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Studies investigating the impact of donor cytomegalovirus (CMV) positivity on the prognosis of liver transplantation (LT) recipients with HCC are currently lacking. A total of 21 759 eligible LT recipients were identified in the UNOS database between January 2002 and June 2023. The patients were divided into the donor CMV-seronegative (n = 7575) and CMV-seropositive (n = 14 814) groups. Moreover, the subgroup analyses by recipient age and gender were conducted. All patients were also divided into 18-40 (n = 271), 40-60 (n = 9538), and ≥ 60 (n = 11 950) groups, male (n = 16 954) and female (n = 4805) groups, respectively. Patients in the donor CMV-seropositive group had shorter overall survival (OS) and disease-free survival (DFS) compared to those in the donor CMV-seronegative group (both p < 0.001). Donor CMV seropositivity was proved to be a risk factor for OS and DFS (both p = 0.001). Patients receiving CMV-seropositive liver grafts had shorter OS and DFS in the 40-60 and ≥ 60 groups (all p < 0.05). Patients receiving CMV-seropositive liver grafts had shorted OS and DFS only in the male group (both p < 0.001). The receipt of donor CMV-seropositive liver grafts is associated with shorter survival and a higher risk of HCC recurrence in LT recipients with HCC. These adverse effects are influenced by recipient age and gender., (© 2025 Wiley Periodicals LLC.)

Background: Impact of preoperative infection on liver transplantation (LT) needs further investigation., Materials and Methods: From 1 January 2015 to 31 December 2022, 24 122 eligible patients receiving LT were enrolled from the China Liver Transplant Registry database. The outcomes of LT were compared after using the propensity score-matched analysis., Results: Compared to the noninfection group, patients in the infection group were more likely to have postoperative effusion, infection, abdominal bleeding, and biliary complications (all P <0.01), and they had shorter 30-day, 90-day survival, and overall survival (all P <0.01). Cox proportional hazards regression analysis revealed that MELD score and cold ischemia time were risk factors for the overall survival in the infection group (both P <0.05). Besides, compared to the nonpulmonary group, patients in the pulmonary group were more likely to have postoperative effusion and infection (both P <0.0001), and less likely to have postoperative abscess and early allograft dysfunction (both P <0.05). Patients in the nonabdominal group also had a higher proportion of postoperative infection than those in the abdominal group ( P <0.05). Furthermore, compared to the number=1 group, patients in the number ≥2 group were more prone to postoperative effusion and infection (both P <0.01), and they also had shorter 30-day and 90-day survival (both P <0.05)., Conclusion: Preoperative infection can result in a higher incidence of early postoperative complications and shorter survival in liver transplant recipients. The types and number of infection sites will also influence the prognosis of liver transplant recipients., (Copyright © 2024 The Author(s). Published by Wolters Kluwer Health, Inc.)

Recurrence of hepatocellular carcinoma (HCC) after liver transplantation (LT) is a marker of poor prognosis. However, the reliable biomarkers of post-LT HCC recurrence remain to be identified. In this study, serial peripheral blood samples from the LT recipients with and without HCC recurrence were collected at five time points. Single-cell mass cytomertry (CyTOF) was utilized for the in-depth analysis of peripheral blood monocellular cells (PBMCs). CyTOF analysis showed that at 3 weeks post-LT, the activated immune cell population was increased, while the fraction of immune cells with suppressive functions (myeloid-derived suppressive cells) was reduced. The post-LT immune composition in patients with LT for HCC was enormously different from that in patients with LT for causes other than HCC. Furthermore, at 3 weeks after LT, compared with patients without recurrence, the patients with HCC recurrences were high in two subsets of T cells: CD57 + HLA-DR + CD8 + and CD28 + γδ. The CD57 + HLA-DR + CD8 + T cells presented high levels of perforin, granzyme B, and Ki-67 and displayed a highly cytotoxic and proliferative phenotype, while the CD28 + γδ T cells had reduced levels of IFN-γ and, hence, were less activated compared to CD28 - cells. Based on these findings, we concluded that analyzing the PBMCs of LT recipients by CyTOF can predict the post-LT HCC recurrence. The distinct immune features can stratify patients with the risk of HCC recurrence at 3 weeks after LT, which will help clinician in further management plan and improve the prognosis of patients., Competing Interests: None., (AJCR Copyright © 2022.)