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SIMAP500: A novel risk score to identify recipients at higher risk of hepatocellular carcinoma recurrence following liver transplantation

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World Journal of Transplantation 2024年第3期14卷 132-143页

作者： Amr Alnagar Nekisa Zakeri Konstantinos Koilias Rosemary E Faulkes Rachel Brown Owen Cain M Thamara P R Perera Keith J Roberts Rebeca Sanabria-Mateos David C Bartlett Yuk Ting Ma Shivan Sivakumar Shishir Shetty Tahir Shah Bobby V M Dasari department of hbp and Liver Transplantation surgery Queen Elizabeth HospitalUniversity Hospitals BirminghamBirmingham B152GWUnited Kingdom Centre for Liver Research Institute of Biomedical ResearchBirmingham B152TTUnited Kingdom department of Hepatology Queen Elizabeth HospitalUniversity Hospitals BirminghamBirmingham B152GWUnited Kingdom department of Pathology University Hospitals Birmingham NHS Foundation TrustBirmingham B152GWUnited Kingdom department of Oncology Queen Elizabeth HospitalUniversity Hospitals of BirminghamBirmingham B152GWUnited Kingdom

BACKGROUND Recurrence of hepatocellular carcinoma(HCC)following liver transplantation(LT)has a devastating influence on recipients’survival;however,the risk of recur-rence is not routinely *** stratification is vital with a long LT waiting time,as that could influence the recurrence despite strict listing *** This study aims to identify predictors of recurrence and develop a novel risk pre-diction score to forecast HCC recurrence following *** A retrospective review of LT for HCC recipients at University Hospitals Bir-mingham between July 2011 and February *** and multivariate analyses were performed to identify recurrence predictors,based on which the novel SIMAP500(satellite nodules,increase in size,microvascular invasion,AFP>500,poor differentiation)risk score was *** 234 LTs for HCC were performed with a median follow-up of 5.3 *** developed in 25 patients(10.7%).On univariate analyses,RETREAT score>3,α-fetoprotein(AFP)at listing 100-500 and>500,bridging,increased tumour size between imaging at the listing time and explant histology,increase in the size of viable tumour between listing and explant,presence of satellite nodules,micro-and macrovascular invasion on explant and poor differentiation of tumours were significantly associated with recurrence,based on which,the SIMAP500 risk score is *** SIMAP500 demonstrated an excellent predictive ability(c-index=0.803)and outper-formed the RETREAT score(c-index=0.73).SIMAP500 is indicative of the time to disease *** SIMAP500 risk score identifies the LT recipients at risk of HCC *** stratification allows patient-centric post-transplant surveillance *** validation of the score is recommended.

关键词： Liver transplantation Hepatocellular carcinoma Recurrence Survival

Decision-making in high-risk leakage duodenopancreatectomy:pancreatic anastomosis or total pancreatectomy?

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Hepatobiliary surgery and Nutrition 2023年第4期12卷 567-569页

作者： Lazare Sommier Fabrizio Panaro Division of hbp surgery and Transplantation Department of SurgeryMontpellier University HospitalSchool of MedicineMontpellierFrance

The Italian team from Verona,questions the place of total pancreatectomy(TP)as an alternative to pancreaticoduodenectomy(PD)in patients at high risk of pancreatic fistula in a monocentric retrospective study running from July 2017 to December 2019(1).A total of 702 patients were included,566 PD of which 101 were at high risk of pancreatic fistula(HR-PD),136 TP of which 86 were PD converted to TP(C-TP)for positive margin of pancreatic section for malignancy(49%),extensive vascular resection(14%)or technical reasons(27%)such as residual non-reconstructible pancreas/friable pancreas/microscopic Wirsung’s duct,10% for other reasons(bleeding......)Patients in the HR-PD group received externalized stent of the Wirsung duct.

关键词： High risk fistula pancreatic anastomosis pancreaticoduodenectomy(PD) total pancreatectomy(TP)

Comment on:“Liver transplantation for iatrogenic bile duct injury during cholecystectomy:a French retrospective multicenter study”

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Hepatobiliary surgery and Nutrition 2022年第4期11卷 577-579页

作者： Salah Khayat Fabrizio Panaro department of surgery/Division of hbp surgery&Transplantation Montpellier University Hospital-School of MedicineMontpellierFrance

We read with great interest the national retrospective multicenter observational study recently published by Chiche and collaborators(1)aiming to review liver transplants related to iatrogenic bile duct injury(BDI)during cholecystectomy and the risk factors for adverse outcomes in order to improve management of *** this study,all liver transplantation(LT)patients between 1994 and 2017 for BDI during cholecystectomy were *** patients were included in 11 French LT centers representing 0.13%of LT indications over this period.

关键词： bile cholecystectomy injury

Intra-operative trans-cystic indocyanine green(ICG)cholangiography:a high-sensitive method to identify bile Ieakage after hepatic resection

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Hepatobiliary surgery and Nutrition 2020年第2期9卷 260-262页

作者： Piera Leon Fabrizio Panaro Division of hbp surgery and Transplantation Department of SurgerySt.Eloi HospitalMontpellier University Hospital-School of MedicineMontpellierFrance

Liver resections are more and more performed *** mortality for hepatic surgery is decreasing over the time,morbidity is still high and mostly affected by bile leak which remain the Achilles’heel of this type of ***,s... 详细信息

关键词： bile operative hepatic

Liver venous deprivation:a bright future for liver metastases-but what about hepatocellular carcinoma?

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Hepatobiliary surgery and Nutrition 2021年第2期10卷 270-272页

作者： Boris Guiu Astrid Herrero Fabrizio Panaro department of Radiology St-Eloi University HospitalMontpellierFrance department of hbp surgery&Transplantation St-Eloi University HospitalMontpellierFrance

Liver venous deprivation(LVD)refers to the percutaneous procedure aiming to simultaneously abrogate both portal inflow and hepatic venous outflow to accelerate liver regeneration of the future liver remnant(FLR),which limits patient drop-out from resection due either to insufficient FLR or tumor *** authors have designated the exact same technique under the acronym RASPE(Radiological Simultaneous Porto-hepatic Vein Embolization)(1)while others reported on‘double embolization’for designating portal vein embolization(PVE)and proximal embolization of one hepatic vein,keeping patent distal venous branches and veno-venous collaterals(2).

关键词： venous Liver deprivation

Small-cell neuroendocrine carcinoma arising from an extra-hepatic bile duct:a case report

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Gastroenterology Report 2021年第4期9卷 380-382,I0003页

作者： Jae Ryong Shim Jae Ri Kim Youngmok Park Hyung-Il Seo Division of hbp surgery and Transplantation Pusan National University Yangsan HospitalYangsanKorea department of surgery Biomedical Research InstitutePusan National University HospitalGudeok-roSeoguBusanKorea

Introduction Neuroendocrine tumors(NETs)are neoplasms with variable malignant potential that may arise from neuroendocrine *** gastrointestinal tract is a common site for primary NETs and annually 1.3 for every 100,000 persons are newly detected[1,2].Although gastrointestinal NETs are common in the small bowel,appendix,rectum,and stomach,those that arise from the extra-hepatic bile duct are extremely rare(0.1%–0.4%)[3-5].

关键词：肝外胆管小细胞神经内分泌癌 neoplasms 病例报告

Sengstaken-Blakemore tubes:a rescue system during liver transplantation

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Hepatobiliary surgery and Nutrition 2022年第1期11卷 171-172页

作者： Antonio Cubisino Fabrizio Panaro Division of General Minimally Invasive and Robotic SurgeryUniversity of Illinois at ChicagoChicagoILUSA Division of hbp surgery and Transplantation Department of SurgeryHôpital Saint EloiCHU-MontpellierMontpellierFrance

A 52-year-old woman has undergone liver transplantation(LT)owing to fulminant viral hepatitis,MELD *** first cadaveric graft allocated was a large-for-size *** was performed with a piggyback side-to-side cavocaval *** the end of the procedure,the removal of the abdominal retractor produced,due to a narrow ribcage,a caval compression with liver congestion because of a reduced caval outflow.

关键词： liver anastomosis graft

Analyzing predictors of graft survival in patients undergoing liver transplantation with donors aged 70 years and over

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World Journal of Gastroenterology 2018年第47期24卷 5391-5402页

作者： Oscar Caso-Maestro Carlos Jiménez-Romero Iago Justo-Alonso Jorge Calvo-Pulido David Lora-Pablos Alberto Marcacuzco-Quinto Félix Cambra-Molero Alvaro García-Sesma Marina Pérez-Flecha Carlos Munoz- Arce Carmelo Loinaz-Segurola Alejandro Manrique-Municio Unit of hbp surgery and Abdominal Organs Transplantation Department of General Surgery“12 de octubre” University HospitalMadrid 28041Spain Clinical Research department Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP)“12 de octubre” University HospitalMadrid 28041Spain

AIM To increase the number of available *** This is a single-center comparative analysis performed between April 1986 and May 2016. Two hundred and twelve liver transplantation(LT) were performed with donors ≥ 70 years old(study group). Then, we selected the first cases that were performed with donors < 70 years old immediately after the ones that were performed with donors ≥ 70 years old(control group).RESULTS Graft and patient survivals were similar between both groups without increasing the risk of complications, especially primary non-function, vascular complications and biliary complications. We identified 5 risk factors as independent predictors of graft survival: recipient hepatitis C virus(HCV)-positivity [hazard ratio(HR) = 2.35; 95% confidence interval(CI): 1.55-3.56; P = 0.00]; recipient age(HR = 1.04; 95%CI: 1.02-1.06; P = 0.00); donor age X model for end-stage liver disease(D-MELD)(HR = 1.00; 95%CI: 1.00-1.00; P = 0.00); donor value of serum glutamic-pyruvic transaminase(HR = 1.00; 95%CI: 1.00-1.00; P = 0.00); and donor value of serum sodium(HR = 0.96; 95%CI: 0.94-0.99; P = 0.00). After combining D-MELD and recipient age we obtained a new scoring system that we called DR-MELD(donor age X recipient age X MELD). Graft survival significantly decreased in patients with a DR-MELD score ≥ 75000, especially in HCV patients(77% vs 63% at 5 years in HCV-negative patients, P = 0.00; and 61% vs 25% at 5 years in HCV-positive patients; P = 0.00). CONCLUSION A DR-MELD ≥ 75000 must be avoided in order to obtain the best results in LT with donors ≥ 70 years old.

关键词： Liver transplantation Aged donors Old donors Marginal donors Donor age

Comment on:liver venous deprivation(LVD)or associating liver partition and portal vein ligation for staged hepatectomy(ALPPS)?A retrospective multicentric study

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Hepatobiliary surgery and Nutrition 2021年第5期10卷 675-677页

作者： Edouard Girard Bertrand Trilling Mircea Chirica Division of hbp surgery and Transplantation Department of Digestive and Emergency SurgeryGrenoble-Alpes University HospitalGrenobleFrance Univ.Grenoble Alpes CNRSCHU Grenoble AlpesGrenoble INPTIMC-IMAGGrenobleFrance

We read with interest the recently published paper by Chebaro et al.(1).The authors compared liver venous deprivation(LVD)and associating liver partition and portal vein ligation for staged hepatectomy(ALPPS)which are two novel techniques used to achieve increased hypertrophy of the future liver remnant(FLR)in view of extensive liver resections(2,3).

关键词： liver deprivation