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Liver transplantation for hepatocellular carcinoma

World Journal of Gastroenterology 2009年第44期15卷 5511-5516页

作者： Sudeep Tanwar Shahid A Khan Vijay Paul Bob Grover Catherine Gwilt belinda smith Ashley Brown Department of Hepatology and Gastroenterology Imperial College LondonSt Mary's Hospital CampusPraed StreetLondon W2 1NYUnited Kingdom

Hepatocellular carcinoma (HCC) is the commonest primary malignancy of the liver. It usually occurs in the setting of chronic liver disease and has a poor prognosis if untreated. Orthotopic liver transplantation (OLT) is a suitable therapeutic option for early,unresectable HCC particularly in the setting of chronic liver disease. Following on from disappointing initial results,the seminal study by Mazzaferro et al in 1996 established OLT as a viable treatment for HCC. In this study,the "Milan criteria" were applied achieving a 4-year survival rate similar to OLT for benign disease. Since then various groups have attempted to expand these criteria whilst maintaining long term survival rates. The technique of living donor liver transplantation has evolved over the past decade,particularly in Asia,and published outcome data is comparable to that of OLT. This article will review the evidence,indications,and the future direction of liver transplantation for liver cancer.

关键词： Hepatocellular carcinoma Selection criteria Liver transplantation Living donors

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Venous thromboembolism prophylaxis practice and its association with outcomes in Australia and New Zealand burns patients

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Burns & Trauma 2021年第1期9卷 642-651页

作者： Lincoln M.Tracy Peter A.Cameron Yvonne Singer Arul Earnest Fiona Wood Heather Cleland belinda J.Gabbe School of Public Health and Preventive Medicine Monash University553 St Kilda RoadMelbourneVictoria3004Australia Emergency and Trauma Centre The Alfred HospitalCommercial RoadMelbourneVictoria3004Australia Victorian Adult Burns Service Alfred Hospital55 Commercial RoadMelbourneVictoria3004AustraliaAustralia Registry Sciences Unit Department of Epidemiology and Preventive MedicineMonash University553 St Kilda RoadMelbourneVictoria3004Australia Biostatistics Unit Department of Epidemiology and Preventive MedicineMonash University553 St Kilda RoadMelbourneVictoria3004Australia Burn Injury Research Unit University of Western Australia35 Stirling HighwayPerthWestern Australia6009Australia Health Data Research UK Swansea University Medical SchoolSwansea UniversitySingleton ParkSwanseaUK

Background:Patients with burn injuries are considered to have an increased risk of venous thromboembolism(VTE).While untreated VTEs can be fatal,no studies have examined chemoprophylaxis *** study aimed to quantify the variation in prevalence of VTE prophylaxis use in patients in Australian and New Zealand burns units and whether prophylaxis use is associated with in-hospital outcomes following burn ***:Admission data for adult burns patients(aged≥16 years)admitted between 1 July 2016 and 31 December 2018 were extracted from the Burns Registry of Australia and New *** effects logistic regression modelling investigated whether VTE prophylaxis usewas associated with the primary outcome of in-hospital ***:There were 5066 admissions over the study *** these patients,81%(n=3799)with a valid response to the VTE prophylaxis data field received some form of VTE *** of VTE prophylaxis ranged from 48.6%to 94.8%of patients between ***-hospital death was recorded in<1%of patients(n=33).After adjusting for confounders,receiving VTE prophylaxis was associated with a decrease in the adjusted odds of in-hospital mortality(adjusted odds ratio=0.21;95%CI,0.07–0.63;p=0.006).Conclusions:Variation in the use of VTE prophylaxis was observed between the units,and prophylaxis use was associated with a decrease in the odds of *** findings provide an opportunity to engage with units to further explore differences in prophylaxis use and develop future best practice guidelines.

关键词： Burn injury Venous thromboembolism Prophylaxis Australia New Zealand

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