scholarly journals Portal hypertension and hepatocellular carcinoma: Navigating uncharted waters

2022 ◽  
Author(s):  
Sabrina Sidali ◽  
Jean‐Charles Nault
Keyword(s):  
Hepatocellular Carcinoma ◽  
Portal Hypertension

Risk Factors for Hepatic Encephalopathy after Transjugular Intrahepatic Portosystemic Shunt in Patients with Hepatocellular Carcinoma and Portal Hypertension

2015 ◽  
Vol 24 (3) ◽  
pp. 301-307 ◽  
Author(s):  
Jiannan Yao ◽  
Li Zuo ◽  
Guangyu An ◽  
Zhendong Yue ◽  
Hongwei Zhao ◽  
...  
Keyword(s):  
Risk Factors ◽  
Hepatocellular Carcinoma ◽  
Portal Hypertension ◽  
Hepatic Encephalopathy ◽  
Pressure Gradient ◽  
Transjugular Intrahepatic Portosystemic Shunt ◽  
Meld Score ◽  
Portosystemic Shunt ◽  
Portal Flow ◽  
Intrahepatic Portosystemic Shunt

Aims: This study aimed at assessing the risk factors for hepatic encephalopathy (HE) after transjugular intrahepatic portosystemic shunt (TIPS) in patients with hepatocellular carcinoma (HCC) and portal hypertension. Method: Consecutive patients (n=279) with primary HCC who underwent TIPS between January 1997 and March 2012 at a single institution were retrospectively reviewed. Patients were followed up for 2 years. Pre-TIPS, peri-TIPS and post-TIPS clinical variables were reviewed using univariate and multivariate analyses to identify risk factors for HE after TIPS. Results: The overall incidence of HE was 41% (114/279). Multivariate analysis showed an increased odds for HE in patients with: >3 treatments with transcatheter arterial chemoembolization (TACE) and/or trans-arterial embolization (TAE) (odds ratio [OR], 4.078; 95% confidence interval [95%CI], 1.748-9.515); hepatopetal portal flow (OR, 2.362; 95%CI, 1.032-5.404); high portosystemic pressure gradient (OR, 1.198; 95%CI, 1.073-1.336) and high pre-TIPS MELD score (OR, 1.693; 95%CI, 1.390-2.062). Odds for HE were increased 1.693 fold for each 1-point increase in the MELD score, and 1.198 fold for each 1-mmHg decrease in the post-TIPS portosystemic pressure gradient. Conclusion: The identification of clinical variables associated with increased odds of HE may be useful for the selection of appropriate candidates for TIPS. Results suggest that an inappropriate decrease in the portosystemic pressure gradient might be associated with HE after TIPS. In addition, >3 treatments with TACE/TAE, hepatopetal portal flow, and high MELD score were also associated with increased odds of HE after TIPS. Key words:  –  –  – .

scholarly journals Hepatic Resection Is Safe and Effective for Patients with Hepatocellular Carcinoma and Portal Hypertension

PLoS ONE ◽  
2014 ◽  
Vol 9 (9) ◽  
pp. e108755 ◽  
Author(s):  
Jian-Hong Zhong ◽  
Hang Li ◽  
Nan Xiao ◽  
Xin-Ping Ye ◽  
Yang Ke ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Portal Hypertension ◽  
Hepatic Resection

Hepatic resection for hepatocellular carcinoma in cirrhotic patients with portal hypertension

2016 ◽  
Vol 20 (4) ◽  
pp. 149-156 ◽  
Author(s):  
Hazem M. Zakaria ◽  
Emad H. Gad ◽  
Ali Nada ◽  
Anwar A. Abdelaleem ◽  
Doha Maher ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Portal Hypertension ◽  
Hepatic Resection ◽  
Cirrhotic Patients

scholarly journals Benefits of Splenectomy and Curative Treatments for Patients with Hepatocellular Carcinoma and Portal Hypertension: a Retrospective Study

2018 ◽  
Vol 23 (11) ◽  
pp. 2151-2162 ◽  
Author(s):  
Youliang Pei ◽  
Songshan Chai ◽  
Yuxin Zhang ◽  
Zhanguo Zhang ◽  
Xiaoping Chen ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Portal Hypertension ◽  
Retrospective Study

Liver resection of hepatocellular carcinoma in patients with portal hypertension and multiple tumors

2018 ◽  
Vol 48 (6) ◽  
pp. 433-441 ◽  
Author(s):  
Takao Ohkubo ◽  
Yutaka Midorikawa ◽  
Hisashi Nakayama ◽  
Masamichi Moriguchi ◽  
Osamu Aramaki ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Portal Hypertension ◽  
Liver Resection ◽  
Multiple Tumors

Risk Factors for Hepatocellular Carcinoma After Splenectomy in Liver Cirrhotic Patients

2021 ◽  
pp. 000313482110415
Author(s):  
Naruhiko Honmyo ◽  
Tsuyoshi Kobayashi ◽  
Shintaro Kuroda ◽  
Kentaro Ide ◽  
Masahiro Ohira ◽  
...  
Keyword(s):  
Risk Factors ◽  
Hepatocellular Carcinoma ◽  
Portal Hypertension ◽  
Cox Regression ◽  
Univariate Analysis ◽  
Hemoglobin Level ◽  
Rank Test ◽  
Predictive Index ◽  
Preoperative Hemoglobin ◽  
Preoperative Hemoglobin Level

Background Splenectomy is sometimes indicated for portal hypertension caused by cirrhosis, which is a risk for hepatic carcinogenesis. This study aimed to identify risk factors for hepatocellular carcinoma (HCC) development after splenectomy. Methods This retrospective study included 65 patients who underwent splenectomy for portal hypertension between 2009 and 2017. Cox regression analyses were performed to identify factors related to HCC development after splenectomy. The predictive index for HCC development was constructed from the results of multivariate analysis, and 3 risk-dependent groups were defined. Discrimination among the groups was estimated using Kaplan-Meier curves and the log-rank test. Results Post-splenectomy, 36.9% of patients developed HCC. In the univariate analysis, the etiology of cirrhosis (hepatitis C virus antibody, P = .005, and hepatitis B surface antigen, P = .008, referring to non-B and non-C patients, respectively), presence of HCC history ( P < .001), and preoperative hemoglobin level ( P = .007) were related to HCC development, and the presence of HCC history ( P = .002) and preoperative hemoglobin level ( P = .022) were independent risk factors. The predictive index classified three groups at risk; the hazards in each group were significantly different (low vs middle risk, P = .035, and middle vs high risk, P = .011). Discussion The etiology of cirrhosis, presence of HCC history, and hemoglobin level were associated with HCC development after splenectomy. The predictive model may aid in HCC surveillance after splenectomy for patients with portal hypertension.

Fontan-Associated Liver Disease: Pathophysiology, Staging, and Management

2021 ◽  
Author(s):  
Luis Téllez ◽  
Enrique Rodríguez de Santiago ◽  
Agustín Albillos
Keyword(s):  
Hepatocellular Carcinoma ◽  
Portal Hypertension ◽  
Liver Disease ◽  
Fontan Procedure ◽  
Elevated Risk ◽  
Histological Changes ◽  
Global Management ◽  
Screening Strategies ◽  
History Of ◽  
Fontan Patients

AbstractFontan-associated liver disease is the term used to encompass the disorders arising from abnormal hemodynamic alterations and systemic venous congestion after the Fontan procedure. The histological changes produced in the liver are similar but not equivalent to those seen in other forms of cardiac liver disease. While the natural history of this form of liver disease is poorly established, many Fontan patients ultimately develop portal hypertension-related complications such as ascites, esophageal varices, malnutrition, and encephalopathy. Fontan survivors also show an elevated risk of hepatocellular carcinoma. Adequate staging of the liver damage is essential to anticipate screening strategies and improve global management.

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