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Liver transplantation as an alternative for the treatment of perihilar cholangiocarcinoma: A critical review

Hepatobiliary & Pancreatic diseases International 2024年第2期23卷 139-145页

作者： Wellington Andraus Francisco Tustumi Alexandre Chagas Santana Rafael Soares Nunes Pinheiro daniel Reis Waisberg Liliana ducatti Lopes Rubens Macedo Arantes Vinicius Rocha Santos Rodrigo Bronze de Martino luiz augusto carneiro d’Albuquerque department of Gastroenterology Transplantation UnitUniversidade de São PauloSão PauloBrazil

Background:Perihilar cholangiocarcinoma(phCCC)is a dismal *** is no consensus regard-ing the best treatment for patients with unresectable *** present review aimed to gather the current pieces of evidence for liver transplantation and liver resection as a treatment for phCCC and to build better guidance for clinical *** sources:The search was conducted in PubMed,Embase,Cochrane,and *** related references were searched *** criteria were:reports in English or Portuguese literature that a)patients with confirmed diagnosis of phCCC;b)patients treated with a curative intent;c)patients with the outcomes of liver resection and liver *** reports,reviews,letters,editorials,conference abstracts and papers with full-text unavailability were excluded from the ***:Most of the current literature is based on observational retrospective studies with low grades of *** resection has better long-term outcomes than systemic chemotherapy or palliation ther-apy and liver transplantation is a good alternative for selected patients with unresectable *** candidates for resection or transplantation should be medically fit and free of intrahepatic or extrahep-atic *** a general rule,patients presenting with a tumor having a longitudinal size>3 cm or extending below the cystic duct,lymph node disease,confirmed extrahepatic dissemination;intraoper-atively diagnosed metastatic disease;a history of other malignancies within the last five years,and did not complete chemoradiation regimen and were medically unfit should not be considered for *** of these criteria should be individually *** transplantation or resection should only be considered in highly experienced hepatobiliary centers,and any decision-making must be based on a multidisciplinary ***:phCCC is a complex condition with high *** therapies,including hepatec-tomy and liv

关键词： Liver transplantation Cholangiocarcinoma Liver neoplasms

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Review of experimental attempts of islet allotransplantation in rodents:Parameters involved and viability of the procedure

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World Journal of Gastroenterology 2014年第37期20卷 13512-13520页

作者： Leandro Ryuchi Iuamoto Alberto Meyer Eleazar Chaib luiz augusto carneiro d'Albuquerque department of Gas-troenterology Liver and Pancreas Transplantation Surgery UnitUniversity of Sao Paulo

The purpose of the present study was to organize the parameters involved in experimental allotransplantation in rodents to elaborate the most suitable model to supply the scarcity of islet donors. We used the PubMed database to systematically search for published articles containing the keywords “rodent islet transplantation” to review. We included studies that involved allotransplantation experiments with rodents’ islets, and we reviewed the reference lists from the eligible publications that were retrieved. We excluded articles related to isotransplantation, autotransplantation and xenotransplantation, i.e., transplantation in other species. A total of 25 studies related to allotransplantation were selected for systematic review based on their relevance and updated data. Allotransplantation in rodents is promising and continues to develop. Survival rates of allografts have increased with the discovery of new immunosuppressive drugs and the use of different graft sites. These successes suggest that islet transplantation is a promising method to overcome the scarcity of islet donors and advance the treatment options for type 1 diabetes.

关键词： Islet transplantation Allograft Immunosuppression Type 1 diabetes Islet grafts diabetes mellitus Islet Hyperglycemia

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Current aspects of renal dysfunction after liver transplantation

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World Journal of Hepatology 2022年第1期14卷 45-61页

作者： Mariana P Pacheco luiz augusto carneiro-d'Albuquerque daniel F Mazo division of Clinical Gastroenterology and Hepatology Department of GastroenterologyUniversity of São Paulo School of MedicineSao Paulo 05403-900Sao PauloBrazil division of digestive Organs Transplant Department of GastroenterologyUniversity of São Paulo School of MedicineSao Paulo 05403-900Sao PauloBrazil division of Gastroenterology Department of Internal MedicineSchool of Medical Sciences of University of CampinasCampinas 13083-878Sao PauloBrazil

The development of chronic kidney disease(CKd)after liver transplantation(LT)exerts a severe effect on the survival of *** widespread adoption of the model for end-stage liver disease score strongly impacted CKd incidence after the procedure,as several patients are transplanted with previously deteriorated renal *** to its multifactorial nature,encompassing pre-transplantation conditions,perioperative events,and nephrotoxic immunosuppressor therapies,the accurate identification of patients under risk of renal disease,and the implementation of preventive approaches,are extremely *** for the evaluation of renal function in this setting range from formulas that estimate the glomerular filtration rate,to non-invasive markers,although no option has yet proved efficient in early detection of kidney *** the nephrotoxicity of calcineurin inhibitors(CNI)as a factor of utmost importance after LT,early nephroprotective strategies are highly *** are based mainly on delaying the application of CNI during the immediate postoperativeperiod,reducing their dosage,and associating them with other less nephrotoxic drugs,such as mycophenolate mofetil and *** review provides a critical assessment of the causes of renal dysfunction after LT,the methods of its evaluation,and the interventions aimed at preserving renal function early and belatedly after LT.

关键词： Liver transplantation Acute kidney injury Chronic kidney disease Calcineurin inhibitor Mycophenolic acid Everolimus

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Unusual cause of gastrointestinal bleeding in a cirrhotic patient:hepatocellular carcinoma with gastric invasion

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Hepatobiliary & Pancreatic diseases International 2009年第4期8卷 431-433页

作者： Marcos Vinicius Perini Paulo Herman Rodrigo Pessoa Willian Abraao Saad luiz augusto carneiro d’Albuquerque University of So Paulo School of Medicine Department of GastroenterologyDigestive Surgery DivisionSo PauloSPBrazil

BACKGROUNd:Upper gastrointestinal(GI)bleeding is a common complication of portal hypertension in cirrhotic patients,and hepatocellular carcinoma(HCC)is the most common tumor in cirrhotic *** from tumor erosion into the GI tract is very rare.A patient with HCC and gastric tumor invasion was described and the previously reported cases were reviewed. METHOd:A patient with upper GI bleeding was treated in a tertiary hospital. RESULTS:A cirrhotic patient with a HCC invading the stomach leading to upper GI bleeding was treated by left lateral segmentectomy and sub-total *** bleeding was controlled and a good surgical outcome was achieved. CONCLUSIONS:HCC with gastric invasion should be differentially diagnosed from upper GI bleeding in cirrhotic *** can be controlled and symptomatic relief marked in selected cases.

关键词： hepatocellular carcinoma gastintestinal hemorrhage surgery bleeding

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Liver transplantation:Fifty years of experience

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World Journal of Gastroenterology 2014年第18期20卷 5363-5374页

作者： Alice Tung Wan Song Vivian Iida Avelino-Silva Rafael Antonio Arruda Pecora Vincenzo Pugliese luiz augusto carneiro d'Albuquerque Edson Abdala Liver and digestive Organ Transplantation Unit Gastroenterology DepartmentUniversity of Sao Paulo Medical SchoolSao Paulo 05403-900Brazil Infectious diseases department University of Sao Paulo Medical SchoolSao Paulo 05403-900Brazil Hepatitis Research Laboratory Infectious Diseases DepartmentUniversity of Sao Paulo Medical SchoolSao Paulo 05403-000Brazil

Since 1963,when the first human liver transplantation(LT)was performed by Thomas Starzl,the world has witnessed 50 years of development in surgical techniques,immunosuppression,organ allocation,donor selection,and the indications and contraindications for *** has led to the mainstream,wellestablished procedure that has saved innumerable lives ***,there are hundreds of liver transplant centres in over 80 *** review aims to describe the main aspects of LT regarding the progressive changes that have occurred over the *** herein review historical aspects since the first experimental studies and the first attempts at human *** also provide an overview of immunosuppressive agents and their potential side effects,the evolution of the indications and contraindications of LT,the evolution of survival according to different time periods,and the evolution of methods of organ allocation.

关键词： Liver transplantation History Survival Indications Organ allocation

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Perioperative blood transfusion decreases long-term survival in pediatric living donor liver transplantation

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World Journal of Gastroenterology 2021年第12期27卷 1161-1181页

作者： Karina Gordon Estela Regina Ramos Figueira Joel Avancini Rocha-Filho luiz Antonio Mondadori Eduardo Henrique Giroud Joaquim Joao Seda-Neto Eduardo Antunes da Fonseca Renata Pereira Sustovitch Pugliese Agustin Moscoso Vintimilla Jose Otavio Costa Auler Jr Maria Jose Carvalho Carmona luiz augusto carneiro d.alburquerque division of Anesthesiology Hospital das ClínicasUniversity of São Paulo School of MedicineSão Paulo 05403-000Brazil department of Anesthesiology AC Camargo Cancer CenterSão Paulo 01509-010Brazil department of Gastroenterology Discipline of Liver and Gastrointestinal TransplantationLaboratory of Medical Investigations LIM37 Hospital das ClinicasUniversity of São Paulo School of MedicineSão Paulo 05402-000Brazil department of Liver Transplantation AC Camargo Cancer CenterSão Paulo 01525-901Brazil department of Gastroenterology Division of Liver and Gastrointestinal TransplantHospital das ClinicasUniversity of São Paulo School of MedicineSão Paulo 05402-000Brazil

BACKGROUNd The impact of perioperative blood transfusion on short-and long-term outcomes in pediatric living donor liver transplantation(PLdLT)must still be ascertained,mainly among young *** and surgical postoperative complications related to perioperative blood transfusion are well described up to three months after adult liver *** To determine whether transfusion is associated with early and late postoperative complications and mortality in small patients undergoing *** We evaluated the effects of perioperative transfusion on postoperative complications in recipients up to 20 kg of body weight,submitted to PLdLT.A total of 240 patients were retrospectively allocated into two groups according to postoperative complications:Minor complications(n=109)and major complications(n=131).Multiple logistic regression analysis identified the volume of perioperative packed red blood cells(RBC)transfusion as the only independent risk factor for major postoperative *** receiver operating characteristic curve was drawn to identify the optimal volume of the perioperative RBC transfusion related to the presence of major postoperative complications,defining a cutoff point of 27.5 mL/***,patients were reallocated to a low-volume transfusion group(LTr;n=103,RBC≤27.5 mL/kg)and a high-volume transfusion group(HTr;n=137,RBC>27.5 mL/kg)so that the outcome could be *** High-volume transfusion was associated with an increased number of major complications and mortality during hospitalization up to a 10-year follow-up *** a short-term period,the HTr showed an increase in major infectious,cardiovascular,respiratory,and bleeding complications,with a decrease in rejection complications compared to the *** a long-term period,the HTr showed an increase in major infectious,cardiovascular,respiratory,and minor neoplastic complications,with a decrease in rejection ***,Cox hazard regr

关键词： Liver transplantation Child Blood transfusion Outcome Liver cirrhosis Mortality

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Living-donor liver transplantation in Budd-Chiari syndrome with inferior vena cava complete thrombosis:A case report and review of the literature

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World Journal of Hepatology 2021年第1期13卷 151-161页

作者： Vinicius Rocha-Santos daniel Reis Waisberg Rafael Soares Pinheiro Lucas Souto Nacif Rubens Macedo Arantes Liliana ducatti Rodrigo Bronze Martino Luciana Bertocco Haddad Flavio Henrique Galvao Wellington Andraus luiz augusto carneiro-d.alburquerque department of Gastroenterology Abdominal Organs Transplantation DivisionHospital das Clinicas da Faculdade de Medicina da Universidade de Sao Paulo(HC-FMUSP)Sao Paulo 05403900SPBrazil department of Gastroenterology Laboratory of Medical Investigation 37(LIM-37)Faculdade de Medicina da Universidade de Sao Paulo(FMUSP)Sao Paulo 01246903Brazil

BACKGROUNd Budd-Chiari syndrome(BCS)is a challenging indication for liver transplantation(LT)due to a combination of massive liver,increased bleeding,retroperitoneal fibrosis and frequently presents with stenosis of the inferior vena cava(IVC).Occasionally,it may be totally thrombosed,increasing the complexity of the procedure,as it should also be *** challenge is even greater when performing living-donor LT as the graft does not contain the retrohepatic IVC;thus,it may be necessary to reconstruct *** SUMMARY A 35-year-old male patient with liver cirrhosis due to BCS and hepatocellular carcinoma beyond the Milan criteria underwent living-donor LT with IVC *** was necessary to remove the IVC as its retrohepatic portion was completely thrombosed,up to almost the right atrium.A right-lobe graft was retrieved from his sister,with outflow reconstruction including the right hepatic vein and the branches of segment V and VIII to the middle hepatic *** to massive subcutaneous collaterals in the abdominal wall,venovenous bypass was implemented before incising the *** right atrium was reached via a transdiaphragramatic *** was performed en bloc with the retrohepatic vena *** was reconstructed with an infra-hepatic vena cava graft obtained from a deceased *** patient remains well on outpatient clinic follow-up 25 mo after the procedure,under an anticoagulation protocol with *** Living-donor LT in BCS with IVC thrombosis is feasible using a meticulous surgical technique and tailored strategies.

关键词： Liver transplantation Living donors Budd-Chiari syndrome Hepatic venoocclusive disease Inferior vena cava Case report

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Evaluation of elastic-viscoplastic self-consistent models for a rolled AZ31B magnesium alloy under monotonic loading along five different material orientations and free-end torsion

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Journal of Magnesium and Alloys 2023年第4期11卷 1264-1275页

作者： Xianyun Zhu Yuqian Wang luiz carneiro Huamiao Wang Yanyao Jiang Light Alloy Research Institute Central South UniversityChangsha 410012China department of Mechanical Engineering University of NevadaRenoNV 89557USA College of Mechanical Engineering Shanghai Jiao Tong UniversityShanghaiChina

Comprehensive experiments including monotonic tension and monotonic compression of specimens taken from a rolled AZ31B Mg thick plate along five different material orientations with respect to the rolled direction(Rd),and free-end torsion of a tubular specimen machined along the thickness direction(Nd)were *** experimental results were used to evaluate an elastic-viscoplastic self-consistent model with the consideration of twinning and detwinning(EVPSC-TdT)on magnesium(Mg)*** EVPSC-TdT model provides stress-strain curves and the hardening rates in close agreement with the experimental results of all the 11 loading *** model adequately predicts the textures after fracture of all the 11 loading cases and the evolutions of tension twins with increasing strains for tension in the Nd,compression in the Rd,and torsion along the *** Swift effect was observed in the experiment and was properly simulated by the model.

关键词： Magnesium alloy Crystal plasticity Twinning Material orientation

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Change in neoadjuvant chemotherapy could alter the prognosis of patients with pancreatic adenocarcinoma: A case report

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World Journal of Clinical Cases 2021年第14期9卷 3418-3423页

作者： Alberto Meyer Bárbara J Carvalho Kayo AA Medeiros Leonardo Z Pipek Fernanda S Nascimento Milena O Suzuki João VT Munhoz Leandro R Iuamoto luiz A carneiro-d.alburquerque Wellington Andraus Gastroenterologia Hospital das Clínicas HCFMUSPFaculdade de MedicinaUniversidade de São PauloSão Paulo 01426-010Brazil Gastroenterologia Faculdade de Medicinada Universidade de São PauloSão Paulo 05403-000Brazil Orthopaedics and Traumatology Faculdade de Medicinada Universidade de São PauloSão Paulo 05403-000Brazil

BACKGROUNd Neoadjuvant treatment has become a standard of care for borderline or locally advanced pancreatic cancer and is increasingly considered even for up-front resectable *** aim of this article is to present the case of a 62-year-old patient with locally advanced pancreatic adenocarcinoma who was successfully treated with gemcitabine plus nab-paclitaxel after the failure of the first line *** SUMMARY Computerized tomography scan and magnetic resonance imaging demonstrated a nodular lesion of ill-defined limits in the body of the pancreas,measuring approximately 4.2 cm×2.7 cm,with an infiltrative *** tumor had contact with the superior mesenteric vein,splenomesenteric junction and the proximal segment of the splenic artery,causing focal reduction of its *** to vascular involvement,neoadjuvant chemotherapy treatment with eight cycles of“folinic acid,5-fluorouracil,irinotecan and oxa-liplatine”(FOLFIRINOX)were *** the end of the cycles,surgery was performed,but the procedure was interrupted due to finding of lesions suspected of *** plus nab-paclitaxel was then successfully used for neoadjuvant treatment with subsequent R0 surgical *** Gemcitabine plus nab-paclitaxel may be effective as an alternative regimen when FOLFIRINOX fails as the first line of treatment,suggesting the need for further studies to identify which patients would benefit from each type of therapeutic approach.

关键词： Neoadjuvant chemotherapy Pancreatic cancer Resectable pancreatic cancer Borderline resectable Neoadjuvant Pancreas Case report

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Beneficial effects of adenosine triphosphate-sensitive K^+ channel opener on liver ischemia/reperfusion injury

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World Journal of Gastroenterology 2014年第41期20卷 15319-15326页

作者： Mateus Antunes Nogueira Ana Maria Mendona Coelho Sandra Nassa Sampietre Rosely Antunes Patzina Fabiano Pinheiro da Silva luiz augusto carneiro d'Albuquerque Marcel Cerqueira Cesar Machado department of Gastroenterology (LIM/37) Medical SchoolUniversity of Sao Paulo department of Clinical Emergency (LIM/51) Medical SchoolUniversity of Sao Paulo

AIM: To investigate the effect of diazoxide administration on liver ischemia/reperfusion injury.

关键词： Liver ischemia/reperfusion diazoxide K+ channel opener Mitochondrial ATP-sensitive potassium channel Liver mitochondria

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