Perioperative anesthetic management of a combined right atrial thrombectomy with living donor liver transplantation

We describe a case of HCC with vascular invasion and right atrial thrombus that was successfully down staged. Patient underwent combined right atrial thrombectomy and living donor liver transplantation (LDLT) in the same setting. Perioperative anesthesia management and perioperative concerns of two major combined procedures are discussed.
Source: Journal of Anaesthesiology Clinical Pharmacology - Category: Anesthesiology Authors: Source Type: research

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Conditions:   Carcinoma, Hepatocellular;   Portal Vein Tumor Thrombus Interventions:   Drug: Lenvatinib Pill;   Procedure: Transarterial chemoembolization(TACE);   Drug: Sorafenib Sponsor:   Beijing Ditan Hospital Enrolling by invitation
Source: ClinicalTrials.gov - Category: Research Source Type: clinical trials
Publication date: 3 October 2019Source: Cell, Volume 179, Issue 2Author(s): Qiang Gao, Hongwen Zhu, Liangqing Dong, Weiwei Shi, Ran Chen, Zhijian Song, Chen Huang, Junqiang Li, Xiaowei Dong, Yanting Zhou, Qian Liu, Lijie Ma, Xiaoying Wang, Jian Zhou, Yansheng Liu, Emily Boja, Ana I. Robles, Weiping Ma, Pei Wang, Yize LiSummaryWe performed the first proteogenomic characterization of hepatitis B virus (HBV)-related hepatocellular carcinoma (HCC) using paired tumor and adjacent liver tissues from 159 patients. Integrated proteogenomic analyses revealed consistency and discordance among multi-omics, activation status of key si...
Source: Cell - Category: Cytology Source Type: research
ute;s PL, Nuño J Abstract From the beginning of liver transplant implementation, biliary anastomosis has been considered its weakness. An anastomotic bile leak is the most frequent cause of bile in the peritoneum (choleperitoneum) after liver transplant but not the only one. Here, we report a 58-year-old man with hepatitis C virus-related cirrhosis who had orthotopic liver transplant due to presence of hepatocellular carcinoma.During the immediate postoperative period, bile leakwas diagnosed on trans-Kehr cholangiography. Contrast extravasation was observed on the graft's cystic duct, and no contrast flow i...
Source: Experimental and Clinical Transplantation : official journal of the Middle East Society for Organ Transplantation - Category: Transplant Surgery Authors: Tags: Exp Clin Transplant Source Type: research
ConclusionsCompared with surgical resection alone, postoperative adjuvant PVC treatment boosts survival and reduces early tumor recurrences in patients surgically treated for HCC and PVTT.
Source: Cancer Medicine - Category: Cancer & Oncology Authors: Tags: ORIGINAL RESEARCH Source Type: research
ConclusionBiliary drainage is one of the key points for successful treatment of icteric-type HCC patients. A staged approach with initial tumor thrombectomy followed by hepatectomy should be considered as one of the options for icteric-type HCC.
Source: International Journal of Surgery Case Reports - Category: Surgery Source Type: research
Portal vein tumor thrombosis (PVTT) is a common phenomenon in advanced stage hepatocellular carcinoma (HCC), with a prevalence rate ranging from 10% to 60% [1]. Patients with HCC and PVTT have a dismal prognosis, with an expected survival of 2 –4 months with the best supportive care [2]. Systemic therapy with Sorafenib is the current standard treatment, recommended by the Barcelona Clinic Liver Cancer (BCLC) staging system [3,4], although, survival benefit following Sorafenib administration is modest, with a median survival time of 5. 6–8.1 months [5,6].
Source: Physica Medica: European Journal of Medical Physics - Category: General Medicine Authors: Tags: Original paper Source Type: research
Abstract Objective: The blood of cancer patients is in a state of hypercoagulability, easily leading to thrombosis. Anemia is also a complication of tumors. Anemia and thrombosis affect the treatment of tumor patients. Methods: Ginsenosides Rb were extracted from the stems and leaves of American ginseng using water-saturated ethanol and ethyl acetate in silica gel column. Tumor mice model was established by injecting H22 hepatocellular carcinoma cells into the axilla of mice. Mice were randomly divided into 6 groups: normal control group, model control group, positive control group, low dose group (7 mg/kg), ...
Source: Biomed Res - Category: Research Authors: Tags: Biomed Res Int Source Type: research
ConclusionsElevated Six2 expression in HCC tumor patients was associated with negative prognosis. Upregulated Six2 promoted tumor growth and facilitated HCC metastasis via TGF-β/Smad signal pathway.
Source: Hepatobiliary and Pancreatic Diseases International - Category: Gastroenterology Source Type: research
AbstractPurposeTo determine the treatment outcome and prognostic factors for survival in patients with hepatocellular carcinoma (HCC) and macrovascular tumor thrombosis (MTT).MethodsBetween January 2010 and December 2018, 66 patients diagnosed with HCC and MTT, who received specific treatment were included. Various clinical and imaging data, treatment methods, outcomes, prognostic factors, and overall survival were evaluated. Outcomes were compared with those of 24 patients treated with supportive care.ResultsMost patients with HCC and MTT showed disease progression (80.3%) and a low 5-year survival rate. The median surviv...
Source: Japanese Journal of Radiology - Category: Radiology Source Type: research
Abstract The intimate connection and the strict mutual cooperation between the gut and the liver realizes a functional entity called gut-liver axis. The integrity of intestinal barrier is crucial for the maintenance of liver homeostasis. In this mutual relationship, the liver acts as a second firewall towards potentially harmful substances translocated from the gut, and is, in turn, is implicated in the regulation of the barrier. Increasing evidence has highlighted the relevance of increased intestinal permeability and consequent bacterial translocation in the development of liver damage. In particular, in patient...
Source: World Journal of Gastroenterology - Category: Gastroenterology Authors: Tags: World J Gastroenterol Source Type: research
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