Cells and Tissues Transplantation. Actualities and Perspectives: The Materials of the National Scientific Conference with International Participation, the 4 th edition, Chisinau, March 20-21, 2026

Lung transplantation in the management of cystic fibrosis

2026-04-03T15:49:52Z

Lung transplantation in the management of cystic fibrosis Rotaru, Ludmila; Rotaru, Tudor Introduction. Cystic fibrosis (CF) is an autosomal recessive genetic disorder caused by mutations in the CFTR gene, affecting multiple organs, particularly the lungs, and leading to progressive respiratory failure. Despite therapeutic advances, some patients progress to advanced stages of the disease, for whom lung transplantation represents the only option with a significant impact on survival. Materials and Methods. A narrative synthesis of specialized literature was conducted using GeneCards, PubMed, the National Library of Medicine, and Hinari, focusing on publications from the past 10 years. Results. Analysis of the specialized literature indicates that lung transplantation in patients with advanced CF leads to significant improvements in respiratory function and quality of life. Posttransplant survival is estimated at 80–90% at one year, 78–82.8% at three years, and 69–77% at five years, while long-term survival at 10 years ranges between 50–62%, with a median of approximately 10–10.7 years. Clinical factors, including chronic infections and post-transplant rejection, influence prognosis, whereas lung retransplantation is associated with lower survival compared to primary transplantation, highlighting the importance of rigorous patient selection and optimal timing of intervention. Optimization of perioperative management and personalized immunosuppressive therapy contributes to complication reduction and improved survival. Multidisciplinary coordination of patient management further enhances clinical outcomes and long-term survival. Conclusions. Lung transplantation represents an essential intervention for patients with advanced CF, significantly improving life expectancy. Rigorous perioperative management, personalized immunosuppressive therapy, and multidisciplinary coordination contribute to the reduction of postoperative complications and improved clinical outcomes. Post-transplant risks persist, requiring continuous monitoring and adaptive interventions.

Fecal microbiota transplantation in metabolic syndrome

2026-04-03T15:45:32Z

Fecal microbiota transplantation in metabolic syndrome Potînga, Irina; Protopop, Svetlana Introduction. Metabolic syndrome (MetS) is a multifactorial disease, and the gut microbiota plays an important role in its pathogenesis. Moreover, recent studies suggest associations between gut dysbiosis and components of MetS. Materials and methods. A descriptive review was conducted on the effects of FMT on MetS components, based on the specialized literature from the period 2015-2025, selected from the PubMed, Springer Nature, BMC databases. Results. The aim of the study is to evaluate the impact of fecal microbiota transplantation (FMT) on patients with MetS. Most of the reviewed studies, in the first 6 weeks after FMT, reported changes in the composition of the gut microbiota and improvements in some clinical parameters: reduction in glycemia, insulinemia and glycated hemoglobin (HbA1c) levels, and increase in HDL-cholesterol levels. Regarding LDL-cholesterol, triglycerides, anthropometric parameters and blood pressure, most studies did not identify significant changes. These results suggest that FMT may improve some metabolic parameters in the short term. Regarding long-term effects, fewer studies have been conducted and their results are controversial. At least 2 studies associate FMT with reduction in abdominal adiposity and changes in the overall composition of the gut microbiota at 26 weeks after FMT. The improvement in insulin sensitivity, reduction in blood glucose, HbA1c and LDL-cholesterol were transient and, in most cases, statistically insignificant. Also, there were no significant differences in weight and body mass index compared to the placebo group. Conclusions. Fecal microbiota transplantation, as an adjuvant therapy, may be useful in the treatment of metabolic syndrome. However, further studies are needed to better understand the molecular mechanisms by which gut microbiota metabolites influence laboratory parameters and clinical conditions of metabolic syndrome.

Pancreatic islet cell autotransplantation as a therapeutic option in chronic pancreatitis complicated by pancreatic pseudocyst

2026-04-03T15:42:05Z

Pancreatic islet cell autotransplantation as a therapeutic option in chronic pancreatitis complicated by pancreatic pseudocyst Pîrțac, Mihail; Berliba, Sergiu; Chira, Inga; Ciobanu, Lorina Introduction. In the management of chronic pancreatitis (CP), pancreatic pseudocyst (PCP) is a complication that requires the attention of surgeons, provided that it is non-neoplastic, recurrent, >6 cm in size, persists >4 weeks, has calcifications, causes ductal strictures, is refractory to endoscopic drainage and endoscopic ductal decompression. When CP is complicated by such a PCP, which progressively destroys the parenchyma, total pancreatectomy with pancreatic islet cell autotransplantation (PACT) can be opted for. Objectives. To analyze the relevance of using PACT in patients with PCP who opt for total pancreatectomy, to evaluate the clinical success and post-operative risks. Materials and methods. Research of scientific literature, from electronic databases such as PubMed, Web of Science and ScienceDirect, was conducted for the last decade. Results. ACIP represents the last therapeutic step when all other medical alternatives fail. The nonfunctional pancreas is completely removed, the islets are isolated from the extracted pancreas, and the islets are retransplanted into the portal vein, thus preserving the reserve of insulin and C-peptide secretion . To increase the therapeutic yield, it is necessary to comply with several clinical conditions: severe CP, basal glycemia <200 mg/dL, HbA1c <8%, islet-positive patient, age <60 years, absence of terminal diseases and advanced cirrhosis. The major contraindication is the presence of type 1 diabetes, since there is a risk of immune rejection of the islet transplant. Post-ACIP results are promising with clinical improvement of up to 90%. Beneficial effects include: reduced risk of insulin dependence and avoidance of severe hyperglycemia, maintenance of normal HbA1c for at least 12 months, pain relief and opioid withdrawal (59%), and total insulin independence when IEQ/kg > 5000 (48%). Post-ACIP risks include: endocrine morbidity (18.6%), postoperative hemorrhage (10%), exocrine symptoms (43.5%), postpancreatectomy pancreatogenic diabetes (<1%), portal vein thrombosis (5%) and mortality (1.6%). Perioperative morbidity is 50%, with the need for surgical reintervention in 16% of patients. Conclusions. ACIP offers an advantageous therapeutic combination for patients with pancreatic complications, such as PCP: it relieves pain, allows preservation of endocrine function and the perioperative risk is minimal.

Implementing regenerative medecine across surgical pathways in liver cirrhosis

2026-04-03T15:28:35Z

Implementing regenerative medecine across surgical pathways in liver cirrhosis Negarî, Nadejda; Minchevici, Delia; Cazacov, Vladimir; Nacu, Viorel Introduction: Liver cirrhotic patients often face surgical and interventional procedures, such as hepatectomy with modulation of future liver remnant, portoenterostomy in cases of biliary atresia, transjugular intrahepatic portosystemic shunt, and liver transplant. Regenerative medicine is progressively tested for the improvement of liver regeneration, prevention of progression of liver fibrosis, and reduction of liver failure. Materials and methods: A systematic review (2020-2026) was performed in PubMed/Medline, Scopus, and ClinicalTrials.gov using “cirrhosis”, “mesenchymal stem cells/MSC/umbilical cord”, “liver-derived progenitor/HALPC/HepaStem”, “organoid/iPSC/hepatocyte-like cells”, and procedural terms like “Kasai”, “transplantation”, “hepatectomy”, “portal vein embolization”, “ALPPS”, “future liver remnant”. The information was collected regarding population, time frame, delivery method, evaluation criteria, and safety. The selection was made using descriptive statistics due to heterogeneity in results. Results: Allogeneic infusion of umbilical cord-derived mesenchymal stem cells has been performed in postoperative cirrhotic patients after Kasai portoenterostomy, allowing the short-term monitoring of liver function. The perioperative administration of MSC has been tested in a controlled form in transplant patients to modulate alloimmune responses, reduce inflammatory damage, and boost graft recovery of function. Liver-derived progenitor products: the development of human allogeneic liverderived progenitor cells (HALPC/HepaStem) in severe cirrhosis-related syndromes such as ACLF gave a regulated development platform that could be potentially applied to surgical mitigation. Regenerative liver surgery, including portal vein embolization, liver venous deprivation, and ALPPSbased procedures, represents the most established strategy to enhance the growth of the future liver remnant in selected patients with compromised liver parenchyma to reduce the risk of posthepatectomy liver failure. In contrast, the iPSC-based graft strategies have been in the field of translation, thus limiting the perioperative use of such methods. Conclusions: Regenerative strategies for operative cirrhosis remain advanced for surgical interventions that stimulate pre-hepatectomy hypertrophy, while MSC and liver-derived progenitor cell-based regenerative therapies remain in early-phase, safety-focused trials for the post-Kasai and peri-transplant context. Future research should focus on standard product, procedure-specific timing, endpoints such as MELD/Child-Pugh, portal hypertension, post-hepatectomy liver failure, and properly powered randomized trials within surgical pathways.