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Contributors
ALAN L. BUCHMAN, MD, MSPH, FACP, FACN, FACG, AGAF (Source: Gastroenterology Clinics of North America)
Source: Gastroenterology Clinics of North America - January 26, 2024 Category: Gastroenterology Source Type: research

Contents
Alan L. Buchman (Source: Gastroenterology Clinics of North America)
Source: Gastroenterology Clinics of North America - January 26, 2024 Category: Gastroenterology Source Type: research

Forthcoming Issues
Advances in Intestinal Transplantation, Part I (Source: Gastroenterology Clinics of North America)
Source: Gastroenterology Clinics of North America - January 26, 2024 Category: Gastroenterology Source Type: research

Abdominal Wall Closure in Intestinal and Multivisceral Transplantation
Failure to close the abdomen after intestinal or multivisceral transplantation (Tx) remains a frequently occurring problem. Two attractive reconstruction methods, especially in large abdominal wall defects, are full-thickness abdominal wall vascularized composite allograft (AW-VCA) and nonvascularized rectus fascia (NVRF) Tx. This review compares surgical technique, immunology, integration, clinical experience, and indications of both techniques. In AW-VCA Tx, vascular anastomosis is required and the graft undergoes hypotrophy post-Tx. Furthermore, it has immunologic benefits and good clinical outcome. NVRF Tx is an easy t...
Source: Gastroenterology Clinics of North America - January 25, 2024 Category: Gastroenterology Authors: Ewout Muylle, Nele Van De Winkel, Ina Hennion, Antoine Dubois, Lieven Thorrez, Nathalie P. Deferm, Jacques Pirenne, Laurens J. Ceulemans Source Type: research

Vaccines and Vaccine Response in the Small Bowel Transplant Patient
Vaccines should be regularly administered and their efficiency controlled, before and after intestinal transplantation. The  household and health care providers should also be immunized, to further prevent transmission. Universal vaccination providing “ herd immunity” should be enforced. Recommendations are given about timing, indications, and contraindications of each individual vaccine, before and after transplant ation. (Source: Gastroenterology Clinics of North America)
Source: Gastroenterology Clinics of North America - January 23, 2024 Category: Gastroenterology Authors: Florence Lacaille Source Type: research

Bioengineering of Intestinal Grafts
Intestinal failure manifests as an impaired capacity of the intestine to sufficiently absorb vital nutrients and electrolytes essential for growth and well-being in pediatric and adult populations. Although parenteral nutrition remains the mainstay therapeutic approach, the pursuit of a definitive and curative strategy, such as regenerative medicine, is imperative. Substantial advancements in the field of engineered intestinal tissues present a promising avenue for addressing intestinal failure; nevertheless, extensive research is still necessary for effective translation from experimental benchwork to clinical bedside app...
Source: Gastroenterology Clinics of North America - January 23, 2024 Category: Gastroenterology Authors: Madushani Herath, Allison L. Speer Source Type: research

Update on Maintenance Immunosuppression in Intestinal Transplantation
Outcomes in intestinal transplantation remain hampered by higher rates of rejection than any other solid organs. However, maintenance immunosuppression regimens have largely remained unchanged despite advances in therapies for induction and treatment of rejection and graft-versus-host disease. Recently, there have been a small number of new maintenance therapies attempted, and older agents have been used in new ways to achieve better outcomes. The authors herein review the traditional maintenance therapies and their mechanisms and then consider updates in new therapies and new ways of using old therapies for maintenance im...
Source: Gastroenterology Clinics of North America - January 23, 2024 Category: Gastroenterology Authors: Satyajit Patwardhan, Julie Hong, Joshua Weiner Source Type: research

Metabolomic Applications in Gut Microbiota-Host Interactions in Human Diseases
The human gut microbiota, consisting of trillions of microorganisms, encodes diverse metabolic pathways that impact numerous aspects of host physiology. One key way in which gut bacteria interact with the host is through the production of small metabolites. Several of these microbiota-dependent metabolites, such as short-chain fatty acids, have been shown to modulate host diseases. In this review, we examine how disease-associated metabolic signatures are identified using metabolomic platforms, and where metabolomics is applied in gut microbiota-disease interactions. We further explore how integration of metagenomic and me...
Source: Gastroenterology Clinics of North America - January 23, 2024 Category: Gastroenterology Authors: Yuxin Li, Shuo Han Source Type: research

Living Donor Intestinal Transplantation
This study explores intestinal transplantation (ITx) as a viable treatment option for intestinal failure (IF). Historical development, donor and recipient considerations, surgical techniques, immunosuppression, and outcomes, are reviewed with particular emphasis to the value of living donor ITx. The review highlights the evolution of ITx and emphasizes the ongoing need for patient-specific selection processes. In the realm of pediatric ITx, the article underlines the significance of early intervention to mitigate IF-related liver disease. Overall, it provides a comprehensive overview of this life-saving procedure. (Source:...
Source: Gastroenterology Clinics of North America - January 16, 2024 Category: Gastroenterology Authors: Pierpaolo Di Cocco, Alessandro Martinino, Federico Pinto, Benito Valdepenas, Mario Spaggiari, Ivo Tzvetanov, Enrico Benedetti Source Type: research

Chimerism-Mediated Tolerance in Intestinal Transplantation
In this review, the authors outlined concepts and strategies to achieve immune tolerance through inducing hematopoietic chimerism after solid organ transplantation and introduced challenges and opportunities in harnessing two-way alloresponses to improve outcomes after intestinal transplantation (ITx). Next, the authors discussed the dynamics and phenotypes of peripheral blood and intestinal graft T-cell subset chimerism and their association with outcomes. The authors also summarized studies on other types of immune cells after ITx and their potential participation in chimerism-mediated tolerance. The authors further disc...
Source: Gastroenterology Clinics of North America - January 16, 2024 Category: Gastroenterology Authors: Kevin Crosby, Katherine D. Long, Jianing Fu Source Type: research

Singing with or About Gastrointestinal Cancers
According to the World Cancer Research Fund International, the gastrointestinal (GI) tract is the organ system most affected by primary malignancies, with 30.7% of cancer cases originating in the GI tract. All areas of the GI tract, where food passes or are involved in the digestion or absorption of food, may be afflicted, from the mouth to the anus. Of these, colorectal cancers are the most common, with close to 2 million new cases annually worldwide. (Source: Gastroenterology Clinics of North America)
Source: Gastroenterology Clinics of North America - December 23, 2023 Category: Gastroenterology Authors: Alan L. Buchman Tags: Foreword Source Type: research

Pathology and Clinical Significance of Inflammatory Bowel Disease-Associated Colorectal Dysplastic Lesions
Timely diagnosis and effective management of colorectal dysplasia play a vital role in preventing mortality from colorectal cancer in patients with chronic inflammatory bowel disease. This review provides a contemporary overview of the pathologic and endoscopic classification of dysplasia in inflammatory bowel disease, their roles in determining surveillance and management algorithms, and emerging diagnostic and therapeutic approaches that might further enhance patient management. (Source: Gastroenterology Clinics of North America)
Source: Gastroenterology Clinics of North America - December 22, 2023 Category: Gastroenterology Authors: Noam Harpaz, Steven H. Itzkowitz Source Type: research

Hepatic Precancerous Lesions and Early Hepatocellular Carcinoma
This review discusses the diagnostic challenges of diagnosing and treating precursor lesions of hepatocellular carcinoma (HCC) in both cirrhotic and non-cirrhotic livers. The distinction of high-grade dysplastic nodule (the primary precursor lesion in cirrhotic liver) from early HCC is emphasized based on morphologic, immunohistochemical, and genomic features. The risk factors associated with HCC in hepatocellular adenomas (precursor lesion in non-cirrhotic liver) are delineated, and the risk in different subtypes is discussed with emphasis on terminology, diagnosis, and genomic features. (Source: Gastroenterology Clinics of North America)
Source: Gastroenterology Clinics of North America - December 16, 2023 Category: Gastroenterology Authors: Kwun Wah Wen, Sanjay Kakar Source Type: research

Early Cancerous Lesions of the Pancreas and Ampulla
Owing to the increased use of advanced imaging techniques, mass-forming (cystic/intraductal) preinvasive neoplasms are being detected much more frequently and they have rapidly become one of the main focuses of interests in medical field. These neoplasms have very distinctive clinical and radiographic findings, exhibit a spectrum of dysplastic transformation, from low-grade dysplasia to high-grade dysplasia, and may be associated with an invasive carcinoma. Accounting for about 5% to 10% of pancreatic ductal adenocarcinomas, they provide a curable target subset in an otherwise biologically dismal pancreas cancer category. ...
Source: Gastroenterology Clinics of North America - December 14, 2023 Category: Gastroenterology Authors: Olca Basturk, N. Volkan Adsay Source Type: research

Barrett's Esophagus and Associated Dysplasia
Early detection of dysplasia and effective management are critical steps in halting neoplastic progression in patients with Barrett's esophagus (BE). This review provides a contemporary overview of the BE-related dysplasia, its role in guiding surveillance and management, and discusses emerging diagnostic and therapeutic approaches that might further enhance patient management. Novel, noninvasive techniques for sampling and surveillance, adjunct biomarkers for risk assessment, and their limitations are also discussed. (Source: Gastroenterology Clinics of North America)
Source: Gastroenterology Clinics of North America - December 12, 2023 Category: Gastroenterology Authors: Deepa T. Patil, Robert D. Odze Source Type: research