Outcomes in Hepatocellular Carcinoma Liver Transplantation before and after the Mandated Six-Month Wait Time

2019 ◽  
Vol 85 (8) ◽  
pp. 900-903
Author(s):  
Venkat Sumanth Potluri ◽  
Julio Sokolich ◽  
Jacentha Buggs ◽  
William Mcclellan ◽  
Ebonie Rogers ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Liver Transplantation ◽  
Resource Utilization ◽  
Wait Time ◽  
Outcome Data ◽  
Continuous Variables ◽  
Before And After ◽  
The Difference ◽  
One Year ◽  
United Network

The United Network for Organ Sharing (UNOS) implemented a policy that requires patients with hepatocellular carcinoma seeking liver transplantation to wait six months before being granted Model for End-Stage Liver Disease exception points. We investigated the difference in resource utilization between patients who underwent liver transplantation before and after the present policy. We conducted a retrospective cohort study of adult liver transplants from 2013 to 2018. Patients were classified into prepolicy or postpolicy groups based on 964 days before or after the wait-time policy. We also retrieved national survival outcome data from United Network for Organ Sharing. Differences across compared groups for continuous variables were assessed using the independent sample t test, and the chi-squared test was used for binary variables. We found statistical differences in recipient age ( P = 0.005), days on wait-list ( P = 0.001), sustained viro-logical response ( P < 0.001), and hepatocellular carcinoma recurrence one year posttransplant ( P = 0.04). There were statistically significant differences in the number of treatment days pretransplant and length of transplant admission stay, indicating an increase in resource utilization in the postpolicy group. No statistically significant differences were found between groups in one-year graft or patient survival despite an observed increase in resource utilization by the hepatocellular carcinoma postpolicy group.

scholarly journals Incidence, Characteristics, and Prognosis of Incidentally Discovered Hepatocellular Carcinoma after Liver Transplantation

2016 ◽  
Vol 2016 ◽  
pp. 1-6 ◽  
Author(s):  
Walid El Moghazy ◽  
Samy Kashkoush ◽  
Glenda Meeberg ◽  
Norman Kneteman
Keyword(s):  
Hepatocellular Carcinoma ◽  
Liver Transplantation ◽  
Tumor Recurrence ◽  
Patient Survival ◽  
Steady Increase ◽  
Liver Transplants ◽  
Significant Difference ◽  
One Year ◽  
Over Time

Background. We aimed to assess incidentally discovered hepatocellular carcinoma (iHCC) over time and to compare outcome to preoperatively diagnosed hepatocellular carcinoma (pdHCC) and nontumor liver transplants.Methods.We studied adults transplanted with a follow-up of at least one year. Patients were divided into 3 groups according to diagnosis of hepatocellular carcinoma.Results.Between 1990 and 2010, 887 adults were transplanted. Among them, 121 patients (13.6%) had pdHCC and 32 patients (3.6%) had iHCC; frequency of iHCC decreased markedly over years, in parallel with significant increase in pdHCC. Between 1990 and 1995, 120 patients had liver transplants, 4 (3.3%) of them had iHCC, and only 3 (2.5%) had pdHCC, while in the last 5 years, 263 patients were transplanted, 7 (0.03%) of them had iHCC, and 66 (25.1%) had pdHCC (P<0.001). There was no significant difference between groups regarding patient survival; 5-year survival was 74%, 75.5%, and 77.3% in iHCC, pdHCC, and non-HCC groups, respectively (P=0.702). Patients with iHCC had no recurrences after transplant, while pdHCC patients experienced 17 recurrences (15.3%) (P=0.016).Conclusions.iHCC has significantly decreased despite steady increase in number of transplants for hepatocellular carcinoma. Patients with iHCC had excellent outcomes with no tumor recurrence and survival comparable to pdHCC.

scholarly journals The impact of COVID 19 pandemic on pattern of cancer mortality in Najran, Saudi Arabia: a single-cancer center experience

2021 ◽  
Author(s):  
Ahmed M Badheeb ◽  
Mohamed A Badheeb ◽  
Hamdi A Alhakimi
Keyword(s):  
Hepatocellular Carcinoma ◽  
Saudi Arabia ◽  
Cancer Treatment ◽  
Cancer Patients ◽  
Cancer Mortality ◽  
Cancer Center ◽  
Anti Cancer ◽  
Before And After ◽  
The Difference ◽  
The Impact

Abstract Background: The aim of this paper is to compare the patterns and determinants of cancer mortality in Najran region before and after the COVID-19 epidemics. The association between cancer mortality and each of age, sex, site of cancer, stage, and the 30-days survival rate after the last dose of chemotherapy were assessed.Materials & Methods: Adult cancer patients who died of cancer in King Khalid Hospital in Najran Saudi Arabia, were included in this retrospective observational study. We compared mortality patterns in a period of 6 months in 2020 (March to August) with the corresponding period of 2019.Results: 50 dead adult cancer patients were included, 24 in 2019 and 26 in 2020. Among them, 21% vs 42% were younger than 65 years of age; 61% vs 62% were males, for the years 2019 & 2020 respectively. The top three killers in 2019 were colorectal, gastro-esophageal cancers, and hepatocellular carcinoma, while in 2020 were colorectal, hepatocellular carcinoma, and lymphomas. About 16.7% of patients died within 30 days of receiving anti-cancer treatment in 2019 in comparison with 7.7% in 2020. The difference in the 30-days mortality after receiving anti-cancer treatment was not statistically significant between 2019 and 2020 (p = 0.329).Conclusion: The Year 2020, the time of the COVID-19pandemic, was not associated with a significant increase in short-term mortality among patients with malignancy in Najran, Saudi Arabia. Our results generally reflect the crucial role of strict preventive national measures in saving lives and warrants further exploration.

scholarly journals Low Serum Melatonin Levels Prior to Liver Transplantation in Patients with Hepatocellular Carcinoma are Associated with Lower Survival after Liver Transplantation

2019 ◽  
Vol 20 (7) ◽  
pp. 1696
Author(s):  
Leonardo Lorente ◽  
Sergio Rodriguez ◽  
Pablo Sanz ◽  
Pedro Abreu-González ◽  
Agustín González-Rivero ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Liver Transplantation ◽  
Antioxidant Capacity ◽  
Total Antioxidant Capacity ◽  
Serum Levels ◽  
High Serum ◽  
Published Data ◽  
Lower Serum ◽  
Total Antioxidant ◽  
One Year

Melatonin administration has been associated with different benefits in animals and patients suffering from liver diseases. However, there is no published data about circulating melatonin levels in patients with hepatocellular carcinoma (HCC) who underwent liver transplantation (LT). Thus, the objective of this observational and retrospective study was to determine whether patients with HCC with lower serum melatonin levels prior to LT have a higher risk of one-year mortality after LT. We measured serum levels of melatonin, malondialdehyde (to assess lipid peroxidation), and total antioxidant capacity (to assess antioxidant state) before LT. One-year surviving LT patients (n = 129) showed higher serum levels of melatonin (p = 0.001) and total antioxidant capacity (p = 0.001) and lower serum levels of malondialheyde (p = 0.01) than non-surviving LT patients (n = 16). Logistic regression analysis showed that high serum melatonin levels prior to LT were associated with lower one-year LT mortality (odds ratio = 0.525; 95% confidence interval (CI) = 0.331–0.834; p = 0.006). We found an association between serum levels of melatonin with serum levels of malondialheyde (rho = −0.22; p = 0.01) and total antioxidant capacity (rho = 0.21; p = 0.01). Thus, the novel findings of our study were the association between high serum melatonin levels prior to LT and survival at first year after LT and the association between serum levels of melatonin with malondialheyde and total antioxidant capacity.

scholarly journals Prognostic Value of Serum Caspase-Cleaved Cytokeratin-18 Levels before Liver Transplantation for One-Year Survival of Patients with Hepatocellular Carcinoma

2016 ◽  
Vol 17 (9) ◽  
pp. 1524 ◽  
Author(s):  
Leonardo Lorente ◽  
Sergio Rodriguez ◽  
Pablo Sanz ◽  
Antonia Pérez-Cejas ◽  
Javier Padilla ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Liver Transplantation ◽  
Prognostic Value ◽  
Cytokeratin 18 ◽  
One Year

scholarly journals Association between Pre-Transplant Serum Malondialdehyde Levels and Survival One Year after Liver Transplantation for Hepatocellular Carcinoma

2016 ◽  
Vol 17 (4) ◽  
pp. 500 ◽  
Author(s):  
Leonardo Lorente ◽  
Sergio Rodriguez ◽  
Pablo Sanz ◽  
Pedro Abreu-González ◽  
Dácil Díaz ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Liver Transplantation ◽  
One Year

scholarly journals Patients with high serum substance P levels previously to liver transplantation for hepatocellular carcinoma have higher risk of one-year liver transplantation mortality

Oncotarget ◽  
2018 ◽  
Vol 9 (30) ◽  
pp. 21552-21559 ◽  
Author(s):  
Leonardo Lorente ◽  
Sergio T. Rodriguez ◽  
Pablo Sanz ◽  
Antonia Pérez-Cejas ◽  
Javier Padilla ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Liver Transplantation ◽  
Substance P ◽  
High Serum ◽  
One Year

scholarly journals Liver Transplantation for Hepatocellular Carcinoma: Impact of Wait Time at a Single Center

2017 ◽  
Vol 16 (3) ◽  
pp. 402-411 ◽  
Author(s):  
William C. Palmer ◽  
David Lee ◽  
Justin Burns ◽  
Kristopher Croome ◽  
Barry Rosser ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Liver Transplantation ◽  
Wait Time ◽  
Single Center

scholarly journals Visual and Refractive Outcomes of Cataract Surgeries Performed in One Year in a Private Practice Setting: Review of 2714 Procedures

2020 ◽  
Vol 2020 ◽  
pp. 1-9
Author(s):  
Laureano A. Rementería-Capelo ◽  
Jorge L. García-Pérez ◽  
Juan Gros-Otero ◽  
Aida Morán ◽  
José M. Sánchez-Pina ◽  
...  
Keyword(s):  
Cataract Surgery ◽  
Private Practice ◽  
Outcome Data ◽  
Practice Setting ◽  
Spherical Equivalent ◽  
Refractive Outcomes ◽  
Preoperative Information ◽  
The Difference ◽  
One Year ◽  
Spectrum Of Patients

Introduction. Currently available outcome data for cataract surgery include mostly patients from public health systems. The purpose of this study was to report the visual and refractive outcomes of cataract procedures performed during one year in a private practice center, which may include a different spectrum of patients. Methods. Our center’s database was used to identify all isolated cataract procedures performed during 2017. The electronic records were reviewed to collect the preoperative information, presence of intra- or postsurgical complications, and visual and refractive outcomes one month after surgery. Results. In 2017, 2714 eyes of 1543 patients underwent cataract surgery in our center. Mean patient age was 70.42 years. 775 eyes (28.55%) had prior ophthalmic pathologies, and 113 eyes (4.16%) had undergone previous surgical procedures. Surgical complications developed in 35 eyes (1.29%), including 9 posterior capsule tears (0.33%) and 3 cases of dropped lens fragments (0.11%). A toric or multifocal intraocular lens was implanted in 45.6% of eyes. As regards postoperative complications, 59 eyes (2.17%) required a return to the operating theater, including 29 eyes (1.07%) requiring reinterventions due to an unexpected refractive result. There were no cases of endophthalmitis. Mean LogMAR-corrected distance visual acuity (CDVA) improved from 0.25 (SD 0.34) preoperatively to 0.04 (SD 0.17) postoperatively; 86.5% of eyes achieved a CDVA ≤0.0, with 97.5% achieving ≤0.3. In 86.4% of eyes, the difference between target and residual spherical equivalent difference was of 0.50 D or lower; 88% of eyes had a spherical equivalent ±0.50 D. Conclusions. The visual and refractive outcomes of cataract surgery in a private practice setting were excellent, well over the benchmarks set by the ESCRS. The safety profile was also within expected standards. This study provides information for ophthalmologists in private practice on expected outcomes.

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