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BackgroundTechnical capabilities for performing liver transplantation have developed rapidly; however, the lack of available livers has prompted the utilization of edge donor grafts, including those donated after circulatory death, older donors, and hepatic steatosis, thereby rendering it difficult to define optimal clinical outcomes. ObjectiveWe aimed to investigate the efficacy of telemedicine for follow-up management after liver transplantation. MethodsTo determine the efficacy of telemedicine for follow-up after liver transplantation, we performed a clinical observation cohort study to evaluate the rate of recovery, readmission rate within 30 days after discharge, mortality, and morbidity. Patients (n=110) who underwent liver transplantation (with livers from organ donation after citizen's death) were randomly assigned to receive either telemedicine-based follow-up management for 2 weeks in addition to the usual care or usual care follow-up only. Patients in the telemedicine group were given a robot free-of-charge for 2 weeks of follow-up. Using the robot, patients interacted daily, for approximately 20 minutes, with transplant specialists who assessed respiratory rate, electrocardiogram, blood pressure, oxygen saturation, and blood glucose level; asked patients about immunosuppressant medication use, diet, sleep, gastrointestinal function, exercise, and T-tube drainage; and recommended rehabilitation exercises. ResultsNo differences were detected between patients in the telemedicine group (n=52) and those in the usual care group (n=50) regarding age (P=.17), the model for end-stage liver disease score (MELD, P=.14), operation time (P=.51), blood loss (P=.07), and transfusion volume (P=.13). The length and expenses of the initial hospitalization (P=.03 and P=.049) were lower in the telemedicine group than they were in the usual care follow-up group. The number of patients with MELD score ≥30 before liver transplantation was greater in the usual care follow-up group than that in the telemedicine group. Furthermore, the readmission rate within 30 days after discharge was markedly lower in the telemedicine group than in the usual care follow-up group (P=.02). The postoperative survival rates at 12 months in the telemedicine group and the usual care follow-up group were 94.2% and 90.0% (P=.65), respectively. Warning signs of complications were detected early and treated in time in the telemedicine group. Furthermore, no significant difference was detected in the long-term visit cumulative survival rate between the two groups (P=.50). ConclusionsRapid recovery and markedly lower readmission rates within 30 days after discharge were evident for telemedicine follow-up management of patients post–liver transplantation, which might be due to high-efficiency in perioperative and follow-up management. Moreover, telemedicine follow-up management promotes the self-management and medication adherence, which improves patients’ health-related quality of life and facilitates achieving optimal clinical outcomes in post–liver transplantation.

Lung cancer is one of the most common malignancies worldwide, with non-small cell lung cancer (NSCLC) being the most common type. As understanding of precise treatment options for NSCLC deepens, circulating tumor DNA (ctDNA) has emerged as a potential biomarker that has become a research hotspot and may represent a new approach for the individualized diagnosis and treatment of NSCLC. This article reviews the applications of ctDNA for the early screening of patients with NSCLC, guiding targeted therapy and immunotherapy, evaluating chemotherapy and postoperative efficacy, assessing prognosis and monitoring recurrence. With the in-depth study of the pathogenesis of NSCLC, plasma ctDNA may become an indispensable part of the precise treatment of NSCLC, which has great clinical application prospects. Article highlights Background Non-small cell lung cancer (NSCLC) has a high morbidity and mortality in the world today. There is a lack of effective means for clinical diagnosis and monitoring of NSCLC recurrence. Circulating tumor DNA (ctDNA) is a hot research direction in the precise treatment of NSCLC. Biological characteristics of circulating tumor DNA Biological characteristics of cell-free circulating DNA. Biological characteristics and genetic information sources of ctDNA. Detecting ctDNA The traditional method of ctDNA detection. The current ctDNA detection method. The advantages and disadvantages of current ctDNA detection methods. Clinical use of ctDNA detection for the diagnosis & treatment of NSCLC Early screening and diagnosis of lung cancer ctDNA detection is helpful to improve the detection rate of clinical lung cancer. ctDNA methylation was combined with imaging examination. Guiding immunotherapy and targeted therapy in patients with NSCLC ctDNA detection was used to evaluate the effect of immunotherapy in patients with NSCLC. ctDNA detection was used to evaluate the effect of targeted therapy in NSCLC patients. Evaluation of chemotherapy efficacy The advantage of ctDNA in evaluating chemotherapy in NSCLC patients. ctDNA monitoring can evaluate the sensitivity of NSCLC patients to chemotherapy. Evaluation of postoperative efficacy Postoperative ctDNA detection can evaluate the efficacy of surgery. Postoperative ctDNA monitoring can predict the risk of recurrence of NSCLC. Assessing prognosis and monitoring recurrence Expert consensus on minimal residual disease. ctDNA monitoring can evaluate the prognosis and recurrence of lung cancer after treatment. Discussion The advantages of ctDNA as a new tumor marker for NSCLC. Limitations of ctDNA detection technology. Challenges and opportunities for clinical application of ctDNA. [ABSTRACT FROM AUTHOR]