Search Results (6,876)

To contrast the COVID-19 pandemic brought by the corona virus SARS-CoV-2, two mRNA-based anti-COVID-19 vaccines (by Pfizer-BioNTech and Moderna) were made available relatively quickly and deployed worldwide based on an emergency approval. Being considered vulnerable and at risk of infection, cancer patients have been prioritized for COVID-19 vaccination and vaccinated repeatedly because of the short time protection provided by these vaccines. Recently, a surge in the incidence and rapid progression of cancers has been observed in many countries, which could (at least partially) represent cancers undiagnosed or untreated during the pandemic. It has also been suggested that the SARS-CoV-2 itself or even the anti-COVID-19 mRNA vaccines could have contributed to the recurrence and worse clinical outcome in cancer patients, given the high incidence of COVID-19 in hospitalized patients and that these patients have been vaccinated with priority several times and in a short period. Although it appears extremely unlikely that SARS-CoV-2 and anti-COVID-19 mRNA vaccines elicit genotoxic events and cause neo-cancerogenesis in a short time, they could still cause non-genotoxic pro-carcinogenic effects by triggering an exaggerated inflammatory reaction, compromising immune homeostasis, stimulating cell proliferation, and negatively affecting cellular stress response and damage repair machinery. This could result in the promotion of regrowth of dormant micrometastases or relapses of stable minimal residual disease. Such a harmful outcome may likely result from a synergy between the virus and the vaccine, especially in multi-vaccinated and multi-infected individuals. Here, I bring the cell pathologist’s point of view and discuss the multiple possible mechanisms by which the virus and the anti-COVID-19 mRNA vaccine might favor tumorigenesis. While a causal link cannot be established at this stage, knowledge of potential carcinogenic risks could help doctors and health policymakers take the best actions to protect vulnerable patients and convince the vaccine developer to design a vaccine free from such harm. Full article

Objectives: To develop an algorithm to assist in the diagnosis of glaucoma with concomitant retinal vein occlusion (RVO) and to compare its diagnostic accuracy with that of ophthalmology residents and specialists. Methods: Fundus photographs of eyes with RVO and those with both RVO and glaucoma were obtained from patients who visited the University of Yamanashi Hospital. All images were preprocessed through normalization and resized to 512 × 512 pixels to ensure uniformity before model training. The diagnostic accuracy of two algorithms—the Comprehensive Fundus Disease Diagnostic Artificial Intelligence Algorithm (CD-AI) and the Glaucoma Concomitant RVO Artificial Intelligence Algorithm (RVO-GLA AI)—was evaluated. CD-AI is a clinical decision support algorithm originally developed to detect eleven common fundus diseases, including glaucoma and RVO. RVO-GLA AI is a fine-tuned version of CD-AI that is specifically adapted to detect glaucoma with or without RVO. Fine-tuning was performed using 1234 images of glaucoma, 1233 images of nonglaucomatous conditions, including RVO, and 15 images of cases with both glaucoma and RVO. The number of comorbid cases was determined empirically by gradually adding glaucomatous eyes with concomitant RVO to the training set, and 15 images provided the best balance between sensitivity and specificity. Because the available number of such cases was limited, this small sample size may have influenced the stability of the performance estimates. For the final evaluation, both algorithms and all ophthalmologists assessed the same independent test dataset comprising 66 fundus images (16 eyes with glaucoma and RVO and 50 eyes with RVO alone). The diagnostic performance of both algorithms was compared with that of three first-year ophthalmology residents and three board-certified ophthalmologists. Results: CD-AI demonstrated high diagnostic accuracy (92.5%) in eyes with glaucoma alone. However, its sensitivity and specificity decreased to 0.375 and 1.0, respectively, in patients with concomitant RVO. In contrast, the RVO-GLA AI achieved an area under the curve (AUC) of 0.875, with a sensitivity of 0.87 and a specificity of 0.71. Across all the ophthalmologists, the average sensitivity was 0.63, and the specificity was 0.87. Specialists achieved a sensitivity of 0.80 and a specificity of 0.89, while residents had a sensitivity of 0.46 and a specificity of 0.85. Conclusions: An AI-based clinical decision support system specifically designed for glaucoma detection significantly improved diagnostic performance in eyes with combined RVO and glaucoma, achieving an accuracy comparable to that of ophthalmologists, even with a limited number of training cases. Full article

Background: Gastroesophageal reflux disease (GERD) exposes restorative materials to gastric acid, which may compromise their esthetic and optical properties. Limited evidence exists regarding the performance of different CAD/CAM ceramics under acidic challenges. Methods: Forty CAD/CAM ceramic discs were prepared (n = 10 per group): high-translucency zirconia (Z; Ceramill Zolid Gen-X), lithium disilicate (E; IPS e.max CAD), zirconia-reinforced lithium silicate (S; VITA Suprinity), and hybrid ceramic (C; Cerasmart 270). Specimens were immersed in simulated gastric acid (0.06 M HCl, pH 1.2) at 37 °C for 96 h. Color difference (ΔE) and translucency parameter (ΔTP) were recorded before and after immersion using a spectrophotometer. Data were analyzed using one-way ANOVA with Tukey’s post hoc test (α = 0.05). Results: All materials exhibited changes in color and translucency after acidic immersion. Group Z demonstrated the lowest ΔE values, indicating the best color stability, whereas group C showed the highest ΔE and a significant reduction in ΔTP. Groups E and S revealed moderate but clinically acceptable changes. Intergroup differences were statistically significant (p < 0.05). Conclusions: Exposure to simulated gastric acid as in (GERD) resulted in measurable alterations in the optical properties of CAD/CAM ceramic materials. The extent of color change and translucency loss differed among the materials tested. High-translucency zirconia (Z) exhibited the greatest stability, while hybrid ceramic (C) showed the most pronounced changes. Zirconia-reinforced lithium silicate (S) and lithium disilicate (E) demonstrated moderate alterations, falling between these two extremes. Full article

Background/Objectives: For completely resected well differentiated (WD) gastroenteropancreatic (GEP) NET, guidelines differ in recommendations for utilization of SSTR-based functional imaging in post-operative surveillance. While ¹¹¹In-Octreotide has previously been the standard of care, imaging with ⁶⁸Ga-labelled peptides has expanded in recent years due to increased sensitivity to detect smaller volume diseases and reduced costs. Though many centres have widely adopted imaging with ⁶⁸Ga-labelled peptides, its role in surveillance of resected GEP NET has not been well defined. We sought to characterize current utilization of imaging with ⁶⁸Ga-DOTATATE PET CT (⁶⁸Ga-DOTA) for post-operative surveillance of WD GEP NET and assess the impact on clinical management. Methods: We conducted a retrospective review of all ⁶⁸Ga-DOTA scans performed from April 2019 to August 2024. Inclusion criteria were age ≥ 18 years with WD grade 1 and 2 GEP NET that had undergone curative-intent surgery, had Stage I-III disease at diagnosis, and had ⁶⁸Ga-DOTA post-operatively. Results: Forty-six scans met the inclusion criteria. We identified four indications for ⁶⁸Ga-DOTA: (1) post-operative assessment (n = 12); (2) routine surveillance (n = 18); (3) recurrence suspected based on cross-sectional imaging (n = 10); and (4) recurrence suspected based on biochemical monitoring (n = 6). Avidity for each indication was observed in 45%, 8%, 50%, and 80%, respectively. Initiation of long-acting somatostatin analogue was the most common management following avidity. Conclusions: ⁶⁸Ga-DOTA best informed clinical decision making when there was clinical suspicion for residual or metastatic disease post-operatively or based on cross-sectional imaging or biochemistry. The utility of this modality for routine surveillance appears limited. Full article

Background: Considering the increased need to deliver adjuvant radiotherapy (RT) after pleurectomy/decortication (P/D) for malignant pleural mesothelioma (MPM) without exceeding the tolerance of the adjacent normal tissue, new advanced RT technologies have been developed. However, radiation to the whole hemithorax presents a challenge because of the increased risk of toxicity occurring with two intact radiosensitive lungs. The aim of this study is to systematically review the literature in order to assess the role of radiotherapy after P/D for MPM, based on the evidence published so far. Methods: We conducted this systematic review according to PRISMA guidelines and registered in an international public register of systematic review (PROSPERO). A PubMed and Cochrane database search was performed to identify articles published from 2005 to 2024 regarding the role of adjuvant radiotherapy after P/D for MPM. We included only level I–III-evidence studies according to the Oxford Centre for Evidence-Based Medicine’s guidance. Results: We selected 11 level II studies. Based on published reports, delivery of high-dose external beam ‘conventional’ RT to the entire hemithorax is not recommended in a P/D setting and hemithoracic intensity-modulated radiotherapy (IMRT) may be considered an encouraging and reasonable therapeutic option, leading to excellent loco-regional control and survival results. Conclusions: Data and experience strongly support that the ideal platform to define potential indication of the adjuvant RT is a multidisciplinary team. Moreover, given the technical difficulty of IMRT treatment, we recommend considering this treatment in experienced centers with dedicated protocols for MPM due to their ability to detect and manage side effects resulting from the disease and the treatment as well as to ensure the best and the latest treatment plan for each patient. Full article

Eyelid retraction, cicatricial entropion, and deformities associated with facial nerve palsy are among the eyelid malpositions most detrimental to the ocular surface, as they cause exposure, tear film instability, inflammation, and potentially significant visual impairment. These conditions present major functional and esthetic challenges, underscoring the need for a clear understanding of their mechanisms and management. A narrative review was conducted using PubMed, MEDLINE, Embase, and Google Scholar to identify English and non-English studies (with English abstracts) addressing eyelid malpositions related to thyroid eye disease, cicatricial processes, and facial nerve palsy. Screening and cross-referencing yielded 115 relevant publications. Studies were excluded if they lacked clinical relevance, did not address the target disorders, involved animals, consisted of insufficient case reports, lacked an English abstract, or were non–peer-reviewed or duplicated. Extracted information included patient demographics, clinical presentations, diagnostic methods, treatments, complications, and outcomes. In thyroid eye disease, eyelid retraction results from adrenergic overstimulation, increased Müller muscle tone, and fibrosis involving the levator–superior rectus complex. Temporary improvement may be achieved with botulinum toxin, corticosteroids, or soft-tissue fillers, whereas sustained correction requires individualized surgical approaches. Cicatricial entropion arises from posterior lamellar contraction caused by inflammatory or iatrogenic injury and is best treated with lamellar repositioning or grafting procedures. In facial nerve palsy, incomplete blinking, punctal malposition, and lacrimal pump dysfunction contribute to tearing and ocular surface instability; management prioritizes corneal protection, eyelid rebalancing, and adjunctive measures such as botulinum toxin or physiotherapy. Across all conditions, tailored, multidisciplinary care is essential to maintain ocular surface integrity, restore eyelid function, and preserve quality of life. Full article

Background: Ulcerative colitis (UC) is a major form of inflammatory bowel disease affecting the gastrointestinal tract. Increasing evidence suggests UC is predisposed to co-occurring with other autoimmune diseases, yet its pathogenesis remains insufficiently understood. Large-scale biobank-based cross-trait genetic analyses may provide insights into the origins of UC and its comorbidities. Methods: Using the UK Biobank and Mount Sinai BioMe Biobank, we conducted genome-wide association studies (GWASs) in individuals of European ancestry. High-impact rare variants were aggregated for collapsing analysis. Genome-wide significant variants were tested in a phenome-wide association study (PheWAS) to explore UC comorbidities. Polygenic risk scores (PRSs) were derived from large-scale GWASs under different thresholds and functionalities, and the best-performing PRS was further applied in a PRS-based PheWAS. Genetic correlation between UC and highly associated traits was evaluated. Results: GWASs identified four genome-wide significant loci, including two novel variants (rs2314757, p = 4.82 × 10⁻¹¹, OR = 0.81; rs6869382, p = 2.48 × 10⁻⁸, OR = 0.83) and two previously reported UC-associated sites (rs4654925, p = 1.85 × 10⁻⁸, OR = 0.84; rs2836882, p = 1.23 × 10⁻¹¹, OR = 0.78) outside the HLA region. The optimal PRS, constructed with SNPs at p < 0.05, conferred an odds ratio of 5.86 (95% CI: 5.05–6.86) for UC in individuals with the highest versus lowest quintile. Both variant- and PRS-based PheWASs consistently highlighted type 1 diabetes (T1D) as the most significant comorbidity, confirmed by genetic correlation analysis. Conclusions: This study reveals novel loci contributing to UC and highlights comorbidities with shared genetic bases. UC PRSs demonstrated strong utility beyond risk prediction, effectively identifying UC-associated traits. A robust genetic correlation was established between UC and T1D. Full article

Despite the availability of conventional serum markers for colorectal cancer (CEA, CA 19-9), there remains a need for more sensitive and specific biomarkers, particularly for early-stage detection. This study evaluated the diagnostic usefulness of serum Relaxin-2 (RLN2) and Chitinase-3-like protein 1 (YKL-40) as potential adjunct markers in patients with CRC. Serum concentrations of all the proteins were measured using a multiplexing assay and CMIA and were subsequently compared using non-parametric statistical tests. The concentrations of YKL-40, CEA, and CA 19-9 were elevated in CRC patients relative to controls (p < 0.05), but not so for RLN2. The concentrations of YKL-40 were also significantly elevated in patients undergoing chemotherapy or preoperative radiotherapy referral. Kruskal–Wallis and post-hoc testing found that YKL-40 and CEA were associated with tumor progression, but RLN2 and CA 19-9 were increased primarily in advanced, metastatic disease. No statistically significant differences in marker levels were observed between cancer subtypes or between histologic grades. Performance analysis for diagnostic purposes showed YKL-40 was moderately sensitive (65%) but very specific (77.5%), and its AUC was 0.702, higher than CA 19-9 (AUC = 0.632) but lower than CEA (AUC = 0.869) (all p < 0.05). RLN2 did not reach statistical significance (AUC = 0.593, p = 0.09). Correlation analysis demonstrated the best correlation with disease stage for CEA and weaker positive correlations for YKL-40, CA 19-9, and RLN2. These findings suggest that YKL-40 may serve as a useful adjunct serum biomarker for CRC diagnosis, especially when combined with conventional markers such as CEA. Full article

Procellariiformes are among the most threatened seabirds globally, yet viral pathogens affecting this group remain poorly understood. Herpesviruses are widespread in birds and capable of establishing latency, reactivating under immunosuppression, and causing severe disease, particularly in cross-species transmission. We surveyed herpesvirus in 50 individuals (12 species) that stranded along the southeastern Brazilian coast (2017–2023). A nested pan-PCR protocol targeting the DNA polymerase gene detected herpesvirus DNA in 24% (12/50) of the birds. Seven distinct herpesvirus sequence types were identified, all clustering within the genus Mardivirus, including two previously known variants and novel lineages. To our best knowledge, this represents the first herpesvirus report in the Black-browed Albatross (Thalassarche melanophris), Cape Verde Shearwater (Calonectris edwardsii), Manx Shearwater (Puffinus puffinus), and Southern Giant-Petrel (Macronectes giganteus), as well as new host reports for the Yellow-nosed Albatross (T. chlororhynchos) and Cory’s Shearwater (C. borealis). No associated lesions were observed in histopathology. Our findings expand the known host range of herpesviruses in Procellariiformes and reveal possible circulation among colonies and non-breeding areas across the Southern and Northern hemispheres. Our results underscore the need for integrative ecological-, virological-, and population-based studies to clarify how seabird ecology influences herpesvirus transmission dynamics and long-term persistence in this group. Full article

Background: There are important gaps in describing the associations between variants found by GWAS and various phenotypes. Prior reports suggest that SNPs in regulatory regions should be further investigated to uncover these associations. Thus, this study involved a novel approach, along with Pharmacoepigenomics, prompting a new coined term “CpG-PGx SNP”. Methods: The rationale behind our analysis strategy was based on the impact of SNPs playing dual roles both in the CpG site disruption/formation and having PGx associations. Thus, we employed GeneCards (relevance score), PharmGKB (significant p-value), and GWAS catalog data for each gene (p < 5 × 10⁻⁸). Following the obtainment of the 25 best-scored genes of four major epigenetic processes (methylation, demethylation, acetylation, and deacetylation), we generated two lists of candidate genes, including potential CpG-PGx SNPs and possible CpG-PGx SNPs. Results: Among 2900 significant PGx annotations, we found 99 potential CpG-PGx SNPs related to 16 genes. CYP2B6, CYP2C19, CYP2D6, and COMT genes were the top genes. Additionally, we found 1230 significant GWAS-based SNPs, among them 329 CpG-SNPs related to 48 genes with at least one CpG site disruption/formation. The top gene with the highest CpG-SNPs was TET2, followed by JMJD1C and HDAC9. Importantly, we detected some synonymous variants in the Epigenetically Modifiable Accessible Region (EMAR), which can provide insights into undiscovered roles of these SNPs. We identified 173 CpG-Disruptive SNPs, 155 CpG-Forming SNPs, and just 1 CpG SNP with both impacts. Conclusions: In conclusion, here we introduce CpG-PGx SNP for the first time and suggest three major genes playing crucial roles in Pharmacoepigenomics (PEpGx), CYP2D6 as the heart of PEpGx, and TET2 with the highest possibility of having CPG-PGx SNPs. We believe that this approach will help the scientific community to utilize “CpG-PGx SNP” to unravel complex disease-driven genetic and epigenetic interactions, yielding therapeutic opportunities. Full article

Despite improved therapeutic concepts, the survival of patients with hepatocellular carcinoma (HCC) is limited. Liver transplantation (LT) is the best possible treatment for suitable patients. This therapy is of particular importance, because it not only removes the cancer but also cures the underlying structural liver disease. Due to the persistent lack of donor organs, however, the oncological prognosis after LT is of particular importance for fair organ allocation. Bonus points on the organ waiting list are rewarded for tumors within a certain tumor extent. In general, macrovascular invasion and extrahepatic tumor manifestation are considered to be contraindications for LT, as survival in these patients is very low. In recent years, however, microvascular invasion and poorly differentiated tumors have also turned out to be unfavorable. Most selection criteria for LT in HCC are still based on very simple imaging criteria like size and number without utilizing additional imaging characteristics inherent to the tumor nodule, which could be processed in a “virtual biopsy”. Recently, diagnostic research has presented the clinical benefit of artificial intelligence (AI) in the use of deep-learning strategies for digital diagnosis of poorly differentiated or microvascular-infiltrated tumors. In addition, evaluation of TACE response is analyzed as a possibility to estimate LT survival. The aim of this review is to provide an overview of recent advances in HCC diagnosis and to classify the clinical relevance of these diagnostic and technical advances. Secondly, we discuss how these advances could affect the organ allocation process. Full article

Background and Objectives: Glaucoma is a leading cause of irreversible blindness, and lowering intraocular pressure (IOP) is the only proven strategy to slow disease progression. We evaluated the clinical efficacy and safety of Micropulse Laser Trabeculoplasty (MLT) in patients with open-angle glaucoma and ocular hypertension, focusing on IOP control, visual function, and adverse events. Materials and Methods: This longitudinal, real-world cohort included 80 patients (132 eyes) treated with MLT between 2018 and 2025 at the Ophthalmology Clinic of the County Emergency Hospital, Bihor. Micropulse laser trabeculoplasty was applied over 360°, except in selected cases (90–300°), depending on anatomical or clinical factors. Outcomes included IOP by Goldmann and non-contact tonometry, best-corrected visual acuity (BCVA), refraction, and safety events. Pre-/post comparisons used paired tests and McNemar’s exact test where appropriate. Results: IOP decreased from 18.15 ± 5.02 to 15.57 ± 3.78 mmHg at 3 months (mean reduction: 2.58 mmHg, p < 0.001), confirmed by GEE adjusted for age, sex, and eye laterality. The proportion of eyes within target ranges increased significantly (IOP ≤ 18 mmHg and ≤21 mmHg; p = 0.0014 and p = 0.0023, respectively). A total of 31.1% of eyes achieved ≥ 20% IOP reduction, and 31.8% had an absolute decrease > 3 mmHg. BCVA and refraction remained stable (p > 0.05). No major complications or IOP spikes > 5 mmHg occurred; transient, self-limited events were uncommon. Conclusions: MLT was associated with a safe and clinically relevant reduction in IOP in patients with open-angle glaucoma and ocular hypertension, with stable visual function and minimal adverse effects observed. These results suggest that MLT may be a useful option for IOP management; however, the lack of a control group limits causal interpretation. Further controlled studies are warranted to confirm these findings. Full article

Fungal diseases represent relevant constraints on global agricultural productivity, causing severe yield losses and deterioration of crop quality. The extensive use of chemical fungicides has produced environmental and health concerns due to their persistence, bioaccumulation, toxicity, and the increasing development of resistant fungal strains. To promote sustainable plant protection strategies, this study aimed to evaluate natural alternative products derived from botanical sources and agro-industrial wastes. Eighteen putative inhibiting products (PIPs), selected based on their availability as spontaneous plants or agro-industrial wastes, together with a commercial resistance inducer, were screened in in vitro assays against a collection of 31 phytopathogenic fungi. The inhibitory activity (IA) from the PIPs was evaluated, and statistical analyses were performed to identify the best performer. Several PIPs showed significant inhibitory activity against several fungal species, while others promoted fungal growth, highlighting the dual nature of the tested PIPs as potential bio-fungicides and growth-promoting agents for beneficial fungi. These findings highlight the value of plant-derived metabolites and agricultural waste valorization as promising sources for the development of sustainable botanical fungicides as well as support the transition toward eco-friendly crop protection strategies aligned with the European Green Deal objectives. Full article

Thoracic aortic aneurysms (TAAs) carry a high risk of fatal rupture, necessitating improved preoperative risk stratification. This study evaluates the predictive value of systemic risk scores—specifically the Model for End-Stage Liver Disease (MELD) and the Charlson Comorbidity Index (CCI)—for in-hospital mortality, length of stay, and one-year mortality in patients undergoing elective ascending aortic surgery. The study further compares MELD variants (MELD-Na and MELD-XI) for their prognostic performance in this context. This retrospective single-center study analyzed digital medical records of 500 patients undergoing elective surgery for ascending thoracic aortic disease between 2003 and 2023. MELD, MELD-Na (incorporating sodium), and MELD-XI (excluding INR for anticoagulated patients) were calculated from preoperative laboratory data. The CCI was derived from documented comorbidities. Outcomes included in-hospital mortality, length of stay (from admission to discharge), and one-year mortality assessed via outpatient follow-up. The study excluded patients undergoing emergency surgery for Stanford type A aortic dissection. MELD-Na incorporates serum sodium, while MELD-XI is a variant that excludes INR for patients with anticoagulation. The Charlson Comorbidity Index (CCI) was derived from patients’ medical histories prior to surgery. Length of stay was defined as total inpatient days between admission and discharge. One-year mortality was assessed via outpatient follow-up data. Loss to follow-up did not exceed 30%. Of 500 patients (median age 64 years, 72.8% male), the MELD-Na score showed the strongest ability to predict in-hospital mortality (AUC = 0.698), outperforming both the standard MELD (AUC = 0.690) and the age-adjusted CCI (AUC = 0.631). For one-year mortality (N = 355), MELD-Na again performed best (AUC = 0.732), while the unadjusted CCI showed minimal predictive value (AUC = 0.509). Predictive power for hospital length of stay was limited across all scores; the age-adjusted CCI achieved the highest, though modest, discrimination (AUC = 0.627). 1-year mortality was assessed in 355 patients with available follow-up data (29.0% lost to follow-up). Among these, non-survivors had significantly higher MELD scores (p < 0.001). MELD-Na demonstrated the strongest predictive performance (AUC = 0.732). The MELD score, particularly MELD-Na, demonstrated strong predictive ability for in-hospital and 1-year mortality, but showed limited value in estimating hospital stay duration. MELD-Na and the age-adjusted CCI provide valuable preoperative prognostic information for patients undergoing elective ascending aortic surgery. While not intended to replace established risk models, their simplicity and reliance on routine clinical data make them attractive tools for early triage, especially in older or multimorbid patients. Their integration into preoperative planning may enhance individualized risk assessment and resource allocation. Full article

Human cytomegalovirus and Epstein–Barr virus are widely distributed viruses that, upon primary infection, establish a lifelong latency in immunocompetent subjects, whereas, in immunocompromised patients, they may give rise to secondary infection. In the latter case, either virus may cause systemic or end-organ disease that, if localized into the intestinal tract, is almost impossible to distinguish from a flare of inflammatory bowel disease. Optimal management of this condition begins with using the right diagnostic test and definitions. Viral load quantification on biological samples (blood or tissue) by real time-polymerase chain reaction not only shows the best diagnostic accuracy but also makes it possible to distinguish between viral reactivation, infection, and disease, the clinical approach to which differs substantially. A crucial role is also played by the host virus-specific T-cell immunity, monitoring of which may improve patient management. In this regard, the advent of new therapeutic and vaccination tools, as in the transplantation field, is expected to improve patients’ outcome. Full article