This elevation could be a result of biliary ductal epithelial cell inflammation caused by alcohol, subsequently causing increased secretion of carbohy-drate antigen 19-9. Carbohydrate antigen 19-9 levels should be interpreted with caution, and treatment should be individually tailored to address individual patient-specific situations.

Biliary tract complications are a significant source of morbidity following living donor liver transplant, especially in pediatric patients. These complications are influenced by graft type, bile duct anatomy, and reconstruction techniques. For a hepaticojejunostomy, percutaneous intervention is the first option preferred. Here, we present a case report of the successful use of a percutaneous biodegradable stent to manage an intrahepatic biliary stricture in an 8-month-old patient who had previously undergone living donor liver transplant for biliary atresia, thereby creating a new biliary path. The patient developed a dominant biliary stricture of segment S2 postoperatively, which was refractory to conventional internal drainage. We created a new biliary path via a novel connection between the intrahepatic duct and the intestinal loop with minimally invasive surgery. The biodegradable stent provided temporary structural support while gradually degrading, which eliminated the need for removal and minimized long-term complications. At 18 month follow-up, the patient remained asymptomatic with satisfactory liver function tests and no evidence of restenosis. This case illustrates the feasibility, safety, and potential benefits of biodegradable stents in pediatric liver transplant recipients. The findings suggest that biodegradable stents could represent a significant advancement in the management of complex biliary tract complications in children, although further studies are necessary to establish the long-term efficacy of this treatment and standardize the protocols.

Our study results showed that the class II HLA-DQ tissue group and anti-HLA antibodies against it play an important role in reducing the need for desensitization therapy and maintaining graft tissue functionality.

Long-term immunosuppression can lead to malignant tumors after kidney transplant. In this case study, we report a rare case of breast cancer occurring in a man after 33 years of kidney transplant. This 55-year-old kidney transplant patient presented with a right breast mass. The biopsy showed an infiltrating carcinoma. The immunohistochemical study was positive for estrogen. The patient underwent a right mastectomy with axillary dissection. Chemotherapy based on docetaxel and radiotherapy was started. Adjuvant treatment with tamoxifen and a switch from azathioprine to sirolimus were conducted. Follow-up showed that the patient died 24 months after presentation. Through this case, we emphasize the importance of vigilance about this rare cancer, often diagnosed at a late stage, which can negatively affect prognosis. Screening for risk factors is crucial.

Left hepatectomy is considered a potential risk factor for extremely severe bile leakage. Preoperative anatomical evaluation of the branching pattern and running course of the biliary tree of the right lobe and careful transection of the hepatic parenchyma near the hilar plate are important.

The review introduces the challenges and potential solutions in xenotransplantation, focusing on pig-to-human organ transplant. Xenotransplantation, mainly with the use of pig organs, is a promising solution because of the reproductive capacity, size, and physiological resemblance of pigs to humans. However, immunological barriers, especially humoral and cellular immune responses, pose substantial challenges. The humoral immune response, involving antibodies targeting xenoantigens, is a substantial barrier. Anti-α-galactose antibodies, targeting α-Gal epitopes, are crucial in hyperacute rejection and acute humoral xenograft rejection. Genetic modifications, including CRISPR/Cas9 technology, aim to eliminate xenoantigens like α-Gal, potentially overcoming these challenges. This review discusses the use of genetically modified pigs for xenotransplantation, emphasizing the removal of xenoantigens, expression of human complement regulatory proteins, and transgenic expres-sion of human regulatory factors. Recent advancements, such as the world's first porcine-to-human heart transplant, highlight the potential of genetic manipu-lation in overcoming immune rejection barriers.

To our knowledge, this study is the first to demonstrate a relationship between pulse wave velocity and cognitive function as measured by the Mini-Mental State Examination and the Montreal-Cognitive Assessment in kidney transplant recipients. These results suggest that cerebrovascular disease may contribute to cognitive impairment in this population.

Few cases of kidney transplant have been reported in patients with situs inversus totalis. We present a 35-year old female patient with situs inversus totalis and chronic kidney disease of unknown origin who received a third graft after failure of 2 previous transplants. The first living related transplant was performed on the right side and failed after 3 years. A second related transplant was then performed on the left side, butthis thrombosed graft was removed in the first week. The patient then underwent a third related transplant on the left side. Retransplant in patients with situs inversus totalis is no different than in patients with normal anatomy, provided that attention is given to the altered vascular anatomy.