According to current knowledge, IBS is primarily classified as a functional disorder, characterized by altered functioning in the central nervous system and the brain-gut axis. Stress plays a major role in sustaining specific mechanisms associated with IBS, contributing to high comorbidity with psychiatric disorders and a substantial deterioration in patients' quality of life. Following recommendations, it is worth examining the psychological aspects that may influence or maintain the experience of symptoms at a physical, cognitive, or behavioural level. The present study attempts to do this by discussing factors, such as GI symptom-specific anxiety, catastrophizing, somatization, or health anxiety. Understanding the complexity of IBS is facilitated by the biopsychosocial model, supporting clinicians in proficient patient management, particularly through multidisciplinary collaboration.

EUS and ERCP developed independently for some years, but in today’s practice they started to converge with each other. For instance, in the case of jaundice due to a pancreatic head tumor we can provide diagnostic (histology sampling, loco-regional staging) and therapeutic (biliary duct stenting, celiac neurolysis) help to the patient with the integrated approach. EUS is a very attractive technique, even among ERCP professionals, due to the advanced need for accurate and real-time imaging information before any therapeutic manoeuvres in the management of bilio-pancreatic pathologies. EUS, which was first developed as an exlusively diagnostic technique, has acquired therapeutic roles, and interventional ERCP recently returned to its original intraductal diagnostic purpose in recent years. The combination of their diagnostic and therapeutic potential is powerful in many clinical situa­tions, such as indeterminate biliary stenosis, biliary stones, chronic pancreatitis and bilio-pancreatic malignancies. The integration between EUS and ERCP can be expressed in different clinical scenarios highlighted in the publication, showing the clinical applicability of performing the two procedures in one endoscopic session, with its positive implications for the patient, the endoscopist and the health care system.

The results of liver transplantation in Hungary are no different from international ones, but the transplant profession suffers from the same donor shortage that causes difficulties in the rest of the world. Joining the Eurotransplant organ exchange program 10 years ago was a milestone in Hungarian organ transplantation, the number of liver transplants practically doubled. However, many domestic initiatives played at least as much role in this background, which led decisively to an increase in domestic donation activity. Unfortunately, during the COVID-19 pandemic, due to the workload of intensive care units, the number of donations decreased by more than 33% and since then it has not been possible to fulfil the pre-2020 activity. This, of course, also affects the number of liver transplants. The use of partial grafts (living donor, "split") can only be considered in sporadic cases; therefore no sharp improvement can be expected from this. The solution would be to report and care for a higher proportion of brain dead as donors as a base source for transplants, as well as filling the waiting list and higher organ acceptance rates. The former would require professional consultation with the associated professions due to a change in the indication area, as other diseases have come to the fore due to the results achieved in the treatment of HCV and HBV. PSC is currently the most common indication in Hungary, but there is a need for more widespread use of liver transplantation in the field of cancer diseases as well. The acceptance of organs basically depends on their quality, but in Hungary, as everywhere in the world, the proportion of extended criteria donors (ECD) is constantly increasing. These grafts are inferior in quality to standard grafts, so their use may also result in worse outcomes. Organ quality could be improved by using various machine perfusion techniques, but in Hungary we are more than 20 years behind in technology due to lack of funding. With the availability of machine perfusion, organ acceptance rates would certainly increase. Another special form of ECD and another possibility of increasing the number of donors is the use of organs from donation after circulatory death (DCD), in Hungary professional discussions are ongoing regarding its introduction. However, in the case of DCD, machine perfusion is essential during liver transplantation. KEYWORDS: liver transplantation, waiting list, organ donation