Metabolic Diseases

代谢性疾病
  • 文章类型: Journal Article
    越来越多的动物研究表明,环境空气污染(AP)与代谢功能障碍相关的脂肪肝(MAFLD)之间存在关联。但相关流行病学证据有限。我们评估了中国西北地区长期接触AP与MAFLD事件风险的相关性。基线和随访之间的平均AP浓度用于评估个体暴露水平。使用Cox比例风险模型和有限的三次样条函数(RCS)来估计PM2.5及其成分与MAFLD风险和剂量反应关系的关联。分位数g计算用于评估混合暴露于空气污染物对MAFLD的联合影响以及各种污染物的重量。我们观察到1516例新发MAFLD,发病率为10.89%。暴露于污染物的增加与MAFLD的几率增加显著相关,风险比(HR)为2.93(95%CI:1.22,7.00),2.86(1.44,5.66),7.55(3.39,16.84),4.83(1.89,12.38),3.35(1.35,8.34),PM2.5、SO42-、NO3-,NH4+,OM,BC,分别。分层分析表明,女性,经常锻炼者和从不饮酒的人更容易受到与环境PM2.5及其成分相关的MAFLD的影响。混合暴露于SO42-,NO3-,NH4+,OM和BC与MAFLD风险增加相关,BC的体重对MAFLD的影响最强。暴露于环境PM2.5及其成分会增加MAFLD的风险。
    Accumulating animal studies have demonstrated associations between ambient air pollution (AP) and metabolic dysfunction-associated fatty liver disease (MAFLD), but relevant epidemiological evidence is limited. We evaluated the association of long-term exposure to AP with the risk of incident MAFLD in Northwest China. The average AP concentration between baseline and follow-up was used to assess individual exposure levels. Cox proportional hazard models and restricted cubic spline functions (RCS) were used to estimate the association of PM2.5 and its constituents with the risk of MAFLD and the dose-response relationship. Quantile g-computation was used to assess the joint effects of mixed exposure to air pollutants on MAFLD and the weights of the various pollutants. We observed 1516 cases of new-onset MAFLD, with an incidence of 10.89%. Increased exposure to pollutants was significantly associated with increased odds of MAFLD, with hazard ratios (HRs) of 2.93 (95% CI: 1.22, 7.00), 2.86 (1.44, 5.66), 7.55 (3.39, 16.84), 4.83 (1.89, 12.38), 3.35 (1.35, 8.34), 1.89 (1.02, 1.62) for each interquartile range increase in PM2.5, SO42-, NO3-, NH4+, OM, and BC, respectively. Stratified analyses suggested that females, frequent exercisers and never-drinkers were more susceptible to MAFLD associated with ambient PM2.5 and its constituents. Mixed exposure to SO42-, NO3-, NH4+, OM and BC was associated with an increased risk of MAFLD, and the weight of BC had the strongest effect on MAFLD. Exposure to ambient PM2.5 and its constituents increased the risk of MAFLD.
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  • 文章类型: Journal Article
    大量证据表明,血管加压素(AVP)和类固醇激素经常一起分泌,并在调节血压方面密切合作,新陈代谢,水-电解质平衡,和行为,从而确保生存和生活的舒适。血管加压素通过调节促肾上腺皮质激素释放激素(CRH)的释放与下丘脑-垂体-肾上腺轴(HPA)的激素在多个水平上合作,促肾上腺皮质激素(ACTH),和多种类固醇激素,以及通过与目标器官中的类固醇相互作用。这些相互作用由HPA的特定组分之间的正反馈和负反馈促进。总之,AVP和HPA作为一个协调的功能AVP-HPA系统密切合作。研究表明,AVP和类固醇激素之间的合作可能受到细胞应激和缺氧的影响,通过新陈代谢,心血管,和呼吸系统疾病;神经性应激;和炎症。越来越多的证据表明,在心血管和代谢疾病中,AVP和类固醇激素之间的中枢和外周相互作用被重新编程,并且这些重排产生有益或有害的影响。本综述强调了AVP和类固醇之间在细胞和系统水平上相互作用的具体机制,并分析了AVP-HPA系统的各种组件的不适当合作对心血管和代谢疾病的发病机理的后果。
    A large body of evidence indicates that vasopressin (AVP) and steroid hormones are frequently secreted together and closely cooperate in the regulation of blood pressure, metabolism, water-electrolyte balance, and behavior, thereby securing survival and the comfort of life. Vasopressin cooperates with hormones of the hypothalamo-pituitary-adrenal axis (HPA) at several levels through regulation of the release of corticotropin-releasing hormone (CRH), adrenocorticotropic hormone (ACTH), and multiple steroid hormones, as well as through interactions with steroids in the target organs. These interactions are facilitated by positive and negative feedback between specific components of the HPA. Altogether, AVP and the HPA cooperate closely as a coordinated functional AVP-HPA system. It has been shown that cooperation between AVP and steroid hormones may be affected by cellular stress combined with hypoxia, and by metabolic, cardiovascular, and respiratory disorders; neurogenic stress; and inflammation. Growing evidence indicates that central and peripheral interactions between AVP and steroid hormones are reprogrammed in cardiovascular and metabolic diseases and that these rearrangements exert either beneficial or harmful effects. The present review highlights specific mechanisms of the interactions between AVP and steroids at cellular and systemic levels and analyses the consequences of the inappropriate cooperation of various components of the AVP-HPA system for the pathogenesis of cardiovascular and metabolic diseases.
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  • 文章类型: Journal Article
    蛋白酪氨酸磷酸酶1B(PTP1B)的过表达会破坏信号通路并导致许多人类疾病。特别是,它在代谢紊乱(I型和II型糖尿病,脂肪肝,和肥胖);神经退行性疾病(阿尔茨海默病,帕金森病);重度抑郁症;钙化性主动脉瓣疾病;以及几种癌症类型。鉴于这众多的治疗应用,在鉴定PTP1B及其作用后不久,开始寻求引入安全和选择性的酶抑制剂。遗憾的是,迄今为止所做的努力被证明是不成功的,由于所有提出的PTP1B抑制剂都失败了,或尚未完成,临床试验。旨在帮助引入新一代PTP1B抑制剂,这项工作收集和组织当前的艺术状态。特别是,这篇综述旨在阐明与PTP1B过表达相关的许多疾病之间的复杂关系,因为我们认为,在处理相互关联的疾病时,建立和遵循全新的整体方法至关重要。考虑到这一点,这篇全面的综述旨在验证PTP1B酶作为一种有前途的分子靶标,并加强这一方向的未来研究。
    Overexpression of protein tyrosine phosphatase 1B (PTP1B) disrupts signaling pathways and results in numerous human diseases. In particular, its involvement has been well documented in the pathogenesis of metabolic disorders (diabetes mellitus type I and type II, fatty liver disease, and obesity); neurodegenerative diseases (Alzheimer\'s disease, Parkinson\'s disease); major depressive disorder; calcific aortic valve disease; as well as several cancer types. Given this multitude of therapeutic applications, shortly after identification of PTP1B and its role, the pursuit to introduce safe and selective enzyme inhibitors began. Regrettably, efforts undertaken so far have proved unsuccessful, since all proposed PTP1B inhibitors failed, or are yet to complete, clinical trials. Intending to aid introduction of the new generation of PTP1B inhibitors, this work collects and organizes the current state of the art. In particular, this review intends to elucidate intricate relations between numerous diseases associated with the overexpression of PTP1B, as we believe that it is of the utmost significance to establish and follow a brand-new holistic approach in the treatment of interconnected conditions. With this in mind, this comprehensive review aims to validate the PTP1B enzyme as a promising molecular target, and to reinforce future research in this direction.
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  • 文章类型: Journal Article
    细胞代谢和氧化还原平衡的协调是一个复杂的,对维持细胞稳态至关重要的多层面过程。脂滴(LD),曾经被认为是中性脂质的惰性储存库,现在被认为是对脂质代谢和能量调节至关重要的动态细胞器。线粒体,牢房的发电站,在能源生产中发挥核心作用,代谢途径,和氧化还原信号。LD和线粒体之间的物理和功能接触促进脂质的直接转移,主要是脂肪酸,对线粒体β氧化至关重要,从而影响能量稳态和细胞健康。这篇综述强调了在理解LD-线粒体相互作用及其调控机制方面的最新进展。引起人们对介导这些接触的蛋白质和途径的关注。我们讨论了这些相互作用的生理相关性,强调它们在维持细胞内能量和氧化还原平衡中的作用,以及这些过程如何对代谢需求和压力条件做出反应。此外,我们探索了LD-线粒体相互作用失调的病理意义,特别是在代谢疾病如肥胖的背景下,糖尿病,和非酒精性脂肪性肝病,以及它们与心血管和神经退行性疾病的潜在联系。最后,这篇综述全面概述了目前对LD-线粒体相互作用的理解,强调了它们在细胞代谢中的重要性,并提出了未来的研究方向,可以揭示代谢和退行性疾病的新治疗靶点。
    The orchestration of cellular metabolism and redox balance is a complex, multifaceted process crucial for maintaining cellular homeostasis. Lipid droplets (LDs), once considered inert storage depots for neutral lipids, are now recognized as dynamic organelles critical in lipid metabolism and energy regulation. Mitochondria, the powerhouses of the cell, play a central role in energy production, metabolic pathways, and redox signaling. The physical and functional contacts between LDs and mitochondria facilitate a direct transfer of lipids, primarily fatty acids, which are crucial for mitochondrial β-oxidation, thus influencing energy homeostasis and cellular health. This review highlights recent advances in understanding the mechanisms governing LD-mitochondria interactions and their regulation, drawing attention to proteins and pathways that mediate these contacts. We discuss the physiological relevance of these interactions, emphasizing their role in maintaining energy and redox balance within cells, and how these processes are critical in response to metabolic demands and stress conditions. Furthermore, we explore the pathological implications of dysregulated LD-mitochondria interactions, particularly in the context of metabolic diseases such as obesity, diabetes, and non-alcoholic fatty liver disease, and their potential links to cardiovascular and neurodegenerative diseases. Conclusively, this review provides a comprehensive overview of the current understanding of LD-mitochondria interactions, underscoring their significance in cellular metabolism and suggesting future research directions that could unveil novel therapeutic targets for metabolic and degenerative diseases.
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  • 文章类型: Journal Article
    植物性饮食(PBD)作为管理各种慢性病的可持续和健康意识的替代方法,正在引起人们的关注。包括代谢功能障碍相关的脂肪变性肝病(MASLD)。在没有药物治疗的情况下,探索改变生活方式改善生化和病理结局的潜力变得至关重要.采用PBDs已显示出有益的效果,例如控制体重,增加代谢健康和改善共存疾病。尽管如此,挑战依然存在,包括坚持困难,确保营养充足,解决潜在的缺陷。这篇综述的目的是全面概述PBDs对MASLD的影响,强调需要在专业支持下进行量身定制的饮食干预,以优化其预防和治疗代谢性疾病的有效性。
    Plant-based diets (PBDs) are gaining attention as a sustainable and health-conscious alternative for managing various chronic conditions, including metabolic dysfunction-associated steatotic liver disease (MASLD). In the absence of pharmacological treatments, exploring the potential of lifestyle modifications to improve biochemical and pathological outcomes becomes crucial. The adoption of PBDs has demonstrated beneficial effects such as weight control, increased metabolic health and improved coexisting diseases. Nonetheless, challenges persist, including adherence difficulties, ensuring nutritional adequacy, and addressing potential deficiencies. The aim of this review is to provide a comprehensive overview of the impact of PBDs on MASLD, emphasizing the need for tailored dietary interventions with professional support to optimize their effectiveness in preventing and treating metabolic diseases.
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  • 文章类型: Journal Article
    乳糜泻(CD)是一种由遗传易感个体摄入含麸质食物引发的慢性自身免疫性疾病。因此,CD的处理包括永久避免小麦,黑麦,大麦,和其他含麸质食物。终身坚持无麸质饮食(GFD)可改善CD的症状,但最近的证据表明,它还与肝脏脂肪变性的高风险以及其他心脏代谢危险因素的共存或出现有关.此外,一些作者还报道,肝脏脂肪变性的风险更高,这是CD本身潜在的肠外并发症.最近的命名法变化将肝脂肪变性与五个心脏代谢危险因素中的至少一个之间的关联指定为代谢功能障碍相关的脂肪变性肝病(MASLD)。MAFLD和CD之间关联的潜在致病因素的扩展网络,在实施饮食疗法之前和之后,最近有描述。这些患者的个体化治疗较少得到证据支持,目前的大多数建议都依赖于经验性的临床判断。这篇综述集中在CD和肝损伤之间的因果关系。作为CD的肠外表现或GFD的副作用,还提到了这些个体的潜在治疗策略。
    Celiac disease (CD) is a chronic autoimmune disorder triggered by the ingestion of gluten-containing food by genetically predisposed individuals. Hence, treatment of CD consists of permanent avoidance of wheat, rye, barley, and other gluten-containing foods. Lifelong adherence to a gluten-free diet (GFD) improves the symptoms of CD, but recent evidence suggests it is also associated with a higher risk for hepatic steatosis and the coexistence or emergence of other cardiometabolic risk factors. Moreover, a higher risk for liver steatosis is also reported by some authors as a potential extraintestinal complication of the CD itself. Recent nomenclature changes designate the association between hepatic steatosis and at least one of five cardiometabolic risk factors as metabolic dysfunction-associated steatotic liver disease (MASLD). An extended network of potentially causative factors underlying the association between MAFLD and CD, before and after dietary therapy is implemented, was recently described. The individualized treatment of these patients is less supported by evidence, with most of the current recommendations relying on empiric clinical judgment. This review focuses on the causative associations between CD and hepatic injury, either as an extraintestinal manifestation of CD or a side effect of GFD, also referring to potential therapeutic strategies for these individuals.
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  • 文章类型: Journal Article
    背景:尽管与脂肪肝疾病相关的遗传危险因素已经很清楚,对代谢功能障碍相关脂肪变性肝病(MASLD)的遗传背景及其相关健康影响知之甚少.与非酒精性脂肪性肝病(NAFLD)相比,MASLD提出了明显不同的诊断标准,以及流行病学和临床特征,但是相关的遗传变异还有待研究。因此,本研究旨在评估MASLD的遗传背景以及MASLD相关遗传变异与代谢相关结局之间的相互作用.
    方法:来自英国生物库的参与者被分为发现和复制队列,用于MASLD全基因组关联研究(GWAS)。以及多基因风险评分(PRS)分析的基础和目标队列。与NAFLD相关的常染色体遗传变异与MASLDGWAS结果进行比较。Kaplan-Meier和Cox回归分析用于评估MASLD和代谢相关结果之间的关联。
    结果:在MASLD的全基因组显著性水平上鉴定出16种单核苷酸多态性(SNP),并在复制队列中重复。在将这些SNP与NAFLD相关遗传变异的结果进行比较后发现差异。具有高PRS的MASLD病例的多变量校正风险比为3.15(95%置信区间,2.54-3.90)用于严重肝病(SLD),2型糖尿病为2.81(2.60-3.03)。高PRS放大了MASLD对SLD和肝外结果的影响。
    结论:MASLDGWAS的高PRS放大了MASLD对SLD和代谢相关结局的影响,从而完善MASLD高风险个体的识别过程。用相关的遗传背景补充这一过程可能会导致更有效的MASLD预防和管理。
    BACKGROUND: Although the inherited risk factors associated with fatty liver disease are well understood, little is known about the genetic background of metabolic dysfunction-associated steatotic liver disease (MASLD) and its related health impacts. Compared to non-alcoholic fatty liver disease (NAFLD), MASLD presents significantly distinct diagnostic criteria, and epidemiological and clinical features, but the related genetic variants are yet to be investigated. Therefore, we conducted this study to assess the genetic background of MASLD and interactions between MASLD-related genetic variants and metabolism-related outcomes.
    METHODS: Participants from the UK Biobank were grouped into discovery and replication cohorts for an MASLD genome-wide association study (GWAS), and base and target cohorts for polygenic risk score (PRS) analysis. Autosomal genetic variants associated with NAFLD were compared with the MASLD GWAS results. Kaplan-Meier and Cox regression analyses were used to assess associations between MASLD and metabolism-related outcomes.
    RESULTS: Sixteen single-nucleotide polymorphisms (SNPs) were identified at genome-wide significance levels for MASLD and duplicated in the replication cohort. Differences were found after comparing these SNPs with the results of NAFLD-related genetic variants. MASLD cases with high PRS had a multivariate-adjusted hazard ratio of 3.15 (95% confidence interval, 2.54-3.90) for severe liver disease (SLD), and 2.81 (2.60-3.03) for type 2 diabetes mellitus. The high PRS amplified the impact of MASLD on SLD and extrahepatic outcomes.
    CONCLUSIONS: High PRS of MASLD GWAS amplified the impact of MASLD on SLD and metabolism-related outcomes, thereby refining the process of identification of individuals at high risk of MASLD. Supplementation of this process with relevant genetic backgrounds may lead to more effective MASLD prevention and management.
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  • 文章类型: Journal Article
    目的:健康教育是心血管代谢疾病(CMD)管理的组成部分。这项研究旨在评估教育偏好是否以及如何随着时间的推移而改变,以及趋势是否因社会人口学特征而异(教育状况,年龄,种族,和性别)。
    方法:在东米德兰兹郡的五个县进行了横断面调查问卷,2017年至2022年英国向CMD成年人(2型糖尿病,心血管疾病或脑血管疾病)。受访者的人口统计数据与健康教育偏好一起收集。统计分析确定人口统计学特征是否影响偏好。绘制了偏好随时间的分布以确定趋势。
    结果:共收集了4301份符合条件的回复。面对面的一对一教育是首选(75.1%的参与者的首选),但在五年期间,受欢迎程度有所下降。人口群体之间的趋势相似。在线教育呈U型趋势:2017年,44%的受访者认为可以接受,2019年达到53%的峰值,但再次下降,到基线以下,43%,到2022年。这种模式在65岁以下的参与者中更受欢迎,但是在研究期间,65岁以上人群的受欢迎程度有所增加。随着时间的推移,除了南亚种族之外,所有人口群体中印刷信息的受欢迎程度也有所下降,对他们来说,它仍然是静态的。
    结论:医生或护士对面对面一对一健康教育的压倒性偏好凸显了保持这种方式的重要性,即使面对当前的NHS压力和数字化趋势。趋势在变化,并且应该继续受到监测,包括不同的社会人口群体之间。
    OBJECTIVE: Health education is integral to cardiometabolic disease (CMD) management. This study aimed to assess whether and how education preferences have changed over time, and whether trends differ by sociodemographic characteristics (education status, age, ethnicity, and sex).
    METHODS: A cross-sectional questionnaire was deployed across five counties in the East Midlands, UK between 2017 and 2022 to adults with CMD (type 2 diabetes, cardiovascular disease or cerebrovascular disease). Respondent demographic data were collected alongside health education preferences. Statistical analyses ascertained whether demographic characteristics influenced preferences. The distribution of preferences over time was charted to identify trends.
    RESULTS: A total of 4301 eligible responses were collected. Face-to-face one-to-one education was preferred (first choice for 75.1% of participants) but popularity waned over the five-year period. Trends were similar amongst demographic groups. Online education showed a U-shaped trend: In 2017, 44% of respondents ranked it as acceptable, peaking at 53% in 2019, but declining again, to below base line, 43%, by 2022. This modality was more popular with participants aged younger than 65 years, but popularity in people older than 65 years increased over the study period. The popularity of printed information also declined over time across all demographic groups except those of South Asian ethnicity, for whom it remained static.
    CONCLUSIONS: The overwhelming preference for face-to-face one-to-one health education from a doctor or nurse highlights the importance of preserving access to this modality, even in the face of current NHS pressures and trends towards digitalisation. Trends are changing, and should continue to be monitored, including between different sociodemographic groups.
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  • 文章类型: Journal Article
    背景:接受肠道尿流改道(IUD)的患者可能由于代谢性酸中毒和肠吸收表面减少而具有更高的骨质疏松症和骨折风险。
    目的:我们对IUD对骨脱矿影响的现有文献进行了系统综述。
    方法:我们系统地搜索了PubMed®,对于2020年4月之前发表的原创文章。主要终点是骨折和骨密度丢失的风险。次要结果是与钙代谢和组织学变化相关的生化和尿液参数的代谢变化。
    结果:我们的电子搜索共识别了2417篇文章。经过详细的审查,我们选择了11项研究,在10369例患者中探讨了宫内节育器对骨骼健康的影响.在3篇文章中研究了骨折的风险,在宫内节育器人群中显示出更高的风险。在评价肠尿流改道与骨密度关系的9篇文章中,5确实发现了正相关。一篇文章评估了IUD后细胞水平的骨代谢,表明该人群的骨转换减少。报告与钙和磷酸盐代谢相关的血清参数数据的八项研究中的三项显示出差异。最后,在三项研究中的两项研究中发现,尿液中吡啶甲酸的浓度与骨密度丢失之间存在相关性。
    结论:尽管已发表的BMD数据相互矛盾,接受宫内节育器的患者似乎有较高的骨折风险.我们的发现支持了在宫内节育器患者中实施骨质疏松症筛查和预防可访问策略的必要性。
    BACKGROUND: Patients undergoing intestinal urinary diversion (IUD) may have a higher risk of osteoporosis and risk of fractures due to metabolic acidosis and decrease of intestinal absorption surface.
    OBJECTIVE: We performed a systematic review of the available literature on the impact of IUD on bone demineralization.
    METHODS: We systematically searched PubMed®, for original articles published before April 2020. Primary end points were the risk of fracture and loss of bone density. Secondary outcomes were the metabolic changes in biochemical and urine parameters related to calcium metabolism and histological changes.
    RESULTS: Our electronic search identified a total of 2417 articles. After a detailed review, we selected 11 studies that addressed the impact of IUD on bone health in 10369 patients. The risk of bone fracture was studied in 3 articles, showing a higher risk in the IUD population. Of the 9 articles evaluating the relation between intestinal urinary diversion and bone density, 5 did find a positive association. One article evaluated the bone metabolism at a cellular level after IUD showing a decrease in bone turnover in this population. Three of the eight studies reporting data on serum parameters related to calcium and phosphate metabolism showed differences. Finally, a correlation between concentration of pyridolines in urine and loss of bone density was found in two of the three studies.
    CONCLUSIONS: Although published data on BMD are contradictory, patients undergoing IUD seem to be at higher risk of bone fractures. Our finding support the need to implement accessible strategies on osteoporosis screening and prevention in IUD patients.
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  • 文章类型: Journal Article
    多米诺肝移植和多米诺辅助部分原位肝移植是新兴的技术,可以扩大肝脏供体库,为肝病患儿提供希望。多米诺肝移植的创新技术已经成为一种开创性的战略,利用在形态正常情况下表现出单酶缺陷的供体结构保存的肝脏,有效地扩大捐赠池。同时,越来越普遍的多米诺辅助部分原位肝移植方法在支持可用供体资源方面发挥着关键作用。这些先进的移植方法为儿科患者提供了独特的机会,尽管肝脏结构和功能完整,但缺乏门静脉高压或肝外受累的早期迹象,在常规移植名单上没有获得优先权。利用最佳临床条件可增强移植后结果,受益的患者会忍受延长的等待期传统移植。接受这些手术的儿童的围手术期管理是复杂的,需要仔细考虑一些因素,包括特定代谢紊乱的临床和代谢状况,以及需要量身定制的围手术期管理计划。此外,在选择合适的多米诺肝移植供体时,对受体新生疾病发展的谨慎考虑具有至关重要的意义,因为它深刻影响预后,死亡率,和发病率。本文叙述了多米诺肝移植的病理生理学,临床评估,围手术期管理,和预后预期,重点关注接受多米诺肝移植的儿童围手术期麻醉注意事项。
    Domino liver transplantation and domino-auxiliary partial orthotopic liver transplantation are emerging techniques that can expand the liver donor pool and provide hope for children with liver disease. The innovative technique of domino liver transplantation has emerged as a pioneering strategy, capitalizing on structurally preserved livers from donors exhibiting single enzymatic defects within a morphologically normal context, effectively broadening the donor pool. Concurrently, the increasingly prevalent domino-auxiliary partial orthotopic liver transplantation method assumes a critical role in bolstering available donor resources. These advanced transplantation methods present a unique opportunity for pediatric patients who, despite having structurally and functionally intact livers and lacking early signs of portal hypertension or extrahepatic involvement, do not attain priority on conventional transplant lists. Utilizing optimal clinical conditions enhances posttransplant outcomes, benefiting patients who would otherwise endure extended waiting periods for traditional transplantation. The perioperative management of children undergoing these procedures is complex and requires careful consideration of some factors, including clinical and metabolic conditions of the specific metabolic disorder, and the need for tailored perioperative management planning. Furthermore, the prudent consideration of de novo disease development in the recipient assumes paramount significance when selecting suitable donors for domino liver transplantation, as it profoundly influences prognosis, mortality, and morbidity. This narrative review of domino liver transplantation will discuss the pathophysiology, clinical evaluation, perioperative management, and prognostic expectations, focusing on perioperative anesthetic considerations for children undergoing domino liver transplantation.
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