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Hepatobiliary & Pancreatic Diseases International 2024年第2期23卷 154-159页

作者： Badi Rawashdeh Richard Bell Abdul Hakeem Raj Prasad Division of transplant surgery Department of General SurgeryMedical College of WisconsinMilwaukeeWI53226USA Leeds Teaching Hospital LeedsUK

Colorectal cancer is a leading cause of cancerrelated mortality,with nearly half of the affected patients developing liver *** three decades,liver resection(LR)has been the primary curative strategy,yet its applicability is limited to about 20%of *** transplantation(LT)for unresectable metastases was attempted unsuccessfully in the 1990s,with high rates of perioperative death and *** is now more interest in this strategy due to improvements in systemic therapies and surgical techniques.A significant study conducted by the Oslo group showed that patients receiving liver transplants had a 60%chance of survival after five *** better results have been achieved by using advanced imaging for risk stratification and further refining selection criteria,especially in the Norvegian SECA *** review carefully charts the development and history of LT as a treatment option for colorectal cancer liver *** revolutionary path from the early days of exploratory surgery to the current situation of cautious optimism is traced,highlighting the critical clinical developments and improved patient selection standards that have made LT a potentially curative treatment for such challenging very well selected cases.

关键词： Liver transplantation Colorectal cancer liver metastases Non-resectable liver metastases

Impact of neoadjuvant multimodal therapy in the setting of locally advanced hepatocellular carcinoma

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World Journal of Gastroenterology 2024年第28期30卷 3452-3455页

作者： Daniele Ferraro Federica Falaschi Luca Nazzaro Giovanni Vennarecci Hepato-biliary and Liver transplant Centre Department of General Surgery and Woman’s HealthAORN Antonio CardarelliNaples 80131Italy

Immunotherapy and the implementation of more aggressive treatment schemes for locally advanced hepatocellular carcinomas have expanded the boundaries of curative *** of these advancements,patients who were once consid... 详细信息

关键词： Hepatocellular carcinoma Immunotherapy Radioembolization Chemoembolization Liver transplantation Liver resection

Role of gut-liver axis and glucagon-like peptide-1 receptor agonists in the treatment of metabolic dysfunction-associated fatty liver disease

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World Journal of Gastroenterology 2024年第23期30卷 2964-2980页

作者： Jakub Rochoń Piotr Kalinowski Ksenia Szymanek-Majchrzak MichałGrąt Department of general Transplant and Liver SurgeryMedical University of WarsawWarsaw 02-097Poland Department of Medical Microbiology Medical University of WarsawWarsaw 02-004Poland

Metabolic dysfunction-associated fatty liver disease(MAFLD)is a hepatic manifestation of the metabolic *** is one of the most common liver diseases worldwide and shows increasing prevalence rates in most *** is a progressive disease with the most severe cases presenting as advanced fibrosis or cirrhosis with an increased risk of hepatocellular *** microbiota play a significant role in the pathogenesis and progression of MAFLD by disrupting the gut-liver *** mechanisms involved in maintaining gut-liver axis homeostasis are *** critical aspect involves preserving an appropriate intestinal barrier permeability and levels of intestinal lumen metabolites to ensure gutliver axis *** increase in intestinal barrier permeability induces metabolic endotoxemia that leads to ***,alterations in the absorption of various metabolites can affect liver metabolism and induce liver steatosis and ***-like peptide-1 receptor agonists(GLP-1 RAs)are a class of drugs developed for the treatment of type 2 diabetes *** are also commonly used to combat obesity and have been proven to be effective in reversing hepatic *** mechanisms reported to be involved in this effect include an improved regulation of glycemia,reduced lipid synthesis,β-oxidation of free fatty acids,and induction of autophagy in hepatic ***,multiple peptide receptor agonists have been introduced and are expected to increase the effectiveness of the treatment.A modulation of gut microbiota has also been observed with the use of these drugs that may contribute to the amelioration of *** review presents the current understanding of the role of the gutliver axis in the development of MAFLD and use of members of the GLP-1 RA family as pleiotropic agents in the treatment of MAFLD.

关键词： Metabolic dysfunction-associated fatty liver disease Metabolic dysfunction-associated steatohepatitis Nonalcoholic fatty liver disease Non-alcoholic steatohepatitis Metabolic syndrome Obesity Gastrointestinal microbiota Glucagon-like peptide-1 Glucagon-like peptide-2 Bariatric surgery

Critical appraisal of novel prediction models and risk calculators for post-hepatectomy liver failure and complications: practicability and generalisability in the real-world setting

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Hepatobiliary surgery and Nutrition 2024年第4期13卷 696-698页

作者： Darren Weiquan Chua Yun Zhao Ye Xin Koh Department of Hepatopancreatobiliary and transplant surgery Singapore General Hospital and National Cancer Centre SingaporeSingaporeSingapore Duke-National University of Singapore Medical School SingaporeSingapore Liver transplant Service SingHealth Duke-National University of Singapore Transplant CentreSingaporeSingapore

Over the last few decades,the evolution of liver resection has progressed through numerous milestones in peri-operative management,operative techniques and novel technologies that have dramatically improved patient safety and outcomes(1).Consequently,such developments have enabled surgeons to embark on liver resections of lesions in technically challenging locations,whereby extended resection or bilovascular reconstruction may be required to ensure oncologic *** the context of extended resections or resection of lesions from heavily diseased livers,concerns remain regarding the adequacy of the remnant future liver remnant(FLR)and liver function,placing patients at risk of the clinical phenomenon known as post-hepatectomy liver failure(PHLF).Although relatively uncommon,PHLF has a reported incidence of up to 32%in the literature and remains an important cause of post-hepatectomy morbidity and mortality(2).Presently,several definitions have been proposed to describe PHLF,the most recent of which was proposed by the International Study Group of Liver surgery(ISGLS).In this definition,PHLF was defined as an increased international normalized ratio(INR)or hyperbilirubinemia on or after post-operative day 5,with further stratification of severity grades(A,B or C)based on the extent of clinical management(3).While definitions in PHLF assist in providing a common diagnostic framework among physicians,establishing predictors in PHLF is conceivably more helpful as it allows surgeons to have important decision-making details prior to planned liver resection.

关键词： Hepatectomy post-hepatectomy liver failure(PHLF) predictive model risk calculation

Does ischemia-free machine perfusion lead to early allograft dysfunction (EAD) free liver transplantation?

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Hepatobiliary surgery and Nutrition 2024年第4期13卷 678-680页

作者： Hani M.Wadei Kristopher P.Croome Division of Kidney and Pancreas transplant Department of TransplantMayo ClinicJacksonvilleFLUSA Division of transplant surgery Department of TransplantMayo ClinicJacksonvilleFLUSA

Normothermic machine perfusion(NMP)is an innovative technique used in solid organ transplantation that involves perfusing the organ with specialized solution or leukocyte depleted red blood cells at near-normal body temperature aiming at mimicking physiological conditions,and providing optimal conditions for organ preservation which leads to reduced risk of ischemia reperfusion injury(IRI)when compared to the standard static cold storage(SCS)(1).One of the key advantages of NMP is its ability to assess the quality of the organ in real-time and assessment of the organ performance prior to *** continuously monitoring parameters such as blood flow,oxygen consumption,and lactate production,clinicians can evaluate the viability of the organ and make more informed decisions about its suitability for *** real-time assessment can help reduce the risk of transplanting organs that may not function optimally or have a higher likelihood of complications ***,NMP may expand the pool of donor organs by allowing for the use of organs that may have been deemed marginal or unsuitable for transplantation using traditional methods(1,2).

关键词： Early allograft dysfunction(EAD) normothermic machine perfusion(NMP) liver transplant outcomes

Assessment of morbidity and mortality after liver transplantation for primary sclerosing cholangitis

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Hepatobiliary surgery and Nutrition 2024年第1期13卷 154-156页

作者： Burcin Ekser Plamen Mihaylov Richard S.Mangus Division of transplant surgery Department of SurgeryIndiana University School of MedicineIndianapolisINUSA

Primary sclerosing cholangitis(PSC)is a progressive liver disease that causes biliary inflammation,recurrent cholangitis,and liver fibrosis(1).Although there are therapeutic options that temporarily reduce the itching and jaundice caused by PSC,there is currently no effective definitive *** rate of disease progression varies among individuals,but it ultimately leads to end-stage liver disease and necessitates liver transplantation(2).

关键词： Complications liver transplantation outcomes primary sclerosing cholangitis(PSC)

Pancreatic neuroendocrine tumors:Are tumors smaller than 2 cm truly indolent?

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World Journal of Gastrointestinal Oncology 2024年第5期16卷 1756-1762页

作者： Sergio Hoyos Pablo Posada-Moreno Natalia Guzman-Arango Romario Chanci-Drago Jaime Chavez Alvaro Andrés-Duarte Santiago Salazar-Ochoa Hepatobilary and Liver transplant Unit Hospital Pablo Tobon Uribe and Gastrohepathology Group Universidad de AntioquiaMedellin 050034AntioquiaColombia Department of general surgery Universidad Pontificia BolivarianaMedellín 050034AntioquiaColombia

BACKGROUND Pancreatic neuroendocrine tumors(PNETs)are relatively rare but rank as the second most common pancreatic *** can be functional,causing early metabolic disturbances due to hormone secretion,or non-functional and diagnosed later based on tumor size-related *** diagnoses of PNETs under 2 cm in size have sparked debates about their management;some practitioners advocate for surgical removal and others suggest observation due to the tumors’lower potential for ***,it is unclear whether managing these small tumors expectantly is truly *** To evaluate poor prognostic factors in PNETs based on tumor size(>2 cm orsurgery,followed by semi-annual con-sultations at the hospital's hepatobiliary surgery *** variables were described using absolute and relative frequencies,and quantitative variables were expressed using measures of central tendency and their corresponding measures of *** The presence of lymph node involvement,neural involvement,and lymphovascular invasion were all associated with an increased risk of mortality,with hazard ratios of 5.68(95%CI:1.26–25.61,P=0.024),6.44(95%CI:1.43–28.93,P=0.015),and 24.87(95%CI:2.98–207.19,P=0.003),*** involvement and lymphovascular invasion were present in tumors smaller than 2 cm in diameter and those larger than 2 cm in *** recurrence rates between the two tumor groups were furthermore similar:18.2%for tumors smaller than 2 cm and 21.4%for tumors larger than 2 *** survival was additionally comparable between the two tumor *** Tumor size does not dictate prognosis;lymph node and lymphovascular involvement a

关键词： Neuroendocrine tumor Pancreatic neoplasm Pancreas Pancreatic neuroendocrine neoplasm Pancreatic neuroendocrine tumors

Time to say goodbye: from Barcelona to Milan and the modern management of hepatocellular carcinoma

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Hepatobiliary surgery and Nutrition 2024年第3期13卷 548-550页

作者： Georgia Sofia Karachaliou Nikolaos Dimitrokallis Dimitrios Moris Division of Gastroenterology Department of MedicineDuke University Medical CenterDurhamNCUSA st Department of surgery&Organ transplant Unit Evangelismos General HospitalAthensGreece Department of surgery Duke University Medical CenterDurhamNCUSA

Hepatocellular carcinoma(HCC)is the most common primary liver malignancy and one of the most common causes of cancer-related death with the projection to increase during the next few decades(1).During the last 3 decades,several staging systems have been introduced for the stratification of the prognosis and management of HCC of all *** is no consensus regarding the universal implementation of one staging system since all the proposed classifications have limitations(2).The Barcelona Clinic Liver Cancer(BCLC)Staging System remains the most widely classification system used for HCC management guidelines that incorporates tumor size,presence of metastatic disease,portal hypertension,Child-Turcotte-Pugh score,total bilirubin and performance ***,it does not account for tumoral behavior,and it is very“conservative”(restrictive)regarding resectability,especially for BCLC-B patients who might benefit from surgical management(3,4).Recent advances in systemic and locoregional therapies have led to changes in many guidelines regarding systemic therapy,as well as the possibility for downstaging patients to undergo surgery or transplant with curative intent.

关键词： Hepatocellular carcinoma(HCC) Barcelona Clinic Liver Cancer(BCLC) tumor burden score

Risk scores for allograft failure: Are they still useful in liver recipients from donation after circulatory death?

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World Journal of transplantation 2024年第4期14卷 95-100页

作者： Mohamed H Mohamed Chairi Mónica Mogollón González Jennifer Triguero Cabrera Inmaculada Segura Jiménez Maria T Villegas Herrera Jesús M Villar del Moral transplant surgery Division Department of SurgeryVirgen de las Nieves University HospitalGranada 18013AndalusiaSpain

BACKGROUND Liver grafts from donation after circulatory death(DCD)are associated with a higher risk of early graft dysfunction,determined by the warm ischemia and cold ischemia *** is essential to have precise criteria to identify this complication in order to guide therapeutic *** To validate different graft and recipient survival scores in patients undergoing liver transplantation(LT)with DCD *** A retrospective and observational unicentric study was conducted on 65 LT patients with grafts obtained from controlled DCD donors from November 2013 to November *** United Kingdom(UK)risk score,early allograft dysfunction(EAD)Olthoff score,and model for early allograft function(MEAF)score were used to evaluate the risk of graft and recipient survival *** survival analysis purposes,we used the Kaplan-Meier method,and the differences between subgroups were compared using the log-rank(Mantel-Cox)*** Sixty-five patients were included in the *** UK risk score did not demonstrate predictive capacity for recipient or graft ***,in donors aged over 70 years old(18.4%),it significantly predicted graft survival(P<0.05).According to Kaplan-Meier survival curves,graft survival rates at 6 months,2 years,and 5 years in the futility group dramatically decreased to 50%compared to the other groups(log-rank 8.806,P<0.05).The EAD Olthoff and MEAF scores did not demonstrate predictive capacity for recipient or graft *** on Kaplan-Meier survival curves,patients with a MEAF score≥7 had a lower graft survival rate at 6 months,2 years,and 5 years compared to patients with a lower MEAF score(log-rank 4.667,P<0.05).CONCLUSION In our series,both UK DCD risk score and MEAF score showed predictive capability for graft survival.

关键词： Liver transplantation Donation after circulatory death Early allograft dysfunction Risk scores Graft surviva

Downstaging strategies for unresectable hepatocellular carcinoma

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World Journal of Gastroenterology 2024年第20期30卷 2731-2733页

作者： Georgia Sofia Karachaliou Nikolaos Dimitrokallis Dimitrios P Moris Division of Gastroenterology Department of MedicineDuke University Medical CenterDurhamNC 27710United States First Department of surgery&Organ transplant Unit Evangelismos General HospitalAthens 10676Greece Department of surgery Duke University Medical CenterDurhamNC 27710United States

A significant number of patients with hepatocellular carcinoma(HCC)are usually diagnosed in advanced stages,that leads to inability to achieve *** options are focusing on downstaging a locally advanced *** is wellsupported in the literature that patients with HCC who undergo successful conversion therapy followed by curative-intent surgery may achieve a significant survival benefit compared to those who receive chemotherapy alone or those who are successfully downstaged with conversion therapy but not treated with *** artery infusion chemotherapy can be a potential downstaging strategy,since recent studies have demonstrated excellent outcomes in patients with colorectal liver metastatic disease as well as primary liver malignancies.

关键词： Unresectable hepatocellular carcinoma Hepatic arterial infusion chemotherapy Downstaging Hepatocellular carcinoma