Outcomes after primary and repeat thermal ablation of hepatocellular carcinoma with or without liver transplantation
Objectives: Thermal ablation (TA) is an established treatment for early HCC. There is a lack of data on the efficacy of repeated TA for recurrent HCC, resulting in uncertainty whether good oncologic outcomes can be obtained without performing orthotopic liver transplantation (OLTx). This study analyses outcomes after TA, with a special focus on repeat TA for recurrent HCC, either as a stand-alone therapy, or in relationship with OLTx. Methods: Data from a prospectively registered database on interventions for HCC in a tertiary [...]
A Clinical Tool to Guide Selection and Utilization of Marginal Donor Livers With Graft Steatosis in Liver Transplantation
Background. Donor liver biopsy (DLBx) in liver transplantation provides information on allograft quality; however, predicting outcomes from these allografts remains difficult. Methods. Between 2006 and 2015, 16 691 transplants with DLBx were identified from the Standard Transplant Analysis and Research database. Cox proportional hazard regression analyses identified donor and recipient characteristics associated with 30-d, 90-d, 1-y, and 3-y graft survival. A composite model, the Liver Transplant After Biopsy (LTAB) score, was created. The Mini-LTAB was then derived consisting of only donor [...]
Attitudes of Canadian Colorectal Cancer Care Providers towards Liver Transplantation for Colorectal Liver Metastases: A National Survey
Abstract: Up to 50% of colorectal cancer (CRC) patients develop colorectal liver metastases (CRLM). The aim of this study was to gauge the awareness and perception of liver transplantation (LT) for non-resectable CRLM, and to describe the current referral patterns and management strategies for CRLM in Canada. Surgeons who provide care for patients with CRC were invited to an online survey through the Canadian Association of General Surgeons, the Canadian Society of Colon and Rectal Surgeons, and the Canadian Society [...]
Importance of reconstruction of middle hepatic vein tributaries of right-lobe grafts in living donor liver transplantation: demonstration of the reconstruction technique
Purpose The aim of the present study on living donor liver transplantation (LDLT) using a right-lobe graft without the middle hepatic vein (MHV) was to investigate the clinical impact of MHV tributary reconstruction using our criteria and techniques. Methods The medical records of 40 patients who underwent adult LDLT using a right-lobe graft without the MHV between April 2008 and December 2020 were retrospectively reviewed. In this cohort, the criterion for MHV tributary reconstruction was estimated drainage volume of each [...]
Choledochoduodenostomy is associated with fewer post-transplant biliary complications compared to Roux-en-Y in primary sclerosing cholangitis patients
Background For primary sclerosing cholangitis (PSC) patients undergoing liver transplantation (LT), a consensus regarding biliary reconstruction remains unresolved. Choledochoduodenostomy (CDD) represents an alternative to Roux-en-Y (RY) and duct-to-duct. We compared long-term post-transplant outcomes between CDD and RY. Methods This was a retrospective review of patients transplanted for PSC who received CDD or RY, with minimum 12-months follow-up. The primary outcome was need for biliary intervention, with either percutaneous transhepatic cholangiography (PTC) or endoscopic retrograde cholangiopancreatography (ERCP). Secondary outcomes included biliary [...]
Four Years of Hepatic Transplantation in the Republic of Moldova
Rezumat Din momentul primului transplant hepatic în Republica Moldova, în 2013, am efectuat 30 de transplante hepatice, primele dintre ele realizate în colaborare cu echipa chirurgicală din România, condusă de Profesorul Irinel Popescu. Deficitul critic de organe cadaverice disponibile ne-au impus să debutăm cu transplant hepatic cu hemi- ficat drept de la donator viu. Într-o treime de transplante hepatice am utilizat grefa de hemificat drept [...]