Beasleyastrup4951
The right atrium was reached
a transdiaphragramatic approach. Hepatectomy was performed
with the retrohepatic vena cava. It was reconstructed with an infra-hepatic vena cava graft obtained from a deceased donor. The patient remains well on outpatient clinic follow-up 25 mo after the procedure, under an anticoagulation protocol with warfarin.
Living-donor LT in BCS with IVC thrombosis is feasible using a meticulous surgical technique and tailored strategies.
Living-donor LT in BCS with IVC thrombosis is feasible using a meticulous surgical technique and tailored strategies.
The oral nucleos(t)ide analogue, entecavir (ETV) was demonstrated to reduce the rate of hepatocellular carcinoma (HCC) in patients with hepatitis B virus (HBV)-associated liver cirrhosis. However, the reduction of HCC differs in various regions of the world.
To investigate the reduction of HCC development due to ETV therapy by meta-analysis.
We surveyed the differences in HCC development following ETV treatment based on published articles using PubMed (2004-2019).
The regions with the most marked reduction in HCC development due to ETV therapy were Spain (1.0%/year) and Canada (Southern part, 1.3%/year), and the most ineffective areas were South Korea (3.6%-3.8%/year), China (3.3%/year), Taiwan (2.4%-3.1%/year), and Hong Kong (2.8%/year). find more Following ETV administration, the incidence of HCC in genotype D regions (1.89% ± 0.28%/year, mean ± SE) was significantly lower than that in genotype C regions (2.91% ± 0.24%/year,
< 0.01). With regard to the initial HBV-DNA level, in genotype C patients (average 5.61 Log
IU/mL) this was almost the same as that in genotype D patients (average 5.46 Log
IU/mL). Moreover, there was no association between the prevalence ratio of HBV and the incidence of HCC on ETV treatment.
The effectiveness of ETV in preventing HCC development in HBV-associated liver cirrhosis is genotype-dependent.
The effectiveness of ETV in preventing HCC development in HBV-associated liver cirrhosis is genotype-dependent.
Abnormal liver function tests (LFTs) in post-liver transplant (LT) patients pose a challenge in the timing and selection of diagnostic modalities. There are little data regarding the accuracy of endoscopic retrograde cholangiopancreatography (ERCP) and liver biopsy (LB) in diagnosing post-transplant complications.
To evaluate the diagnostic performance of ERCP and LB in patients with non-vascular post-LT complications.
This single-center retrospective study evaluated patients undergoing both ERCP and LB for evaluation of elevated LFTs within 6 mo of LT from 2000 to 2017. Diagnostic operating characteristics including accuracy, sensitivity and specificity for various diagnoses were calculated for ERCP and LB. The R factor (ratio of alkaline phosphatase to alanine aminotransferase) was also calculated for each patient.
Of the 1284 patients who underwent LT, 91 patients (74.7% males, mean age of 51) were analyzed. Anastomotic strictures (AS, 24.2%), acute cellular rejection (ACR, 11%) and concurrent AS/ACR (14.3%) were the most common diagnoses. ERCP carried an accuracy of 79.1% (95%CI 69.3-86.9), LB had an accuracy of 93.4% (95%CI 86.2-97.5), and the combination of the two had an accuracy of 100% (95%CI 96-100). There was no difference between patients with AS and ACR in mean R factor (AS 1.9
ACR 1.1,
= 0.24). Adverse events did not differ between the two tests (ERCP 3.1%
LB 1.1%,
= 0.31).
In patients with abnormal LFTs after LT without vascular complications, the combination of LB and ERCP carries low risk and improves diagnostic accuracy over either test alone.
In patients with abnormal LFTs after LT without vascular complications, the combination of LB and ERCP carries low risk and improves diagnostic accuracy over either test alone.
Infections and associated morbidity and mortality may be more frequent in children who have undergone liver transplant than in healthy children. Immunization strategies to prevent vaccine-preventable infections (VPIs) can effectively minimize this infection burden. However, data on age-appropriate immunization and VPIs in children after liver transplant in Asia are limited.
To evaluate the immunization status, VPIs and non-VPIs requiring hospitalization in children who have undergone a liver transplant.
The medical records of children who had a liver transplant between 2004 and 2018 at King Chulalongkorn Memorial Hospital (Bangkok, Thailand) were retrospectively reviewed. Immunization status was evaluated
their vaccination books. Hospitalization for infections that occurred up to 5 years after liver transplantation were evaluated, and divided into VPIs and non-VPIs. Hospitalizations for cytomegalovirus and Epstein-Barr virus were excluded. Severity of infection, length of hospital stay, ventilator su common sites of infection. The most common pathogens that caused VPIs were rotavirus, influenza virus, and varicella-zoster virus.
Incomplete immunization was common pre- and post-transplant, and nearly all children required hospitalization for non-VPIs or VPIs within 5 years post-transplant. Infection severity was high in the first year post-transplant.
Incomplete immunization was common pre- and post-transplant, and nearly all children required hospitalization for non-VPIs or VPIs within 5 years post-transplant. Infection severity was high in the first year post-transplant.
Hepatitis C virus (HCV) infection is a public health concern worldwide. Several factors, including genetic polymorphisms, may be evolved in the progression of HCV infection to liver diseases. Interferon lambdas (IFNLs) modulate the immune response during viral infections. IFNLs induce antiviral activity, interfering in the viral replication by promoting the expression of several genes that regulate immunological functions. The interferon lambda-4 (
) rs12979860 polymorphism, which is characterized by a C to T transition in intron 1, is associated with spontaneous and treatment-induced clearance of HCV infection and may play a role in the development of HCV-associated liver diseases, including hepatocellular carcinoma (HCC).
To investigate the association of
rs12979860 polymorphism with fibrosis, cirrhosis, and HCC in patients with chronic HCV infection.
This study was comprised of 305 chronic HCV-infected patients (53 fibrosis, 154 cirrhosis, and 98 HCC cases). The control group was comprised of 260 HCV-negative healthy individuals.