John P. Roberts, Alan Venook, Robert Kerlan, Francis Yao – 27 July 2010 – This opinion piece explores an “ablate and wait” strategy for improving the 5‐year recurrence‐free outcome of liver transplantation in patients with hepatocellular carcinoma. The Milan criteria delimit by tumor size and number a population of patients who have good survival after liver transplantation.
Fabio Piscaglia, Alessandro Cucchetti, Eleonora Terzi, Alice Gianstefani – 27 July 2010
Mahesh Bandara, Fredric D. Gordon, Akmal Sarwar, M. Elizabeth Knauft, Elizabeth A. Pomfret, Richard B. Freeman, Joel A. Wirth – 27 July 2010 – Pulmonary arterial hypertension (PAH) associated with portal hypertension [portopulmonary hypertension (PPHTN)] occurs in 2% to 10% of patients with advanced liver disease and carries a very poor prognosis without treatment. Most hepatic transplantation centers consider moderate to severe PPHTN to be a contraindication to liver transplantation because of the high rate of perioperative complications.
Kymberly D. S. Watt, Elizabeth Coss, Rachel A. Pedersen, Ross Dierkhising, Julie K. Heimbach, Michael R. Charlton – 27 July 2010 – Optimizing the utility of liver transplantation requires the identification of factors that confer increased risk of posttransplant mortality. Elevated serum troponin (TN) levels are strongly predictive of posttransplant mortality after kidney transplantation.
Eric J. Grossman, J. Michael Millis – 27 July 2010 – Orthotopic liver transplantation (OLT) is currently incorporated into the treatment regimens for specific nonhepatocellular malignancies. For patients suffering from early‐stage, unresectable hilar cholangiocarcinoma (CCA), OLT preceded by neoadjuvant radiotherapy has the potential to readily achieve a tumor‐free margin, accomplish a radical resection, and treat underlying primary sclerosing cholangitis when present. In highly selected stage I and II patients with CCA, the 5‐year survival rate is 80%.
Maurizio Biselli, Stefano Gitto, Annagiulia Gramenzi, Roberto Di Donato, Lucia Brodosi, Matteo Ravaioli, Gian Luca Grazi, Antonio Daniele Pinna, Pietro Andreone, Mauro Bernardi – 27 July 2010 – Many prognostic systems have been devised to predict the outcome of liver transplantation (LT) candidates. Today, the Model for End‐Stage Liver Disease (MELD) is widely used for organ allocation, but it has shown some limitations. The aim of this study was to investigate the performance of MELD compared to 5 different score models.
Toshiyasu Kawahara, Christian Toso, Donna N. Douglas, Mahra Nourbakhsh, Jamie T. Lewis, David Lorne Tyrrell, Garry A. Lund, Thomas A. Churchill, Norman M. Kneteman – 27 July 2010 – Human hepatocyte transplantation is an alternative treatment for acute liver failure and liver diseases involving enzyme deficiencies. Although it has been successfully applied in selected recipients, both isolation and transplantation outcomes have the potential to be improved by better donor selection.
Thomas A. Aloia, Richard Knight, A. Osama Gaber, R. Mark Ghobrial, John A. Goss – 27 July 2010 – Older recipient age is associated with worse posttransplant survival. Although the median age of liver disease patients undergoing orthotopic liver transplantation (OLT) continues to rise, prognostic factors for posttransplant survival specific to older patients have not been defined.
Michael J. Englesbe, Douglas E. Schaubel, Shijie Cai, Mary K. Guidinger, Robert M. Merion – 27 July 2010 – Portal vein thrombosis (PVT) complicates the liver transplant operation and potentially affects waiting list survival. The implications on calculations of survival benefit, which balance both waiting list and posttransplant survival effects of PVT, have not been determined. The objective of this study is to describe the effect of PVT on the survival benefit of liver transplantation.
Giacomo Germani, Amar Dhillon, Lorenzo Andreana, Vincenza Calvaruso, Penelopi Manousou, Graziella Isgró, Andrew Kenneth Burroughs – 23 July 2010