Revisiting the indications for liver transplantation in cirrhotic patients considering the long ‐term outcomes of cirrhotic patients

In this study, we investigated long ‐term survival of cirrhotic patients without hepatocellular carcinoma (HCC) and the proper timing of liver transplantation in the era with recent progress of management.Patients and MethodsWe first classified 217 non ‐transplant cirrhotic patients without HCC according to the long‐term survival based on Child‐Turcotte‐Pugh (CTP) scores and the MELD scores. And then, we compared them with the survival after liver transplantation in 114 patients with liver cirrhosis.ResultsWe classified into 4 groups (class A as CTP score of 5,6, B as 7,8, C as 9 ‐12, D as 13‐15) according to the long‐term survival of the patients, the survivals of patients with class C and D were significantly worse compared with transplant patients (P
Source: Journal of Hepato-Biliary-Pancreatic Sciences - Category: Gastroenterology Authors: Tags: ORIGINAL ARTICLE Source Type: research

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ConclusionsThe 5 ‐5‐500 rule could predict prognosis in BCLC‐B patients with hepatic resection. Hepatic resection might provide survival benefit for selected patients with BCLC‐B HCC within the 5‐5‐500 rule.
Source: Journal of Hepato-Biliary-Pancreatic Sciences - Category: Gastroenterology Authors: Tags: ORIGINAL ARTICLE Source Type: research
Liver transplanted patients are at high risk of metabolic syndrome and its complications. We aimed to prospectively evaluate the early onset of cardiovascular alterations in patients submitted to the transplant waiting list. From January 2014 to January 2016, 54 out of 79 patients on the waiting list with decompensated cirrhosis or hepatocellular-carcinoma received the transplant, 50 were followed for 24 months, 2 died post-surgery and 2 were lost to follow-up. A significantly increased prevalence of visceral adiposity (epicardial adipose tissue thickness (p  = 0.001) and worsening of carotid damage (p = 0.003) and...
Source: Digestive and Liver Disease - Category: Gastroenterology Authors: Tags: Liver, Pancreas and Biliary Tract Source Type: research
Background: Hepatocellular carcinoma (HCC) accounts for 90% of primary hepatic malignancies. With the exception of chronic hepatitis B (CHB), other etiologies of chronic liver disease require progression to cirrhosis before HCC development. Case reports have described HCC in noncirrhotic patients with hepatitis C (HCV) and nonalcoholic fatty liver disease. Goal: The aim of this study was to determine the prevalence of patients without cirrhosis and CHB who developed HCC among a large cohort of HCC patients and to identify independent variables that are associated with no cirrhosis among patients with HCC. Study: Fr...
Source: Journal of Clinical Gastroenterology - Category: Gastroenterology Tags: LIVER, PANCREAS & BILIARY TRACT: Original Articles Source Type: research
Abstract De novo hepatocellular carcinoma (HCC) post‐transplantation in patients without viral hepatitis is extremely rare, with only three reported adult cases in the English literature. Here, we present a case of de novo HCC that developed in a 7‐year‐old female, who at 8 months of age received a liver, small bowel, spleen, and pancreas transplantation 6.5 years ago for gastroschisis and total parenteral nutrition (TPN)‐related cirrhosis. The post‐transplant course was complicated by Epstein‐Barr virus (EBV) infection, post‐transplant lymphoproliferative disease, and subsequent development of multifoca...
Source: Pediatric Transplantation - Category: Transplant Surgery Authors: Tags: CASE REPORT Source Type: research
Conclusion MBL2 rs11003123 polymorphism may be a marker for the risk of HCC occurrence in patients with HBV-related cirrhosis in the Chinese population.
Source: Hepatobiliary and Pancreatic Diseases International - Category: Gastroenterology Source Type: research
ConclusionsPTCS in conjunction with endoscopic and radiologic interventions can aid in managing post‐LT biliary complications and avoiding reoperation. This article is protected by copyright. All rights reserved.
Source: Journal of Hepato-Biliary-Pancreatic Sciences - Category: Gastroenterology Authors: Tags: Original Article Source Type: research
Conclusion Nrf2 and Nrf2-related genes are aberrantly expressed in the liver in different diseases and the increase of NQO1 was the most notable finding, especially in HCC.
Source: Hepatobiliary and Pancreatic Diseases International - Category: Gastroenterology Source Type: research
Conclusions: In patients with cirrhosis, serum ferritin levels are associated with markers of liver insufficiency, inflammation, and circulatory dysfunction but not portal hypertension.
Source: Journal of Clinical Gastroenterology - Category: Gastroenterology Tags: LIVER, PANCREAS AND BILIARY TRACT: Original Articles Source Type: research
Conclusions Adjuvant chemotherapy after LT for HCC can significantly prolong patient's survival and delay the recurrence of HCC. For advanced HCC with poor differentiation, patients may perhaps benefit from the early implantation of adjuvant chemotherapy after LT.
Source: Hepatobiliary and Pancreatic Diseases International - Category: Gastroenterology Source Type: research
Conclusions Much can be done to prevent HCC recurrence after liver transplantation. In future, effort is likely to be directed towards combining multidisciplinary approaches and various treatment modalities.
Source: Hepatobiliary and Pancreatic Diseases International - Category: Gastroenterology Source Type: research
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