AIM To perform a systematic review and meta-analysis on platelet-to-lymphocyte ratio(PLR) as a risk factor for post-transplant hepatocellular cancer(HCC) recurrence. METHODS A systematic literature search was performe...AIM To perform a systematic review and meta-analysis on platelet-to-lymphocyte ratio(PLR) as a risk factor for post-transplant hepatocellular cancer(HCC) recurrence. METHODS A systematic literature search was performed using PubM ed. Participants of any age and sex, who underwent liver transplantation for HCC were considered following these criteria:(1) studies comparing pre-transplant low vs high PLR values;(2) studies reporting post-transplant recurrence rates; and(3) if more than one study was reported by the same institute, only the most recent was included. The primary outcome measure was set for HCC recurrence after transplantation. RESULTS A total of 5 articles, published between 2014 and 2017, fulfilled the selection criteria. As for the quality of the reported studies, all the investigated articles presented an overall high quality. A total of 899 cases were investigated: 718 cases(80.0%) were males. Three studies coming from European countries and one from Japan presented HCV as the main cause of cirrhosis. On the opposite, one Chinese study presented a greater incidence of HBV-related cirrhotic cases. In all the studies apart one, the PLR cut-off value of 150 was reported. At meta-analysis, high PLR value was associated with a significant increase in recurrence after transplantation(OR = 3.33; 95%CI: 1.78-6.25; P < 0.001). A moderate heterogeneity was observed among the identified studies according to the Higgins I^2 statistic value.CONCLUSION Pre-transplant high PLR values are connected with an increased risk of post-operative recurrence of hepatocellular cancer. More studies are needed for better clarify the biological mechanisms of this results.展开更多
AIM To perform a systematic review and meta-analysis on donor-to-recipient gender mismatch as a risk factor for post-transplant graft loss. METHODS A systematic literature search was performed using PubM ed, Cochrane ...AIM To perform a systematic review and meta-analysis on donor-to-recipient gender mismatch as a risk factor for post-transplant graft loss. METHODS A systematic literature search was performed using PubM ed, Cochrane Library database and EMBASE. The primary outcome was graft loss after liver transplantation. Odds ratios and 95% confidence intervals were calculated to compare the pooled data between groups with different donor-to-recipient gender matches. Three analyses were done considering(1) gender mismatches(F-M and M-F) vs matches(M-M and F-F);(2) Femaleto-Male mismatch vs other matches; and(3) Male-toFemale mismatch vs other matches.RESULTS A total of 7 articles were analysed. Gender mismatch(M-F and F-M) was associated with a significant increase of graft loss respect to match(M-M and F-F)(OR: 1.30; 95%CI: 1.13-1.50; P < 0.001). When F-M mismatch was specifically investigated, it confirmed its detrimental role in terms of graft survival(OR: 1.83; 95%CI: 1.20-2.80; P = 0.005). M-F mismatch failed to present a significant role(OR: 1.09; 95%CI: 0.73-1.62; P = 0.68).CONCLUSION Gender mismatch is a risk factor for poor graft survival after liver transplantation. Female-to-male mismatch represents the worst combination. More studies are needed with the intent to better clarify the reasons for these results.展开更多
To the Editor:A large international study has been recently published focusing on the combination of morphological aspects and alpha-fetoprotein(AFP)as predictors of survival in patients with hepatocellular cancer(HCC...To the Editor:A large international study has been recently published focusing on the combination of morphological aspects and alpha-fetoprotein(AFP)as predictors of survival in patients with hepatocellular cancer(HCC)treated with liver transplantation(LT)[1].As a matter of fact,morphology and biology represent the two sides of the same展开更多
When the first series of adult-to-adult living donor liver transplantation(A2A-LDLT)were performed in Hong Kong[1],it was immediately clear that great technical challenges existed,mainly concerning the middle hepatic ...When the first series of adult-to-adult living donor liver transplantation(A2A-LDLT)were performed in Hong Kong[1],it was immediately clear that great technical challenges existed,mainly concerning the middle hepatic vein(MHV)tributaries management.展开更多
Trans-arterial radio-embolization(TARE)with yttrium-90 represents one of the most efficacious approaches for the treatment of selected patients with advanced hepatocellular cancer(HCC)(1).
background Common bile duct injuries(CBDIs)remains a rare but serious complication in children undergoing laparoscopic cholecystectomy(LC),with an incidence of 0.44%.In severe lesions,a major liver resection may be ne...background Common bile duct injuries(CBDIs)remains a rare but serious complication in children undergoing laparoscopic cholecystectomy(LC),with an incidence of 0.44%.In severe lesions,a major liver resection may be necessary as a definitive treatment.The current principles for safe hepatectomy are mainly focused on the liver parenchyma that remains after resection.Therefore,one of the main factors related to posthepatectomy hepatic insufficiency is the quantity and quality of the future liver remnant(FLR).To achieve an optimal FLR,techniques such as portal vein embolization(PVE)are available.Case presentation We present the case of a 5-year-old child with a severe CBDI after LC,treated with preoperative PVE followed by a right hepatectomy as definitive treatment.No reports of liver resections and PVE are described in the literature concerning the pediatric population.展开更多
文摘AIM To perform a systematic review and meta-analysis on platelet-to-lymphocyte ratio(PLR) as a risk factor for post-transplant hepatocellular cancer(HCC) recurrence. METHODS A systematic literature search was performed using PubM ed. Participants of any age and sex, who underwent liver transplantation for HCC were considered following these criteria:(1) studies comparing pre-transplant low vs high PLR values;(2) studies reporting post-transplant recurrence rates; and(3) if more than one study was reported by the same institute, only the most recent was included. The primary outcome measure was set for HCC recurrence after transplantation. RESULTS A total of 5 articles, published between 2014 and 2017, fulfilled the selection criteria. As for the quality of the reported studies, all the investigated articles presented an overall high quality. A total of 899 cases were investigated: 718 cases(80.0%) were males. Three studies coming from European countries and one from Japan presented HCV as the main cause of cirrhosis. On the opposite, one Chinese study presented a greater incidence of HBV-related cirrhotic cases. In all the studies apart one, the PLR cut-off value of 150 was reported. At meta-analysis, high PLR value was associated with a significant increase in recurrence after transplantation(OR = 3.33; 95%CI: 1.78-6.25; P < 0.001). A moderate heterogeneity was observed among the identified studies according to the Higgins I^2 statistic value.CONCLUSION Pre-transplant high PLR values are connected with an increased risk of post-operative recurrence of hepatocellular cancer. More studies are needed for better clarify the biological mechanisms of this results.
文摘AIM To perform a systematic review and meta-analysis on donor-to-recipient gender mismatch as a risk factor for post-transplant graft loss. METHODS A systematic literature search was performed using PubM ed, Cochrane Library database and EMBASE. The primary outcome was graft loss after liver transplantation. Odds ratios and 95% confidence intervals were calculated to compare the pooled data between groups with different donor-to-recipient gender matches. Three analyses were done considering(1) gender mismatches(F-M and M-F) vs matches(M-M and F-F);(2) Femaleto-Male mismatch vs other matches; and(3) Male-toFemale mismatch vs other matches.RESULTS A total of 7 articles were analysed. Gender mismatch(M-F and F-M) was associated with a significant increase of graft loss respect to match(M-M and F-F)(OR: 1.30; 95%CI: 1.13-1.50; P < 0.001). When F-M mismatch was specifically investigated, it confirmed its detrimental role in terms of graft survival(OR: 1.83; 95%CI: 1.20-2.80; P = 0.005). M-F mismatch failed to present a significant role(OR: 1.09; 95%CI: 0.73-1.62; P = 0.68).CONCLUSION Gender mismatch is a risk factor for poor graft survival after liver transplantation. Female-to-male mismatch represents the worst combination. More studies are needed with the intent to better clarify the reasons for these results.
文摘To the Editor:A large international study has been recently published focusing on the combination of morphological aspects and alpha-fetoprotein(AFP)as predictors of survival in patients with hepatocellular cancer(HCC)treated with liver transplantation(LT)[1].As a matter of fact,morphology and biology represent the two sides of the same
文摘When the first series of adult-to-adult living donor liver transplantation(A2A-LDLT)were performed in Hong Kong[1],it was immediately clear that great technical challenges existed,mainly concerning the middle hepatic vein(MHV)tributaries management.
文摘Trans-arterial radio-embolization(TARE)with yttrium-90 represents one of the most efficacious approaches for the treatment of selected patients with advanced hepatocellular cancer(HCC)(1).
文摘background Common bile duct injuries(CBDIs)remains a rare but serious complication in children undergoing laparoscopic cholecystectomy(LC),with an incidence of 0.44%.In severe lesions,a major liver resection may be necessary as a definitive treatment.The current principles for safe hepatectomy are mainly focused on the liver parenchyma that remains after resection.Therefore,one of the main factors related to posthepatectomy hepatic insufficiency is the quantity and quality of the future liver remnant(FLR).To achieve an optimal FLR,techniques such as portal vein embolization(PVE)are available.Case presentation We present the case of a 5-year-old child with a severe CBDI after LC,treated with preoperative PVE followed by a right hepatectomy as definitive treatment.No reports of liver resections and PVE are described in the literature concerning the pediatric population.
