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Liver transplantation for hepatocellular carcinoma:an update

Hepatobiliary & Pancreatic Diseases International 2011年第3期10卷 234-242页

作者： ali zarrinpar Fady Kaldas Ronald W Busuttil Dumont-UCLA Transplant Center Division of Liver and Pancreas Transplantation Department of Surgery David Geffen School of Medicine at UCLA

BACKGROUND: Hepatocellular carcinoma (HCC) is a heterogeneous malignancy with multiple etiologies, high incidence, and high mortality. The standard surgical management for patients with HCC consists of locoregional ablation, surgical resection, or liver transplantation, depending on the background state of the liver. Eighty percent of patients initially presenting with HCC are unresectable, either due to the extent of tumor or the level of underlying hepatic dysfunction. While in patients with no evidence of cirrhosis and good hepatic function resection has been the surgical treatment of choice, it is contraindicated in patients with moderate to severe cirrhosis. Liver transplantation is the optimal surgical treatment. DATA SOURCES: PubMed search of recent articles (from January 2000 to March 2011) was performed looking for relevant articles about hepatocellular carcinoma and its treatment. Additional articles were identified by evaluating references from selected articles. RESULTS: Here we review criteria for transplantation, the types, indications, and role of locoregional therapy in treating the cancer and in downstaging for possible later transplantation. We also summarize the contribution of immunosuppression and adjuvant chemotherapy in the management and prevention of HCC recurrence. Finally we discuss recent advances in imaging, tumor biology, and genomics as we delineate the remaining challenges for the diagnosis and treatment of this disease. CONCLUSIONS: Much can be improved in the diagnosis and treatment of HCC. A great challenge will be to improve patient selection to criteria based on tumor biology. Another will be to incorporate systemic agents post-operatively in patients at high risk for recurrence, paying close attention to efficacy and safety. The future direction of the effort in treating HCC will be to stimulate prospective trials, develop molecular imaging of lymphovascular invasion, to improve recipient selection, and to investigate biomarkers

关键词： liver transplantation hepatocellular carcinoma liver neoplasm downstaging immunosuppression locoregional therapy

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3D human nonalcoholic hepatic steatosis and fibrosis models

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Bio-Design and Manufacturing 2021年第2期4卷 157-170页

作者： Sushila Maharjan Diana Bonilla Princy Sindurakar Hongbin Li Wanlu Li Sergio Duarte ali zarrinpar Y.Shrike Zhang Division of Engineering in Medicine Department of MedicineBrigham and Women’s HospitalHarvard Medical School65 Landsdowne StCambridgeMA 02139USA Department of Biology College of the Holy CrossWorcesterMA 01610USA Department of Surgery University of Florida1600 SW Archer RdGainesvilleFL 32610USA Department of Biomedical Engineering University of FloridaGainesvilleFL 32610USA Department of Biochemistry and Molecular Biology University of FloridaGainesvilleFL 32610USA

This study presents a simple and robust three-dimensional human hepatic tissue model to emulate steatotic and fibrotic conditions and provide an in vitro model for drug testing and mechanistic *** a photolithographic biofabrication method with a photomask featuring hexagonal units,liver cells,including a human hepatic cell line(HepG2-C3A)and a human hepatic stellate cell line(LX-2)were embedded in gelatin methacryloyl *** steatosis was induced by supraphysiological concentration of free fatty acids;hepatic fibrosis was induced by transforming growth factor-β*** of steatosis was confirmed by Oil Red O and BODIPY staining and was inhibited with toyocamycin and obeticholic *** of fibrosis was confirmed by immunostaining for collagen type I and alpha smooth muscle actin and inhibited by rapamycin and curcumin *** model was further preliminarily validated using primary human hepatocytes in a similar *** constructs provide a viable,biologically relevant,and higher throughput model of hepatic steatosis and fibrosis and may facilitate the study of the mechanisms of disease and testing of liver-directed drugs.

关键词： Nonalcoholic fatty liver disease(NAFLD) Gelatin methacryloyl(GelMA) Photocrosslinking Steatosis

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