Review
Oncology
Laura Crocetti, Elena Bozzi, Paola Scalise, Irene Bargellini, Giulia Lorenzoni, Davide Ghinolfi, Daniela Campani, Emanuele Balzano, Paolo De Simone, Roberto Cioni
Summary: Liver transplantation is the primary treatment for patients with unresectable early-stage hepatocellular carcinoma and cirrhosis. While traditional Milan criteria are restrictive, there is a trend towards expanding inclusion criteria due to a limited organ supply. Locoregional therapies play a crucial role in selecting patients who will benefit the most from transplantation and meet the criteria for transplantation.
Article
Gastroenterology & Hepatology
Allison J. Kwong, T. Tara Ghaziani, Francis Yao, Daniel Sze, Ajitha Mannalithara, Neil Mehta
Summary: The utilization of locoregional therapy, especially radioembolization, is increasing among liver transplant candidates in the United States. Patients with greater tumor burden and more compensated liver disease receive more treatments while waiting for transplantation. Bridging therapy is associated with a lower risk of waitlist dropout.
CLINICAL GASTROENTEROLOGY AND HEPATOLOGY
(2022)
Review
Gastroenterology & Hepatology
Cody R. Criss, Mina S. Makary
Summary: Hepatocellular carcinoma is the second leading cause of cancer-related death globally. Despite screening efforts and treatment algorithms, recurrence rates for the disease remain high. Unlike first-line treatment, there is no consensus or general recommendations for recurrent HCC. This review examines recent evidence on salvage loco-regional therapies for recurrent HCC after failed curative-intent.
WORLD JOURNAL OF GASTROENTEROLOGY
(2023)
Article
Radiology, Nuclear Medicine & Medical Imaging
Seo Yeon Youn, Bohyun Kim, Dong Hwan Kim, Ho Joong Choi, Pil Soo Sung, Joon-Il Choi
Summary: This study evaluated the factors predicting recurrence-free survival and overall survival after curative surgery in HCC patients treated with LRT. The study found that the LR-TR viable category at the time of surgery, preoperative AFP level, number of LRT sessions, and resection surgery independently predicted recurrence. A risk score categorized patients into different risk groups, predicting the 1-year recurrence rate. Postoperative recurrence and failure to meet the Milan criteria predicted death in patients.
EUROPEAN RADIOLOGY
(2022)
Review
Oncology
Kohei Ogawa, Yasutsugu Takada
Summary: Hepatocellular carcinoma (HCC) is a common cancer in men and a leading cause of cancer death. Liver transplantation (LT) is a treatment option for HCC patients. Locoregional therapy, such as transarterial chemoembolization and radiofrequency ablation, has been used as a pretreatment before LT. In Western countries, locoregional therapy is used to bridge until transplantation or for downstaging. Recent reports have clarified the effects of bridging and downstaging locoregional therapy before LT.
Article
Surgery
Kenta Inomata, Hiroshi Yagi, Taizo Hibi, Masahiro Shinoda, Kentaro Matsubara, Yuta Abe, Minoru Kitago, Hideaki Obara, Osamu Itano, Shigeyuki Kawachi, Minoru Tanabe, Go Wakabayashi, Motohide Shimazu, Yuko Kitagawa
Summary: Successful downstaging for HCC cases beyond the MC provides similar outcomes to those within the MC at presentation, regardless of the histopathological findings.
Article
Oncology
I-Hsuan Chen, Chien-Chin Hsu, Chee-Chien Yong, Yu-Fan Cheng, Chih-Chi Wang, Chih-Che Lin, Chao-Long Chen
Summary: AFP response to LRT can be used to stratify the risk of HCC recurrence after LDLT. A comparable result to the control can be expected if a partial AFP response of over 15% decline is achieved.
Review
Oncology
Yasuyuki Tamai, Naoto Fujiwara, Takamitsu Tanaka, Shugo Mizuno, Hayato Nakagawa
Summary: Hepatocellular carcinoma is the fourth leading cause of cancer-related deaths worldwide. Immune checkpoint inhibitors have improved the therapeutic efficacy for advanced HCC, but their response rates are still unsatisfactory. Researchers are actively exploring combination therapies of ICIs with locoregional therapy to overcome this limitation.
Review
Radiology, Nuclear Medicine & Medical Imaging
Giuseppe Mamone, Settimo Caruso, Mariapina Milazzo, Giorgia Porrello, Ambra Di Piazza, Giovanni Gentile, Vincenzo Carollo, Francesca Crino, Gianluca Marrone, Gianvincenzo Sparacia, Luigi Maruzzelli, Roberto Miraglia, Salvatore Gruttadauria
Summary: Liver transplantation provides the best survival benefit for hepatocellular carcinoma (HCC) patients who cannot undergo resection. The Milan criteria have been developed to select suitable candidates for transplantation, aiming to improve survival and reduce the risk of HCC recurrence. However, up to 20% of cases experience HCC recurrence after transplantation, posing a significant challenge due to poor prognosis. Various extended criteria have been proposed to accommodate the increasing demand for organs and the associated higher risk of recurrence. Radiologists need to be aware of the possibility of HCC recurrence involving multiple organs after transplantation. Understanding the location and radiologic appearance of recurrent HCC is crucial for choosing the most appropriate therapy.
INSIGHTS INTO IMAGING
(2023)
Review
Gastroenterology & Hepatology
Paul J. Thuluvath, Chau To, Waseem Amjad
Summary: Hepatocellular cancer is a common and deadly cancer worldwide. Liver transplantation is the preferred treatment for unresectable HCC, but due to long waiting periods, locoregional therapies may be needed for some patients.
AMERICAN JOURNAL OF GASTROENTEROLOGY
(2021)
Review
Gastroenterology & Hepatology
Mina S. Makary, Stuart Ramsell, Eric Miller, Eliza W. Beal, Joshua D. Dowell
Summary: Hepatocellular carcinoma is the most common primary cancer of the liver with a low survival rate. Liver-directed locoregional therapies offer effective treatment options for patients with unresectable disease, with different goals based on disease stage. The review explores various therapies and prognostic factors for HCC.
WORLD JOURNAL OF GASTROENTEROLOGY
(2021)
Article
Surgery
Alessandro D. Mazzotta, Alina Pascale, Luis Cano, Olivier Rosmorduc, Marc-Antoine Allard, Antonio Sa Cunha, Rene Adam, Daniel Cherqui, Eric Vibert, Nicolas Golse
Summary: This study evaluated the impact of the number of nodules on the prognosis of liver transplant candidates, finding that patients with >=5 nodules had lower survival rates, suggesting the exclusion of high-risk patients.
TRANSPLANT INTERNATIONAL
(2021)
Article
Medicine, General & Internal
Indah Jamtani, Kwang-Woong Lee, Yunhee Choi, YoungRok Choi, Jeong-Moo Lee, Eui-Soo Han, Kwangpyo Hong, Gyu-Seong Choi, Jong Man Kim, Nam-Joon Yi, Suk Kyun Hong, Jeik Byun, Su Young Hong, Sanggyeun Suh, Jae-Won Joh, Kyung-Suk Suh
Summary: This study aimed to develop a tailored prediction model of HCC-specific survival after transplantation, validated internally and externally. By combining multiple risk factors, the model showed good accuracy in predicting HCC-specific survival tailored for patients undergoing transplantation. The calculated SALT predictor provided accurate information on expected survival rates based on risk scores and specific characteristics.
JOURNAL OF CLINICAL MEDICINE
(2021)
Review
Biochemistry & Molecular Biology
Zurabi Lominadze, Kareen Hill, Mohammed Rifat Shaik, Justin P. Canakis, Mohammad Bourmaf, Cyrus Adams-Mardi, Ameer Abutaleb, Lopa Mishra, Kirti Shetty
Summary: The emerging field of immuno-oncology has brought exciting developments in the treatment of hepatocellular carcinoma (HCC), with potential benefits in liver transplantation settings. Immune therapeutic agents have shown promise in down-staging advanced HCCs pre-transplant and managing recurrent HCC post-transplant. This review discusses optimal regimens in the context of liver transplantation.
INTERNATIONAL JOURNAL OF MOLECULAR SCIENCES
(2023)
Review
Oncology
J. J. X. Lee, D. W-M Tai, S. P. Choo
Summary: With more treatment options available for advanced hepatocellular carcinoma (HCC), it is important to re-examine the timing and sequencing of locoregional and systemic therapy, especially for patients with intermediate HCC, in order to optimize responses while preserving liver reserves and achieving the best possible survival outcomes.
Article
Surgery
Cyrus A. Feizpour, Katrina Gauntt, Madhukar S. Patel, Bob Carrico, Parsia A. Vagefi, David Klassen, Malcolm MacConmara
Summary: The study shows that the use of MPH in DCD procurements does not cause delays in WIT and does not negatively affect organ yield of other concurrently procured organs.
AMERICAN JOURNAL OF TRANSPLANTATION
(2022)
Article
Gastroenterology & Hepatology
Tommy Ivanics, Carla Fiorella Murillo Perez, Marco P. A. W. Claasen, Madhukar S. Patel, Gabriela Morgenshtern, Lauren Erdman, Chaya Shwaartz, Luckshi Rajendran, Grainne M. O'Kane, Bettina E. Hansen, Sean P. Cleary, Gonzalo Sapisochin
Summary: We evaluated the natural progression, pattern, and timing of various disease states after liver resection for HCC using multistate modeling and created a practical calculator to provide prognostic information for patients and clinicians.
Article
Cardiac & Cardiovascular Systems
Cyrus A. Feizpour, Jordan Hoffman, Madhukar S. Patel, Benjamin Wang, Christine Hwang, Keki Balsara, Ashish Shah, Jigesh A. Shah, Steven I. Hanish, Parsia A. Vagefi, Malcolm MacConmara
Summary: Normothermic machine perfusion is a growing technology in organ transplantation, especially for donation after cardiac death, as it reduces cold ischemia time and prevents complications. This case demonstrates the successful preservation and transplantation of both liver and heart allografts using normothermic machine perfusion.
JOURNAL OF CARDIAC SURGERY
(2022)
Article
Gastroenterology & Hepatology
Tommy Ivanics, Walter Nelson, Madhukar S. Patel, Marco P. A. W. Claasen, Lawrence Lau, Andre Gorgen, Phillipe Abreu, Anna Goldenberg, Lauren Erdman, Gonzalo Sapisochin
Summary: This study developed an accurate posttransplantation HCC recurrence prediction calculator using machine learning algorithms, with the CoxNet-based model showing a concordance score of 0.75. The recalibrated risk algorithms, including AFP score and MORAL score, were outperformed by the CoxNet model in predicting posttransplantation HCC recurrence.
LIVER TRANSPLANTATION
(2022)
Letter
Gastroenterology & Hepatology
Madhukar S. Patel, Anand Ghanekar, Blayne Amir Sayed, Gonzalo Sapisochin, Ian McGilvray, Nathanael Raschzok, Trevor Reichman, Markus Selzner, Zita Galvin, Mamatha Bhat, Jennifer Stunguris, Vicky L. Ng, Les Lilly, Nazia Selzner, Mark S. Cattral
LIVER TRANSPLANTATION
(2022)
Editorial Material
Gastroenterology & Hepatology
Colin Dunn, Bo Lin, Nicole E. Rich, Madhukar S. Patel, Purva Gopal, Amit G. Singal
CLINICAL GASTROENTEROLOGY AND HEPATOLOGY
(2023)
Article
Gastroenterology & Hepatology
Tommy Ivanics, David Wallace, Marco P. A. W. Claasen, Madhukar S. Patel, Rushin Brahmbhatt, Chaya Shwaartz, Andreas Prachalias, Parthi Srinivasan, Wayel Jassem, Nigel Heaton, Mark S. Cattral, Nazia Selzner, Anand Ghanekar, Gabriela Morgenshtern, Neil Mehta, Allan B. Massie, Jan van der Meulen, Dorry L. Segev, Gonzalo Sapisochin
Summary: This multicenter international comparative analysis shows that the long-term outcomes of living donor liver transplantation in the United States, the United Kingdom, and Canada are excellent, despite low utilization rates. There is no statistically significant difference in mortality risk between the evaluated countries. However, the incidence and risk of retransplantation vary between countries, with the highest in the United Kingdom and the lowest in the United States.
JOURNAL OF HEPATOLOGY
(2022)
Article
Surgery
Tommy Ivanics, Ashley Limkemann, Madhukar S. Patel, Marco P. A. W. Claasen, Luckshi Rajendran, Woo Jin Choi, Chaya Shwaartz, Nazia Selzner, Les Lilly, Mamatha Bhat, Cynthia Tsien, Markus Selzner, Ian McGilvray, Blayne Sayed, Trevor Reichman, Mark Cattral, Anand Ghanekar, Gonzalo Sapisochin
Summary: Despite the increase in living donor liver transplants, the outcomes of retransplantation after living donor liver transplant need further investigation. This study compared the waitlist outcomes and survival post-retransplant in recipients of initial living or deceased donor grafts. The results showed similar waitlist mortality and survival rates for both types of transplants.
Article
Surgery
Tommy Ivanics, Delvin So, Marco P. A. W. Claasen, David Wallace, Madhukar S. Patel, Annabel Gravely, Woo Jin Choi, Chaya Shwaartz, Kate Walker, Lauren Erdman, Gonzalo Sapisochin
Summary: Many countries have national registries of liver transplant data, which are used to generate predictive models. However, the performance and transferability of these models are unclear. This study developed machine learning algorithm-based models using data from 3 national registries to predict 90-day post-transplant mortality and evaluated the predictive performance and external validity of each model.
AMERICAN JOURNAL OF TRANSPLANTATION
(2023)
Article
Gastroenterology & Hepatology
Tommy Ivanics, Marco P. A. W. Claasen, Madhukar S. S. Patel, Emmanouil Giorgakis, Shirin E. E. Khorsandi, Parthi Srinivasan, Andreas Prachalias, Krishna Menon, Wayel Jassem, Miriam Cortes, Blayne A. A. Sayed, Amit K. K. Mathur, Kate Walker, Rhiannon Taylor, Nigel Heaton, Neil Mehta, Dorry L. L. Segev, Allan B. B. Massie, Jan H. P. van Der Meulen, Gonzalo Sapisochin, David Wallace
Summary: Comparing the utilization and outcomes of DCD LT between the UK and the US provides insights into the international differences. The study found that although the use of DCD livers increased in both countries, the long-term transplant outcomes in the UK were superior to those in the US.
LIVER INTERNATIONAL
(2023)
Article
Pediatrics
Christine S. Hwang, Yash Kadakia, Jorge A. Sanchez-Vivaldi, Madhukar S. Patel, Jigesh A. Shah, Lucia DeGregorio, Dev M. Desai, Parsia A. Vagefi, Malcolm MacConmara
Summary: This study examined the incidence, risk factors, and outcomes of delayed graft function (DGF) in pediatric recipients of living donor kidneys. The results showed that pediatric patients who experienced DGF had significantly poorer allograft survival, and small recipients and those with focal segmental glomerulosclerosis (FSGS) had a higher rate of DGF.
PEDIATRIC TRANSPLANTATION
(2022)
Letter
Gastroenterology & Hepatology
Madhukar S. Patel, Nicolas Goldaracena
LIVER TRANSPLANTATION
(2023)
Editorial Material
Chemistry, Multidisciplinary
Warren C. W. Chan, Natalie Artzi, Chunying Chen, Xiaodong Chen, Dean Ho, Tony Hu, Kazunori Kataoka, Luis M. Liz-Marzan, Rahmi Oklu, Wolfgang J. Parak
Article
Chemistry, Multidisciplinary
Zefu Zhang, Hassan Albadawi, Richard J. Fowl, Joseph L. Mayer, Brian W. Chong, Rahmi Oklu
Summary: It is shown that instant hemostasis can be achieved by filling the aneurysm sac with a novel biomaterial, rescuing catastrophic bleeding in large-animal models. The optimized gel embolic agent with catheter-injectable and X-ray visible versions outperforms the control groups. The combinatorial approach using gel embolic agent and flow diverter stent may change medical practice and save lives.
ADVANCED MATERIALS
(2023)
Article
Radiology, Nuclear Medicine & Medical Imaging
Lisa Rotellini-Coltvet, Alex Wallace, Gia Saini, Sailendra Naidu, Jefferey Scott Kriegshauser, Indravadan Patel, Grace Knuttinen, Sadeer Alzubaidi, Rahmi Oklu
Summary: The study aimed to demonstrate the safety and effectiveness of percutaneous transesophageal gastrostomy (PTEG) as a palliative option for patients with malignant bowel obstructions (MBOs). The study also provided a comprehensive review of PTEG indications, placement technique, and short- and long-term outcomes. The results showed that PTEG is an effective and safe option for improving clinical symptoms and enhancing the quality of life in patients with MBOs.
JOURNAL OF VASCULAR AND INTERVENTIONAL RADIOLOGY
(2023)