Objective To investigate the immunoregulatory effects of immunonutrient ω-3 polyunsaturated fatty acid (PUFA) and its applications in organ transplantation. Methods Relevant literatures of recent years were reviewed. Results The immunoregulatory effects of ω-3 PUFA can inhibit proliferation and activation of the immunocompetent cells including T cell and B cell, reduce cytokine production, modulate immunologic response, improve graft function, pro-long survival, reduce episodes of rejection, and lessen adverse reactions of immunosuppressor.Conclusion ω-3 PUFA should have wide applications in organ transplantation due to its immunoregulatory effects. However, this research should be further studied.
Objective To summarize the role of costimulatory molecules in inducing immune tolerance of organ transplantation. Methods Domestic and international publications online involving costimulatory molecules and immune tolerance in recent years were collected and reviewed. Results The relationship between costimulatory pathways and transplantation immunity has already been clarified in recent years. The main costimulatory molecules alreadly found mainly include B7-CD28/CTLA4, CD40-CD154, 4-1BB/4-1BBL, and ICOS-B7h, etc. Costimulatory pathways com-inhibition or combining with other immunosuppression methods could obtain stable and long lasting immune tolerance. Conclusions With the development of immunology and molecular biology, costimulatory pathways of T lymphocyte activation will be further interpreted. Other new costimulatory molecules will be discovered in the future, which will afford theory evidence for inducing immune tolerance.
Objective To review the research progress of Toll-like receptors （TLRs） signaling and its effects in organ transplantation. Methods The structural and functional features of TLRs and their ligands were summarized，the literatures in recent years about the research progress of TLRs signaling in animal experiment and clinical organ transplantation were reviewed. Results TRLs played an important role in the organ transplantation，the activation of TLRs could activate the specific immune system，and contribute to ischemic reperfusion injury，acute and chronic allograft rejections，and induce the immune tolerance. Early treatment intervention could reduce the activation of TRLs through ischemic reperfusion injury in the organ transplantation，and improve the allograft survival. The efficient immunosuppressive drugs which aimed at the related immunosuppressive target in immune and its signal transduction pathway could reduce ischemic reperfusion injury in the organ transplantation and immune rejection. Conclusions TRLs signaling plays an important role in ischemic reperfusion injury，immune rejection，and immune regulation.
ObjectiveIn order to provide a data base for fund project applicants and funding priorities, we would summarize the basic situation and key points of basic research in liver transplantation by analyzing the projects funded by the Natural Science Foundation of China (NSFC) in the field of liver transplantation.MethodsThrough the big data knowledge management and service platform of NSFC, internet-based science information system, and shared service network of NSFC, we searched the funding project information in the liver transplantation relevant field from 2010 to 2019, then analyzed the effectiveness of the Young Scientists Fund of NSFC in promoting young researchers and the research focus and development direction of funding projects.ResultsIn the latest 10 years, NSFC persistently and stably funded the basic research in the field of liver transplantation, with the total number of funding projects was 387, and the funding budget was 198.215 million yuan. The main types of funding projects were the General Program and the Youth Science Fund. There were 210 General Program project (54.3%) with an amount of 113.14 million yuan (57.1%), 127 Young Scientists Fund (32.8%) with an amount of 27.9 million yuan (14.1%), and 22 Fund for Less Developed Regions (5.7%) with an amount of 9.03 million yuan (4.6%). Sun Yat-sen University and Zhejiang University were far ahead of other supporting institutions in both the total number of projects undertaken and the amount of funds granted. The youth/surface ratio reached as high as 72.2% (13/18). The conversion rate of Young Scientists Fund to higher-level projects reached about 50%, which was significantly higher than the overall level of 24.7% (21/85) in the field of liver transplantation. The funding projects were mainly distributed in application code H0318 (liver regeneration, liver protection, liver failure, and artificial liver, 58, 15.0%), H0321 (organ transplantation of digestive system, 169, 43.7%), and H1006 (organ transplantation and transplantation immunity, 50, 12.9%). The main research fields were transplantation immunity and liver injury and liver protection. At the same time, projects such as graft function and complications of liver transplantation were also funded. There were few studies on the immune status of long-term survival in patients after liver transplantation and the mechanism on prevention of immunosuppressant-related diseases.ConclusionsThe NSFC has a great leading effect on the discipline development and talent cultivation of liver transplantation. However, there are still some problems in the discipline layout, such as the lack of attention to the mechanism of long-term graft function and chronic immune rejection.
Objective We aimed to investigate the attitude and suggestion from doctors, pharmacists and civil servants concerning brain death and organ transplantation and the legislation. Methods A questionnaire with 10 sections and 44 questions was designed and distributed. The effective questionnaire data was then recorded and checked for descriptive analysis. Results In 1 400 questionnaires distributed, 1 063 were responded and 969 of them were valid and analyzed. The respondents showed an incomplete understanding of brain death and organ transplantation laws. Seventy-four percent of the respondents recognized and accepted the standard of brain death. They agreed that legislation should be involved in the removal of organs for transplantation, the future use of the organs, and insurance and compensation for the donor for possible health risks induced by organ removal. Of the 969 respondents, 92% considered it necessary to have legislation in brain death and organ transplantation, and 61% thought that it is time to legislate. Conclusion Legislation for brain death and organ transplantation is urgent and timely in China. The laws must include the respective rights and obligations of patients, close relatives, and medical institutions. Educating the public about brain death and organ transplantation should also be encouraged in a variety of ways.
Objective To summarize the application and progress of common autologous organ transplantation (AOT) techniques. Method A literature review and summary of previous and recent studies on common AOT was performed, including autologous liver transplantation, autologous kidney transplantation and intestinal autotransplantation techniques. Results AOT solved the issues of bleeding that cannot be controlled by in vivo resection of lesions, difficulties in vascular reconstruction, and the inability to radically resect lesions, and extended the indications for treatment of partially diseased conditions. Conclusions The AOT technique has an ameliorating effect on the tight donor situation in China, providing more potential donors. And the application of the AOT technique effectively avoids the usage of postoperative immunosuppressive drugs and the progression of lesions due to waiting for allogeneic organ transplantation. However, the clinical benefit in malignant tumors remains to be further investigated.
ObjectiveTo systematically review the efficacy and safety of direct oral anticoagulants (DOACs) compared with vitamin K antagonists (VKA) in solid organ transplant (SOT) recipients. MethodsThe PubMed, Embase, Web of Science, Cochrane Library, CNKI, WanFang Data, CBM and VIP databases were electronically searched to collect clinical studies on DOACs (rivaroxaban, apixaban, idoxaban, dabigatran) compared with VKA in SOT recipients from inception to May 15, 2024. Two reviewers independently screened literature, extracted data and assessed the risk of bias of the included studies. Meta-analysis was then performed by using RevMan 5.3 software. ResultsA total of 11 cohort studies involving 1 408 SOT recipients were included. The meta-analysis results showed that compared with VKA, DOACs could reduce the risk of any bleeding (RR=0.47, 95%CI 0.37 to 0.60, P<0.05) and major bleeding (RR=0.56, 95%CI 0.37 to 0.84, P<0.05) in SOT recipients. But there were no statistically significant differences in the total incidence of thrombotic events, VTE incidence, and stroke incidence between the two groups. ConclusionCurrent evidence shows that DOACs are not inferior to VKA in anticoagulation therapy for SOT recipients, but they perform better in terms of any bleeding and major bleeding. Due to the limited quality and quantity of the included studies, more high quality studies are needed to verify the above conclusion.
