO2 matrix via "sol-gel" methods. Aerogels were produced by supercritical drying of the wet gels impregnated with the POMs, and lyogels were obtained by means of a lyophilization process. These materials were characterized by scanning electron microscopy (SEM), transmission electron microscopy (TEM), Fourier transformed infrared (FT-IR) spectroscopy and thermoanalytical techniques (TGA-DSC). We found that a large fraction of POMs are lost during the aging time, and solvent exchange for lyophilization. However the thermal stability of the bare matrix is modified by the inclusion of POMs. Some aggregates with a high content of POMs were found via SEM-EDX.http://ref.scielo.org/3fg9t