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| 1 | Analyzing predictors of graft survival in patients undergoing liver transplantation with donors aged 70 years and over显示文摘AIM To increase the number of available grafts.METHODS This is a single-center comparative analysis performed between April 1986 and May 2016. Two hundred and twelve liver transplantation(LT) were performed with donors ≥ 70 years old(study group). Then, we selected the first cases that were performed with donors < 70 years old immediately after the ones that were performed with donors ≥ 70 years old(control group).RESULTS Graft and patient survivals were similar between both groups without increasing the risk of complications, especially primary non-function, vascular complications and biliary complications. We identified 5 risk factors as independent predictors of graft survival: recipient hepatitis C virus(HCV)-positivity [hazard ratio(HR) = 2.35; 95% confidence interval(CI): 1.55-3.56; P = 0.00]; recipient age(HR = 1.04; 95%CI: 1.02-1.06; P = 0.00); donor age X model for end-stage liver disease(D-MELD)(HR = 1.00; 95%CI: 1.00-1.00; P = 0.00); donor value of serum glutamic-pyruvic transaminase(HR = 1.00; 95%CI: 1.00-1.00; P = 0.00); and donor value of serum sodium(HR = 0.96; 95%CI: 0.94-0.99; P = 0.00). After combining D-MELD and recipient age we obtained a new scoring system that we called DR-MELD(donor age X recipient age X MELD). Graft survival significantly decreased in patients with a DR-MELD score ≥ 75000, especially in HCV patients(77% vs 63% at 5 years in HCV-negative patients, P = 0.00; and 61% vs 25% at 5 years in HCV-positive patients; P = 0.00). CONCLUSION A DR-MELD ≥ 75000 must be avoided in order to obtain the best results in LT with donors ≥ 70 years old. | Oscar Caso-Maestro Carlos Jiménez-Romero Iago Justo-Alonso Jorge Calvo-Pulido David Lora-Pablos Alberto Marcacuzco-Quinto Félix Cambra-Molero Alvaro García-Sesma Marina Pérez-Flecha Carlos Munoz- Arce Carmelo Loinaz-Segurola Alejandro Manrique-Municio | 2018 | World Journal of Gastroenterology2018，24，47： | 2 |
| 2 | Burden of adult variceUa hospitalizations in Spain (2001 -2007) 显示文摘 | Jose Maria Guillen Ruth Gil- Prieto Alejandro Alvaro | 2010 | Human Vaccines2010，6，8： | 1 |
| 3 | 赫尔辛基古根海姆博物馆显示文摘波罗的海的女儿——赫尔辛基是芬兰最大的港口城市,人口密集,有着地球上极少数城市所特有的活力与创造力,而这创造力,尤其体现在它的建筑和设计上。赫尔辛基一直鼓励和致力于现代化高科技的蓬勃发展。但是,尽管赫尔辛基这个城市现已具备大都会的魅力和高标准的生活条件,但实际上,芬兰整体上仍然处于农业社会, | Peru Caada Xabler Arranz Alejandro Iturbe Julen Quevedo Jon Andonl Iparragulrre Ubay Calle Alvaro Arbina Igor Gonzalez Iigo Salaburu Nagila Ramos Martín García 姜敏华 | 2015 | 现代装饰2015，0，3： | 0 |
| 4 | Post-transplant biliary complications using liver grafts from deceased donors older than 70 years:Retrospective case-control study显示文摘BACKGROUND The shortage of liver grafts and subsequent waitlist mortality led us to expand the donor pool using liver grafts from older donors.AIM To determine the incidence,outcomes,and risk factors for biliary complications(BC)in liver transplantation(LT)using liver grafts from donors aged>70 years.METHODS Between January 1994 and December 31,2019,297 LTs were performed using donors older than 70 years.After excluding 47 LT for several reasons,we divided 250 LTs into two groups,namely post-LT BC(n=21)and without BC(n=229).This retrospective case-control study compared both groups.RESULTS Choledocho-choledochostomy without T-tube was the most frequent technique(76.2%in the BC group vs 92.6%in the non-BC group).Twenty-one patients(8.4%)developed BC(13 anastomotic strictures,7 biliary leakages,and 1 nonanastomotic biliary stricture).Nine patients underwent percutaneous balloon dilation and nine required a Rouxen-Y hepaticojejunostomy because of dilation failure.The incidence of post-LT complications(graft dysfunction,rejection,renal failure,and non-BC reoperations)was similar in both groups.There were no significant differences in the patient and graft survival between the groups.Moreover,only three deaths were attributed to BC.While female donors were protective factors for BC,donor cardiac arrest was a risk factor.CONCLUSION The incidence of BC was relatively low on using liver grafts>70 years.It could be managed in most cases by percutaneous dilation or Roux-en-Y hepaticojejunostomy,without significant differences in the patient or graft survival between the groups. | Carlos Jimenez-Romero Iago Justo-Alonso Pilar del Pozo-Elso Alberto Marcacuzco-Quinto Cristina Martín-Arriscado-Arroba Alejandro Manrique-Municio Jorge Calvo-Pulido Alvaro García-Sesma Ricardo San Román Oscar Caso-Maestro | 2023 | World Journal of Gastrointestinal Surgery2023，15，8： | 0 |
| 5 | Adaptive evolution of chestnut forests to the impact of ink disease in Spain显示文摘Phytophthora cinnamomi(Pc)is an extremely destructive soil-borne pathogen of Asiatic origin responsible for“ink disease”in chestnut.This work assesses the adaptive potential to the impact of Pc of four Spanish populations of Castanea sativa undergoing different selection pressures.To explore the evolvability of C.satiVa to Pc in the selected populations,parameters obtained from neutral and functional genetic diversity were compared with estimates of quantitative genetic variability.Nine expressed sequence tags-simple sequence repeat(EST-SSR)markers were selected and their transferability and polymorphism in 137 C.sativa individuals were evaluated.To test the potential of EST-SSR markers for early selection of Pc tolerant plant material,the offspring of selected individuals were challenged with Pc.Expressed sequence tags-simple sequence repeat markers and seedling life expectancy after Pc inoculation revealed significant different responses of C.sativa populations to Pc.The genetic variability observed within populations showed the potential response capacity of Spanish C.sativa populations to undergo fast adaptive evolution.The heritability value obtained for the “life expectancy”variable(h^2=0.21±0.11)indicated that selection for resistance to Pc is possible.Genetic patterns reflected two evolutionarily meaningful groupings of populations,corresponding to the different selective pressure of the oomycete between sites.The differentiation coefficient obtained through markers classified as under neutral selection(FST=0.185)was lower than the quantitative genetic differentiation of“life expectancy”between C.sativa populations(QST=0.682),providing evidence that selection acted spatially in a heterogeneous manner.A first link has been identified in trees between population structure and adaptive responses to pathogen-induced selection.The study identified one marker under positive selection that could be used in marker assisted selection to predict resistance to Pc in non-inoculated C.sativa trees. | Francisco Alcaide Alejandro Solla Marcello Cherubini Claudia Mattioni Beatriz Cuenca Alvaro Camisón M.Angela Martín | 2020 | Journal of Systematics and Evolution2020，58，4： | 0 |
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