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Ex vivo liver resection and auto-transplantation as an alternative for the treatment of liver malignancies: Progress and challenges

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Hepatobiliary & Pancreatic Diseases International 2024年第2期23卷 117-122页

作者： Xin Yang Lu Lu Wen-Wei Zhu Yi-Feng Tao Cong-Huan Shen Jin-Hong Chen Zheng-Xin Wang Lun-Xiu Qin Hepatobiliary Surgery and liver transplantation Centers Department of General SurgeryHuashan Hospital&Cancer Metastasis InstituteFudan UniversityShanghai 200040China

Hepatectomy is still the major curative treatment for patients with liver ***,it is still a big challenge to remove the tumors in the central posterior area,especially if their location involves the retrohepatic inferior vena cava and hepatic *** vivo liver resection and auto-transplantation(ELRA),a hybrid technique of the traditional liver resection and transplantation,has brought new hope to these patients and therefore becomes a valid alternative to liver *** to its technical difficulty,ELRA is still concentrated in a few hepatobiliary centers that have experienced surgeons in both liver resection and liver *** efficacy and safety of this technique has already been demonstrated in the treatment of benign liver diseases,especially in the advanced alveolar ***,the application of ELRA for liver malignances has gained more ***,standardization of clinical practice norms and international consensus are still *** prognostic impact in these oncologic patients also needs further *** this review,we summarized the principles and recent progresses on ELRA.

关键词： Ex vivo liver resection liver auto-transplantation Oncology liver malignancies

Beyond the Rex: an innovative meso-intrahepatic portal vein bypass for late-onset extrahepatic portal vein occlusion after living donor liver transplantation

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Hepatobiliary Surgery and Nutrition 2024年第4期13卷 662-668页

作者： Chee-Chien Yong Hsu-Ting Yen Yu-Fan Cheng Leona Bettina Dungca Raymond Joseph De Vera Itsuko Chih-Yi Chen Chao-Long Chen department of Surgery Liver Transplantation CenterKaohsiung Chang Gung Memorial HospitalChang Gung University College of MedicineKaohsiung department of Cardiovascular Surgery Liver Transplantation CenterKaohsiung Chang Gung Memorial HospitalChang Gung University College of MedicineKaohsiung department of Diagnostic Radiology Liver Transplantation CenterKaohsiung Chang Gung Memorial HospitalChang Gung University College of MedicineKaohsiung

The Meso-Rex bypass(MRB)is recognized as an effective treatment for portal hypertension secondary to extrahepatic portal vein occlusion(EHPVO)both in the pediatric and adult population,within or outside the context of liver *** is the preferred surgical treatment in most centers because not only does it addresses the portal hypertension,but also restores physiologic portal hepatopetal ***,the Rex recess,the landmark for this technique,may not be safely accessible in some *** present a 22-year-old male who underwent living donor liver transplant(LDLT)for neonatal *** presented with variceal bleeding due to EHPVO at 13 years after *** endoscopic,radiologic,and surgical interventions were employed to address the recurrent gastrointestinal bleeding,but results have been *** performed a meso-intrahepatic portal vein bypass(MIPVB),an innovative alternative to the MRB,for this patient with extensive post-operative adhesions,perihilar collaterals,and cavernous *** creation in patients where the Rex recess is inaccessible is technically *** with a multidisciplinary team approach,meticulous preoperative planning,and close follow-up,the authors have demonstrated that it is a safe and feasible option for patients with late-onset EHPVO after liver transplantation.

关键词： Meso-Rex bypass(MRB) portal vein occlusion liver transplantation(LT)

Combined hepatocellular cholangiocarcinoma: A clinicopathological update

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World Journal of Hepatology 2024年第5期16卷 766-775页

作者： Mukul Vij Fadl H Veerankutty Ashwin Rammohan Mohamed Rela department of Pathology Institute of Liver Disease and TransplantationChennai 600044India Comprehensive liver Care Institute VPS LakeshoreCochin 682040India Institute of liver Disease and transplantation Dr.Rela Institute and Medical CentreChennai 600044India

Combined hepatocellular-cholangiocarcinoma(cHCC-CCA)is a rare primary liver cancer associated with an appalling *** diagnosis and manage-ment of this entity have been challenging to physicians,radiologists,surgeons,pathologists,and oncologists *** diagnostic and prognostic value of biomarkers such as the immunohistochemical expression of nestin,a progenitor cell marker,have been explored *** a better understanding of biology and the clinical course of cHCC-CCA,newer treatment modalities like immune checkpoint inhibitors are being tried to improve the survival of patients with this rare *** this review,we give an account of the recent developments in the pathology,diagnostic approach,and management of cHCC-CCA.

关键词： Combined hepatocellular-cholangiocarcinoma Immunotherapy Nestin Hepatocellular carcinoma Cholangiocarcinoma liver cancer Biomarker Immune checkpoint inhibitors Pathology Genomic landscape

Clinical feasibility of modified extended left hemihepatectomy in advanced perihilar cholangiocarcinoma

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Hepatobiliary Surgery and Nutrition 2024年第1期13卷 165-167页

作者： Hye-Sung Jo Dong-Sik Kim Division of HBP Surgery and liver transplantation Department of SurgeryKorea University College of MedicineSeoulRepublic of Korea

Curative resection is undoubtedly the most important prognostic factor in perihilar cholangiocarcinoma(1).The current consensus of surgical resection of perihilar cholangiocarcinoma consists of hemihepatectomy,including caudate lobectomy and aggressive lymphadenectomy,depending on the extent of bile duct *** decisions on whether to resect the right or left liver and whether to perform an extended hepatectomy or trisectionectomy are all aimed at obtaining negative radial and longitudinal margins(2,3).

关键词： Treatment outcome hepatectomy perihilar cholangiocarcinoma

A single center analysis of long-term outcomes and survival related risk factors in liver retransplantation

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Hepatobiliary Surgery and Nutrition 2024年第3期13卷 425-443,I0011页

作者： Zhihao Li Yi Ping Sng Chao-Long Chen Chih-Che Lin Shih-Ho Wang Chee-Chien Yong liver transplantation Center and department of Surgery Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of MedicineKaohsiung

Background:liver retransplant is the only option to save a patient with liver graft ***,it is controversial due to its poor survival outcome compared to primary *** deceased organ donation in Taiwan leads to high waitlist ***,living-donor grafts offer a valuable alternative for *** study aims to analyze the single center’s outcome in living donor liver retransplantation(re-LDLT)and deceased donor liver retransplantation(re-DDLT)as well as the survival related confounding risk ***:This is a single center retrospective study including 32 adults who underwent liver retransplantation(re-LT)from June 2002 to April *** cohort was divided into a re-LDLT and a re-DDLT group and survival outcomes were *** outcomes over different periods,the effect of timing on survival,and multivariate analysis for risk factors were also demonstrated Results:Of the 32 retransplantations,the re-LDLT group(n=11)received grafts from younger donors(31.3 vs.43.75 years,P=0.016),with lower graft weights(688 vs.1,457.2 g,Ptransplantation after 2010 was *** analysis showed that the timing of retransplantation(early ***)did not affect patient *** analysis revealed that prolonged warm ischemia time(WIT)and intraoperative blood transfusion were related to poor long-term ***:Retransplantation with living donor graft demonstrated good long-term outcomes with acceptable complications to both recipient and *** may serve as a choice in areas lacking deceased *** timing of retransplantation did not affect the long-term *** effort should be made to reduce WIT and massive blood transfusion as they contributed to poor survi

关键词： Retransplantation living donor liver retransplantation(re-LDLT) deceased donor liver retransplantation(re-DDLT) timing of retransplantation long-term outcome

Influence of sex on outcomes of liver transplantation for hepatocellular carcinoma:a multicenter cohort study in China

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Cancer Biology & Medicine 2024年第4期21卷 347-362页

作者： Jian Chen Zhe Yang Fengqiang Gao Zhisheng Zhou Junli Chen Di Lu Kai Wang Meihua Sui Zhengxin Wang Wenzhi Guo Guoyue Lyu Haizhi Qi Jinzhen Cai Jiayin Yang Shusen Zheng Xiao Xu Zhejiang University School of Medicine Hangzhou 310030China Institute of Organ transplantation Zhejiang UniversityHangzhou 310030China department of Hepatobiliary and Pancreatic Surgery Shulan Hospital of HangzhouHangzhou 310006China National Center for Healthcare Quality Management in liver Transplant Hangzhou 310003China department of General Surgery Huashan HospitalFudan UniversityShanghai 200040China department of Hepatobiliary and Pancreatic Surgery The First Affiliated Hospital of Zhengzhou UniversityZhengzhou 450052China department of Hepatobiliary and Pancreatic Surgery The First Hospital of Jilin UniversityChangchun 130021China department of liver transplantation Second Xiangya HospitalCentral South UniversityChangsha 410008China department of Organ transplantation Center The Affiliated Hospital of Qingdao UniversityQingdao 266003China department of liver Surgery and liver transplantation Center West China HospitalSichuan UniversityChengdu 610044China NHC Key Laboratory of Combined Multi-organ transplantation Hangzhou 310003China department of Hepatobiliary and Pancreatic Surgery The First Affiliated HospitalZhejiang University School of MedicineHangzhou 310003China

Objective:Sex-specific differences are observed in various liver diseases,but the influence of sex on the outcomes of hepatocellular carcinoma(HCC)after liver transplantation(LT)remains to be *** study is the first Chinese nationwide investigation of the role of sex in post-LT outcomes in patients with ***:Data for recipients with HCC registered in the China liver Transplant Registry between January 2015 and December 2020 were *** associations between donor,recipient,or donor-recipient transplant patterns by sex and the post-LT outcomes were studied with propensity score matching(PSM).The survival associated with different sex-based donor-recipient transplant patterns was further ***:Among 3,769 patients enrolled in this study,the 1-,3-,and 5-year overall survival(OS)rates of patients with HCC after LT were 96.1%,86.4%,and 78.5%,respectively,in female recipients,and 95.8%,79.0%,and 70.7%,respectively,in male recipients after PSM(P=0.009).However,the OS was comparable between recipients with female donors and male *** analysis indicated that male recipient sex was a risk factor for post-LT survival(HR=1.381,P=0.046).Among the donor-recipient transplant patterns,the male-male donor-recipient transplant pattern was associated with the poorest post-LT survival(P<0.05).Conclusions:Our findings highlighted that the post-LT outcomes of female recipients were significantly superior to those of male recipients,and the male-male donor-recipient transplant pattern was associated with the poorest post-LT *** from male donors may provide the most benefit to female *** results indicate that sex should be considered as a critical factor in organ allocation.

关键词： Sex liver transplantation hepatocellular carcinoma outcome recipient donor

Multifaceted roles of lymphatic and blood endothelial cells in the tumor microenvironment of hepatocellular carcinoma:A comprehensive review

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World Journal of Hepatology 2024年第4期16卷 537-549页

作者： Jing-Jing Li Jia-Xi Mao Han-Xiang Zhong Yuan-Yu Zhao Fei Teng Xin-Yi Lu Li-Ye Zhu Yang Gao Hong Fu Wen-Yuan Guo department of liver Surgery and Organ transplantation Shanghai Changzheng HospitalNaval Medical UniversityShanghai 200003China

The tumor microenvironment is a complex network of cells,extracellular matrix,and signaling molecules that plays a critical role in tumor progression and *** and blood vessels are major routes for solid tumor metastasis and essential parts of tumor drainage ***,recent studies have shown that lymphatic endothelial cells(LECs)and blood endothelial cells(BECs)also play multifaceted roles in the tumor microenvironment beyond their structural functions,particularly in hepatocellular carcinoma(HCC).This comprehensive review summarizes the diverse roles played by LECs and BECs in HCC,including their involvement in angiogenesis,immune modulation,lymphangiogenesis,and *** providing a detailed account of the complex interplay between LECs,BECs,and tumor cells,this review aims to shed light on future research directions regarding the immune regulatory function of LECs and potential therapeutic targets for HCC.

关键词： Lymphatic endothelial cells Blood endothelial cells Hepatocellular carcinoma Tumor microenvironment

Early bifurcation of hepatic artery in right-sided living-donor hepatectomy at Asan Medical Center: rarely a critical issue

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Hepatobiliary Surgery and Nutrition 2024年第3期13卷 520-522页

作者： Deok-Bog Moon Gil-Chun Park Sang Hoon Kim Sung-Min Kim Division of Hepatobiliary Surgery and liver transplantation Department of SurgeryAsan Medical CenterUniversity of Ulsan College of MedicineSeoulKorea

In living donor liver transplantation(LDLT),early bifurcation of hepatic artery(HA)relative to the cutting line of bile duct(BD)requires additional skeletonization of the hilar plate,especially around BD,compared to opposite ***,it may preclude higher chances of biliary complications such as bile leak and biliary stenosis in the ***,donor surgeons should be well aware of the anatomical correlations among HA,BD,and portal vein(PV),based on preoperative 3-dimensional(3D)images,and also intraoperatively perform meticulous dissection of HA from the surrounding tissues and minimize the damage of microcirculation to the BD without using energy devices such as electrocautery(1).When extensive dissection around BD&its ischemic damage in the donor is expected to obtain single HA opening of the harvesting graft,we prefer separate two HA openings including right anterior and posterior HAs to single right HA(RHA)opening without skeletonization of donor’s BD.

关键词： Living donor liver transplantation(LDLT) hepatic artery(HA) early bifurcation right-sided living-donor

Complex role of neutrophils in the tumor microenvironment: an avenue for novel immunotherapies

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Cancer Biology & Medicine 2024年第10期 849-863页

作者： Mao Zhang Haokai Qin Yingcheng Wu Qiang Gao department of liver Surgery and transplantation Liver Cancer Institute and Zhongshan Hospital State Key Laboratory of Genetic Engineering Human Phenome Institute Fudan University

Neutrophils, which originate from the bone marrow and are characterized by a segmented nucleus and a brief lifespan, have a crucial role in the body's defense against infections and acute inflammation. Recent research has uncovered the complex roles of neutrophils as regulators in tumorigenesis, during which neutrophils exhibit a dualistic nature that promotes or inhibits tumor progression. This adaptability is pivotal within the tumor microenvironment(TME). In this review, we provide a comprehensive characterization of neutrophil plasticity and heterogeneity, aiming to illuminate current research findings and discuss potential therapeutic avenues. By delineating the intricate interplay of neutrophils in the TME, this review further underscores the urgent need to understand the dual functions of neutrophils with particular emphasis on the anti-tumor effects to facilitate the development of effective therapeutic strategies against cancer.

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