Percutaneous ablation of hepatocellular carcinoma: State‐of‐the‐art

Riccardo Lencioni, Dania Cioni, Laura Crocetti, Carlo Bartolozzi – 30 January 2004 – Percutaneous ablation is considered the best treatment option for patients with early‐stage hepatocellular carcinoma (HCC) who are not candidates for surgical resection or liver transplantation. Several methods have been developed, including intratumoral injection of ethanol or acetic acid, and thermal ablation with radiofrequency, laser, microwaves, or cryosurgery. Percutaneous ethanol injection (PEI) has been the most widely used technique.

Estimation of glomerular filtration rates before and after orthotopic liver transplantation: Evaluation of current equations

Thomas A. Gonwa, Linda Jennings, Martin L. Mai, Paul C. Stark, Andrew S. Levey, Goran B. Klintmalm – 30 January 2004 – The ability to estimate rather than measure the glomerular filtration rate (GFR) in patients before and after liver transplantation would be helpful in estimating risk, dosing drugs, and assessing long‐term toxicity of calcineurin inhibitors. Currently available equations for estimating the GFR have not been validated in either the pre‐ or post‐liver transplant population.

A common staging system for hepatocellular carcinoma

Adrian M. Di Bisceglie, Steven Strasberg – 30 January 2004 – The Consensus Panel makes the following recommendations based on the above currently available evidence. 1The primary staging should be clinical staging, which can be applied to all patients. The CLIP system should be the clincial staging system of choice, because it is generally applicable to most patients, it includes easily collected variables. Most importantly, it has been externally and prospectively validated.

Bile acids enhance the activity of the insulin receptor and glycogen synthase in primary rodent hepatocytes

Song Iy Han, Elaine Studer, Seema Gupta, Youwen Fang, Liang Qiao, Weiqun Li, Steven Grant, Philip B. Hylemon, Paul Dent – 30 January 2004 – Previously, we demonstrated that deoxycholic acid (DCA)‐induced ERK1/2 and AKT signaling in primary hepatocytes is a protective response. In the present study, we examined the regulation of the phosphatidylinositol 3 (PI3) kinase/AKT/glycogen synthase (kinase) 3 (GSK3)/glycogen synthase (GS) pathway by bile acids.

Laparoscopic iatrogeny of the hepatic hilum as an indication for liver transplantation

Juan Angel Fernández, Ricardo Robles, Caridad Marín, Francisco Sánchez‐Bueno, Pablo Ramírez, Pascual Parrilla – 6 January 2004 – The introduction of biliary laparoscopic surgery led to an increase in the incidence of liver hilum injuries. These types of lesions are very serious, because they can lead to secondary biliary cirrhosis or fulminant hepatic failure and the need for liver transplantion (LT). We present three cases of liver hilum injuries, which were treated with LT; one case was due to severe and persistent cholangitis, and two cases were due to fulminant hepatic failure.

Hepatic arterial anatomy for right liver procurement from living donors

Yoji Kishi, Yasuhiko Sugawara, Junichi Kaneko, Nobuhisa Akamatsu, Hiroshi Imamura, Hirotaka Asato, Norihiro Kokudo, Masatoshi Makuuchi – 6 January 2004 – Living donor liver transplantation (LDLT) using right liver grafts is now widely performed. Anatomic classifications of the hepatic artery for right liver procurement, however, are limited. In this study, celiac and mesenteric angiograms of 223 consecutive living donors in a single institution were evaluated. Details of the arterial anastomosis and results were reviewed in 72 patients who underwent primary LDLT using right liver grafts.

Incomplete improvement of visuo‐motor deficits in patients with minimal hepatic encephalopathy after liver transplantation

Sergei Mechtcheriakov, Ivo W. Graziadei, Michael Mattedi, Thomas Bodner, André Kugener, Hartmann H. Hinterhuber, Josef Marksteiner, Wolfgang Vogel – 6 January 2004 – Previous studies have suggested reversibility of minimal hepatic encephalopathy in patients with liver cirrhosis after liver transplantation (LT), however, this topic is controversially discussed. We investigated this issue in a prospective study on liver cirrhotic patients listed for LT.

Hepatitis B virus genotype A and D and clinical outcomes of liver transplantation for HBV‐related disease

Raffaele Girlanda, Abdul H Mohsen, Heather Smith, Erwin Sablon, Man‐Fung Yuen, John O'Grady, Paolo Muiesan, Mohamed Rela, Nigel Heaton, Suzanne Norris – 6 January 2004 – Hepatitis B virus (HBV) genotypes have been associated with specific patterns of disease and response to antiviral therapy. We investigated the effect of HBV genotype on HBV recurrence and mortality after liver transplantation (LT). Pretransplant sera of 45 hepatitis B surface antigen (HBsAg) positive adults were submitted for HBV genotyping by a reverse‐phase hybridization line probe assay with genotype‐specific probes.

A prospective cross‐over study comparing the effect of mycophenolate versus azathioprine on allograft function and viral load in liver transplant recipients with recurrent chronic HCV infection

Amany Zekry, Margret Gleeson, Seren Guney, Geoffrey W. McCaughan – 6 January 2004 – It has been suggested that Mycophenolate Mofetil (MMF) may have an antiviral effect in patients with recurrent HCV infection post‐liver transplantation. We conducted a prospective cross‐over study in liver transplant recipients with recurrent chronic HCV infection to examine whether substitution of azathioprine (AZA) with MMF would reduce HCV load and improve allograft function. Thirteen long standing HCV liver transplant recipients receiving AZA were enrolled in a 9‐month prospective cross‐over study.

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