scholarly journals Blood Transfusions and Tumor Biopsy May Increase HCC Recurrence Rates after Liver Transplantation

2017 ◽  
Vol 2017 ◽  
pp. 1-9 ◽  
Author(s):  
Daniel Seehofer ◽  
Robert Öllinger ◽  
Timm Denecke ◽  
Moritz Schmelzle ◽  
Andreas Andreou ◽  
...  
Keyword(s):  
Risk Factors ◽  
Liver Transplantation ◽  
Multivariate Analysis ◽  
Vascular Invasion ◽  
Significant Risk ◽  
Blood Transfusions ◽  
Prognostic Impact ◽  
Tumor Biopsy ◽  
Related Risk ◽  
Hcc Recurrence

Introduction. Beneath tumor grading and vascular invasion, nontumor related risk factors for HCC recurrence after liver transplantation (LT) have been postulated. Potential factors were analyzed in a large single center experience. Material and Methods. This retrospective analysis included 336 consecutive patients transplanted for HCC. The following factors were analyzed stratified for vascular invasion: immunosuppression, rejection therapy, underlying liver disease, age, gender, blood transfusions, tumor biopsy, caval replacement, waiting time, Child Pugh status, and postoperative complications. Variables with a potential prognostic impact were included in a multivariate analysis. Results. The 5- and 10-year patient survival rates were 70 and 54%. The overall 5-year recurrence rate was 48% with vascular invasion compared to 10% without (p<0.001). Univariate analysis stratified for vascular invasion revealed age over 60, pretransplant tumor biopsy, and the application of blood transfusions as significant risk factors for tumor recurrence. Blood transfusions remained the only significant risk factor in the multivariate analysis. Recurrence occurred earlier and more frequently in correlation with the number of applied transfusions. Conclusion. Tumor related risk factors are most important and can be influenced by patient selection. However, it might be helpful to consider nontumor related risk factors, identified in the present study for further optimization of the perioperative management.

scholarly journals Achieving Complete Remission of Hepatocellular Carcinoma: A Significant Predictor for Recurrence-Free Survival after Liver Transplantation

2019 ◽  
Vol 2019 ◽  
pp. 1-7 ◽  
Author(s):  
Christin Bürger ◽  
Miriam Maschmeier ◽  
Anna Hüsing-Kabar ◽  
Christian Wilms ◽  
Michael Köhler ◽  
...  
Keyword(s):  
Risk Factors ◽  
Hepatocellular Carcinoma ◽  
Liver Transplantation ◽  
Complete Remission ◽  
Tumor Recurrence ◽  
Significant Risk ◽  
Treatment Modalities ◽  
Special Focus ◽  
The Impact ◽  
Hcc Recurrence

Background. Liver transplantation (LT) is a curative treatment for hepatocellular carcinoma (HCC) and the underlying primary liver disease; however, tumor recurrence is still a major issue. Therefore, the aim of this study was to assess predictors and risk factors for HCC recurrence after LT in patients within and outside the Milan criteria with a special focus on the impact of different bridging strategies. Methods. All patients who underwent LT for HCC between 07/2002 and 09/2016 at the University Hospital of Muenster were consecutively included in this retrospective study. Database research was performed and a multivariable regression analysis was conducted to explore potential risk factors for HCC recurrence. Results. A total of 82 patients were eligible for the statistical analysis. Independent of bridging strategy, achieving complete remission (CR) was significantly associated with a lower risk for tumor recurrence (p = 0.029; OR = 0.426, 95% CI 0.198-0.918). A maximal diameter of lesion < 3 cm was also associated with lower recurrence rates (p = 0.040; OR = 0.140, 95% CI 0.022-0.914). Vascular invasion proved to be an independent risk factor for HCC recurrence (p = 0.004; OR = 11.357, 95% CI 2.142-60.199). Conclusion. Achieving CR prior to LT results in a significant risk reduction of HCC recurrence after LT independent of the treatment modalities applied.

scholarly journals Vancomycin-resistance Enterococcal Colonization in Hospitalized Patients in Relation to Antibiotic Usage in a Tertiary Care Hospital of North India

2015 ◽  
Vol 7 (02) ◽  
pp. 108-111 ◽  
Author(s):  
Tuhina Banerjee ◽  
Shampa Anupurba ◽  
Joel Filgona ◽  
Dinesh K Singh
Keyword(s):  
Risk Factors ◽  
Multivariate Analysis ◽  
Tertiary Care ◽  
Significant Risk ◽  
Antibiotic Use ◽  
Antibiotic Usage ◽  
Hospitalized Patients ◽  
University Hospital ◽  
North India ◽  
Care Hospital

ABSTRACT Background: Alarming rise of vancomycin-resistant enterococci (VRE) is a global cause of concern. Several factors have been held responsible for such rise, of which antibiotic usage is a prominent one. Objectives: This study was undertaken to determine the intestinal VRE colonization rate amongst hospitalized patients in relation to use of various antibiotics in the Intensive Care Unit (ICU) of a tertiary care university hospital, India. Materials and Methods: Stool samples were collected weekly from all the patients in the adult ICU for a period of 6 months and processed for isolation and phenotypic and genotypic characterization of VRE isolates. Patient and treatment details were noted and cases (those with VRE in stool) and controls (those without VRE in stool) were compared statistically. Further, a multivariate analysis was done to identify those antibiotics as independent risk factors for VRE colonization. Results: VRE colonization was found in 34.56% (28/81) of the patients studied, with the majority 75% (21/28) carrying the vanA gene. The cases had significantly more (P < 0.05) duration of hospital stay and antibiotic exposure. Intake of metronidazole, vancomycin, and piperacillin-tazobactam were identified as significant risk factors both in univariate and multivariate analysis. Conclusion: A potential reservoir of VRE was thus revealed even in low VRE prevalence setting. Based on this high colonization status, restriction of empirical antibiotic use, reviewing of the ongoing antibiotic policy, and active VRE surveillance as an integral part of infection control strategy were suggested.

Risk Factors for Development of Biliary Complications after Surgery for Solitary Liver Hydatid Cyst

2017 ◽  
Vol 83 (1) ◽  
pp. 30-35 ◽  
Author(s):  
Ali Surmelioglu ◽  
Ilter Ozer ◽  
Enver Reyhan ◽  
Tahsin Dalgic ◽  
Yilmaz Ozdemir ◽  
...  
Keyword(s):  
Risk Factors ◽  
Hydatid Cyst ◽  
Significant Risk ◽  
Conservative Surgery ◽  
World Health ◽  
Biliary Leakage ◽  
Liver Hydatid Cyst ◽  
Related Risk ◽  
Solitary Liver ◽  
Health Organization

Biliary leakage (BL) is the most common cause of postoperative morbidity after conservative liver hydatid cyst surgery. The objective of this study was to determine incidence of BL and related risk factors in patients with solitary liver hydatid cyst who underwent conservative surgery. A total of 186 patients were included in this study. Age, gender, cyst recurrence, diameter, and localization, World Health Organization Informal Working Group on Echinococcosis (WHO-IWGE) classification, cavity management techniques, cyst content, and alkaline phosphatase (ALP) levels were evaluated with univariate and multivariate analyses. Of these patients 104 were female and 82 were male. The mean age was 43.5 ± 14.7 years. Postoperative BL was detected in 36 (19.4%) patients. Cyst diameter (P = 0.019), cyst localization (P = 0.007), WHO-IWGE classification (P = 0.017), and ALP level (P = 0.001) were the most significant risk factors for BL. Independent risk factors for BL were perihilar localization, large cyst diameter, high ALP level, and advanced age according to WHO-IWGE classification.

Advanced stage, elevated LDH, primary sites, but not adolescent (A) age (≥ 15 years) as risk factors for disease progression in childhood (C) and adolescent (A) mature B-NHL: Report of the FAB/LMB 96 international trial

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. 10032-10032
Author(s):  
M. S. Cairo ◽  
R. Sposto ◽  
M. Gerrard ◽  
I. Waxman ◽  
S. Goldman ◽  
...  
Keyword(s):  
Risk Factors ◽  
Multivariate Analysis ◽  
Risk Factor ◽  
Risk Group ◽  
Significant Risk ◽  
High Risk Group ◽  
Stage Iii ◽  
Group A ◽  
Independent Risk Factors ◽  
Group B

10032 Background: We recently reported the results in C & A with low risk (group A), intermediate risk (group B) and high risk (group C) mature B-NHL treated on FAB/LMB 96 (Gerrard et al, Br J Haematol, 2008; Patte et al, Blood, 2007; Cairo et al, Blood, 2007, respectively). Adolescent age (15–21 yrs) has historically been considered to be an independent risk factor for poor outcome in subsets of mature B-NHL (Hochberg/Cairo et al, Br J Haematol, 2008; Burkhardt et al, Br J Haematol 2005; Cairo et al, Br J Haematol, 2003). Methods: We analyzed the EFS of all pts treated on FAB/LMB 96 and the following risk factors were significant in a univariate and Cox multivariate analysis: age (<15 vs ≥15 yrs), stage I/II vs III/IV, primary sites, LDH <2 vs ≥2 NL and histology (DLBCL vs BL/BLL). Results: 1111 pts (15%, 15–21 years) were treated with group A (N = 132), group B (N = 744), and group C (N = 235) therapy. Five year EFS (CI95) for all, A, B, C pts was 86% (84%,88%), 98% (93%, 100%), 87%% (84%, 89%), and 79%% (73%,84%), respectively. Age (≥15 yrs), LDH ≥2NL, stage III/IV, and BM+/CNS+ and histology were significant univariate risk factors for decreased EFS (P<0.045, <0.0001, <0.0001, <0.0001, and <0.0001 respectively). Multivariate analysis demonstrated age ≥15 yrs and DLBCL histology were no longer independent significant risk factors (p = .82 and 0.08, respectively), but LDH (RR 2.0, p = .001), stage III/IV (RR 3.8, p<0.001), and primary sites including PMBL (RR 4.0, p<.001) and BM+/CNS+ (RR 2.8, p<0.001) were independent significant risk factors for poorer outcome. Conclusions: With the use of modern short but intense FAB-LMB 96 therapy, adolescent age is no longer a poor risk factor in children with mature B-NHL. The independent risk factors identified in this study (stage, LDH, primary site) for decreased EFS in C & A mature B-NHL will form the basis of the next risk adapted international pediatric mature B-NHL trial. No significant financial relationships to disclose.

LIVER TRANSPLANTATION IN 444 CHILDREN: A MULTIVARIATE ANALYSIS OF RISK FACTORS IMPACT ON SURVIVAL.

1999 ◽  
Vol 67 (7) ◽  
pp. S214
Author(s):  
R. Reding ◽  
F. Gennari ◽  
J. Jamart ◽  
M. Janssen ◽  
E. Sokal ◽  
...  
Keyword(s):  
Risk Factors ◽  
Liver Transplantation ◽  
Multivariate Analysis ◽  
Impact On Survival

scholarly journals Risk factors for intraoperative massive transfusion in pediatric liver transplantation: a multivariate analysis

2017 ◽  
Vol 14 (2) ◽  
pp. 173-180 ◽  
Author(s):  
Seok-Joon Jin ◽  
Sun-Key Kim ◽  
Seong-Soo Choi ◽  
Keum Nae Kang ◽  
Chang Joon Rhyu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Liver Transplantation ◽  
Multivariate Analysis ◽  
Massive Transfusion ◽  
Pediatric Liver Transplantation ◽  
Pediatric Liver

RISK FACTORS FOR PRIMARY DYSFUNCTION AFTER LIVER TRANSPLANTATION—A MULTIVARIATE ANALYSIS

1993 ◽  
Vol 55 (4) ◽  
pp. 807-813 ◽  
Author(s):  
RUTGER J. PLOEG ◽  
ANTHONY M. DʼALESSANDRO ◽  
STUART J. KNECHTLE ◽  
MARK D. STEGALL ◽  
JOHN D. PIRSCH ◽  
...  
Keyword(s):  
Risk Factors ◽  
Liver Transplantation ◽  
Multivariate Analysis ◽  
Primary Dysfunction

Graft-versus-host disease after orthotopic liver transplantation: multivariate analysis of risk factors

2015 ◽  
Vol 29 (12) ◽  
pp. 1063-1066 ◽  
Author(s):  
Mohamed A. Elfeki ◽  
Surakit Pungpapong ◽  
Petrina V. Genco ◽  
Raouf E. Nakhleh ◽  
Justin H. Nguyen ◽  
...  
Keyword(s):  
Risk Factors ◽  
Liver Transplantation ◽  
Multivariate Analysis ◽  
Orthotopic Liver Transplantation ◽  
Graft Versus Host Disease ◽  
Host Disease ◽  
Graft Versus Host

Risk factors and patterns of HCC recurrence: Experience after 116 liver transplantation

2007 ◽  
Vol 39 (10) ◽  
pp. A40
Author(s):  
R. Montalti ◽  
G. Rompianesi ◽  
M. Masetti ◽  
L. Losi ◽  
F. Di Benedetto ◽  
...  
Keyword(s):  
Risk Factors ◽  
Liver Transplantation ◽  
Hcc Recurrence
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