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"Preemptive" Live Donor Liver Transplantation for Fibrolamellar Hepatocellular Carcinoma: A Case Report

TRANSPLANTATION PROCEEDINGS 2008年第10期40卷 3806-3807页

作者： Fouzas, I. Sotiropoulos, G. C. Molmenti, E. P. Beckebaum, S. Schmitz, K. J. Broelsch, C. E. Lang, H. Malago, M. Johannes Gutenberg Univ Hosp Dept Gen & Abdominal Surg D-55131 Mainz Germany Univ Hosp Essen Dept Gen Visceral & Transplantat Surg Essen Germany Univ Hosp Essen Inst Pathol & Neuropathol Essen Germany Hippocrat Univ Hosp Organ Transplant Unit Thessaloniki Greece

Fibrolamellar (FL) hepatocellular carcinoma (HCC) is a distinctive form of primary HCC that occurs principally in children and young adults. Although liver transplantation is not contraindicated for FL-HCC, noncirrhotic patients with large HCC tumors (including FL-HCCs) are not prioritized. Although hepatic resection is considered to be the primary treatment for FL-HCC, living donor liver transplantation is evolving into a potentially better alternative. Herein we have reported successful "preemptive" living donor liver transplantation for presumed recurrence of FL-HCC after an extended right hepatectomy with resection and synthetic graft replacement of the inferior vena cava.

关键词： Adult Carcinoma Hepatocellular Combined Modality Therapy Factor V Female 成年人癌肝细胞综合疗法因子Ⅴ 肝肿瘤活体供者突变安全 Adults Liver Transplantation Carcinoma primary treatment Extended right hemihepatectomy grafts synthetic Combined Modality Therapy blood clotting factor 5 ectomy human-centered computing Inferior Vena Cava Living Donors Young Adult

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HCV histological recurrence and survival following liver transplantation in patients with and without hepatocellular carcinoma

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TRANSPLANTATION PROCEEDINGS 2008年第6期40卷 1974-1975页

作者： De Martin, E. Senzolo, M. Boninsegna, S. Guido, M. Masier, A. Germani, G. Tomat, S. Brolese, A. Neri, D. Cillo, U. Gambato, M. Russo, F. P. Farinati, F. Burra, P. Univ Padua Dept Surg Gastroenterol Sci Gastroenterol Padua Italy Univ Padua Inst Pathol Padua Italy

Background and aim. Hepatitis C virus (HCV)-related cirrhosis is one of the leading indication for liver transplantation (LT) and a major risk factor for the development of hepatocellular carcinoma (HCC). HCV recurrence after LT is universal. This study evaluated HCV recurrence and Survival in patients transplanted for HCV and HCC. Methods. We evaluated all adults transplanted for HCV cirrhosis between January 1999 and December 2006, HCC was diagnosed on the explant and HCV recurrence confirmed on protocol liver biopsies performed at 6 months and yearly after LT. The sustained viral response (SVR) was defined as HCV-RNA undetectable at 6 months after therapy discontinuation. The patient survival rates were assessed with Kaplan-Meier curves and the chi-square test was used when appropriate. Results. Two hundred sixteen patients underwent LT for HCV including 153 men and 63 women of mean age 54 years with a mean follow-up of 35 months. There were 71 (33%) HCC+ patients. At 1, 3, and 5 years from LT severe fibrosis (Scheuer 3-4) due to the HCV recurrence was reported in 18%, 14%, and 11% for HCC+ and 14%, 16%, and 28% for HCC- patients respectively (P = NS). HCC recurred only in 3 (4%) patients at a mean follow-up of 3 years. Patients who received antiviral treatment after LT were 10% HCC+ and 12% HCC- patients (P = NS). SVR was seen in 3/7 (43%) of HCC+ and in 10/18 (55%) of HCC- patients (P = NS). At 1, 3, and 5 years the patient survivals was 91%, 86%, and 86% for HCC+ and 94%, 86%, and 83% for HCC- patients, respectively (P = NS). Conclusions. Severe fibrosis due to HCV recurrence, which increases over time, involves one third of transplanted patients at 5 years after LT. The long-term survival was identical among HCC+ compared to HCC- recipients. The recurrence of HCC was negligible and did not affect patient survival.

关键词： Hepatitis C virus Recurrence Lymphotoxin survival aspects 复发淋巴毒素 Level Trigger Hepatocellular Cancer Risk Factors Lymphotoxin-alpha Peripheral Nervous System Survival Liver Transplantation human-centered computing Relapse Patients

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Living Donor Liver Transplantation for Hepatocellular Carcinoma in Patients Exceeding the UCSF Criteria

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TRANSPLANTATION PROCEEDINGS 2008年第9期40卷 3185-3188页

作者： Fouzas, I. Sotiropoulos, G. C. Lang, H. Nadalin, S. Beckebaum, S. Sgourakis, G. Saner, F. H. Radtke, A. Papanikolaou, V. Baba, H. A. Paul, A. Broelsch, C. E. Malago, M. Johannes Gutenberg Univ Hosp Dept Gen & Abdominal Surg D-55131 Mainz Germany Hippocration Univ Hosp Organ Transplant Unit Thessaloniki Greece Univ Hosp Dept Gen Visceral & Transplantat Surg Essen Germany Univ Hosp Inst Pathol & Neuropathol Essen Germany

Background. Living donor liver transplantation (LDLT) represents an alternative to expand the organ pool for adult patients with hepatocellular carcinoma (HCC) and end-stage liver disease. The purpose of this study was to demonstrate our institutional experience using criteria exceeding those of the University of California San Francisco (UCSF). Patients and Methods.. Between September 1998 and December 2006, 22 LDLTs were performed for HCC among patients exceeding the UCSF criteria. Results. There were 17 men and 5 women of median age 55 years. Multifocal tumors were present in 19 of 22 patients. Tumor grading was: grade I (n = 8), grade II (n = 10), and grade III (n = 4). Microvascular invasion was observed in 7 liver explants. Five patients died from complications unrelated to HCC recurrence at 2, 6, 9, 10, and 14 months' posttransplant. Seven patients developed tumor recurrences at 3, 3, 5, 7, 9, 10, and 35 months after LDLT, and 4 died at 6, 10, 17, and 75 months' posttransplantation. Currently, 13 patients are alive (3 with tumor recurrence) at a median of 24 months' posttransplant. Rates for 1- and 3-year overall versus recurrence-free survivals were 73% and 62% versus 54% and 34%, respectively. Conclusions. LDLT for HCC patients exceeding the UCSF criteria is characterized by an acceptable overall but poor recurrence-free survival. Its application requires an honest approach to donor and recipient information.

关键词： Hepatocellular Cancer End Stage Liver Disease Liver Transplantation human-centered computing Living Donors Patients Recurrent Neoplasm

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UGT1A7 haplotype is associated with an increased risk of hepatocellular carcinoma in hepatitis B carriers

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CANCER SCIENCE 2008年第2期99卷 340-344页

作者： Kong, Sun-Young Ki, Chang-Seok Yoo, Byung Chul Kim, Jong-Won Sungkyunkwan Univ Sch Med Samsung Med Ctr Dept Lab Med & Genet Seoul 135710 South Korea Sungkyunkwan Univ Sch Med Samsung Med Ctr Dept Internal Med Seoul 135710 South Korea Natl Canc Ctr Res Inst & Hosp Ctr Clin Serv Dept Lab Med Goyang Si 410769 Gyeonggi Do South Korea

The UGT1A7 gene encodes UDP-glucuronosyltransferase, a key enzyme catalyzing the glucuronidation of various carcinogens. In this study, we investigated the association between haplotypes of the whole UGT1A7 gene and the risk of hepatocellular carcinoma (HCC) in patients with chronic hepatitis B. Sequence analysis of exon1 and the promoter region of the UGT1A7 gene was carried out to determine haplotype profiles for 244 patients with hepatocellular carcinoma, 223 hepatitis B carriers, and 314 healthy control subjects. Hepatitis B carriers with haplotypes other than haplotype 1 (Ht1;CTCTCGTG at -341, -57, 33, 387, 391, 392, 622, and 756) had a significantly greater risk of developing HCC with odds ratios (OR) of 1.67 (95% confidence interval [CI];1.11-2.52) for Ht1/others and 1.85 (95% CI;1.09-3.14) for others/others. In multivariate logistic regression analysis including age and haplotypes from Ht1 to Ht4, the presence of Ht2 (CGAGAACG) or Ht4 (CTCGAATG) was associated with HCC risk (OR = 1.45 [95% CI;1.03-2.03] and 4.95 [95% CI;1.75-13.98], respectively). The results of this study show that the UGT1A7 haplotype is a suitable susceptibility marker for the development of HCC in hepatitis B carriers.

关键词： Haplotypes Risk Cephalic index Primary carcinoma of the liver cells 单元型危险 UGT1A7 gene carrier of factor IX deficiency promoter regions Hepatocellular Cancer multivariate logistic regression analysis Haplotypes human-centered computing Hepatitis B

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Salvage Liver Transplantation for Recurrent Hepatocellular Carcinoma After Liver Resection: Feasibility of the Milan Criteria and Operative Risk

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TRANSPLANTATION PROCEEDINGS 2008年第10期40卷 3558-3561页

作者： Kim, B. -W. Park, Y. -K. Kim, Y. -B. Wang, H. -J. Kim, M. -W. Ajou Univ Dept Surg Sch Med Suwon 441749 South Korea Ajou Univ Dept Pathol Sch Med Suwon 441749 South Korea

Introduction. Although the Milan criteria are widely accepted for liver transplantation (OLT) for hepatocellular carcinoma (HCC), they have not been fully evaluated as feasible for salvage liver transplantation (SLT) of recurrent HCC after hepatic resection. The operative difficulties of SLT increase the operative risk. The aim of this study was to evaluate the feasibility of the Milan criteria for SLT and its operative complications. Patients and methods. From March 2005 to November 2007, 46 HCC patients received OLT including 15 SLTs after prior partial hepatectomy (SLT group) and 31 primary OLTs (PLT group). Results. There was no postsurgical hospital mortality among the SLT group but one case in the PLT group due to pneumonia followed by sepsis. There was no difference in the incidence of surgical complications between the two groups. Overall survival rates of SLT group patients were similar to those of the PLT group (P =.14), especially comparing both groups of patients within the Milan criteria (P =.89). There was no recurrence of HCC among the patients within the Milan criteria. Conclusions. SLT is a feasible procedure for recurrent HCC meeting the Milan criteria;the operative risk of the SLT is also acceptable.

关键词： Adult Carcinoma Hepatocellular Feasibility Studies Female humans Liver Neoplasms 成年人癌肝细胞可行性研究肝肿瘤肝移植肿瘤复发局部病人选择 Carcinoma MCHR2 gene Recurrent Hepatocellular Carcinoma Liver Neoplasms human-centered computing Adults Optical Line Terminal Liver Transplantation

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Case-control study on cigarette smoking and the risk of hepatocellular carcinoma among Japanese

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CANCER SCIENCE 2008年第1期99卷 93-97页

作者： Hara, Megumi Tanaka, Keitaro Sakamoto, Tatsuhiko Higaki, Yasuki Mizuta, Toshihiko Eguchi, Yuichiro Yasutake, Tsutomu Ozaki, Iwata Yamamoto, Kyosuke Onohara, Shingo Kawazoe, Seiji Shigematsu, Hirohisa Koizumi, Shunzo Saga Univ Dept Prevent Med Saga 8498501 Japan Saga Univ Dept Internal Med Saga 8498501 Japan Saga Univ Fac Med Dept Gen Med Saga 8498501 Japan Saga Prefectural Hosp Koseikan Dept Internal Med Saga 8408571 Japan

Emerging epidemiologic data suggest that cigarette smoking may increase the risk of hepatocellular carcinoma (HCC), yet considerable controversies (e.g. inconsistent dose-response relationships) still exist with this association. We examined whether smoking was associated with HCC risk in a case-control study including 209 incident HCC cases and two different control groups (256 hospital controls and 381 patients with chronic liver disease [CLD] without HCC). Comparison of HCC cases with CLD patients, but not with hospital controls, demonstrated a significantly increased risk of HCC for current smokers. After adjustment for sex, age, heavy drinking history and hepatitis virus markers, odds ratios (and 95% confidence intervals) for former and current smokers relative to never smokers were 1.0 (0.6-1.7) and 2.5 (1.4-4.6), respectively, against CLD patients, as compared with 0.8 (0.3-2.3) and 1.8 (0.6-5.1), respectively, against hospital controls. In terms of pack-years during lifetime, dose-response relationship was not evident against either control group (P trend = 0.43), but it became clearer for more recent cigarette use among CLD patients. For example, regarding cumulative cigarette consumption during the last 5 years, adjusted odds ratios (and 95% confidence intervals) for 1-4 and 5+ pack-years relative to no use were 1.9 (1.1-3.6) and 2.8 (1.5-5.2) (P trend = 0.003), respectively. These results suggest that cigarette smoking may play a crucial role in the late stage of HCC development and that CLD patients may benefit from their earliest smoking cessation.

关键词： Adult Aged Carcinoma Hepatocellular Case-Control Studies Female humans 成年人老年人癌肝细胞病例对照研究日本肝肿瘤吸烟 Carcinoma Hepatocellular Cancer hospital Case-Control Studies Confidence intervals cigarette consumption Cigarette Smoking human-centered computing Adults Odds Ratio Current smoker

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Management of de novo hepatocellular carcinoma developing in a transplanted liver

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DIGESTIVE DISEASES AND SCIENCES 2008年第5期53卷 1424-1425页

作者： Kita, Yoshiaki Yanaga, Katsuhiko Jikei Univ Sch Med Dept Surg Minato Ku Tokyo 1058471 Japan

We read with great interest the recent paper by Croitoru et al. on de novo hepatocellular carcinoma (HCC) occurring in a transplanted liver. The authors made a detailed analysis of their own patient and also reported cases of de novo HCC developing in the explanted liver with recurrent hepatitis C (HCV)-related cirrhosis. We completely agree with the authors' conclusion that it is necessary to follow up liver recipients with recurrent HCV-related cirrhosis carefully in order to be able to diagnose de novo HCC in the early stage and, consequently, initiate effective therapy.

关键词： Carcinoma Hepatocellular humans Liver Neoplasms Liver Transplantation 癌肝细胞肝肿瘤肝移植再手术移植物 liver transplant Liver Cirrhosis Liver Transplantation Liver Neoplasms human-centered computing Carcinoma

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Virtual humans Elicit Skin-Tone Bias Consistent with Real-World Skin-Tone Biases

Virtual Humans Elicit Skin-Tone Bias Consistent with Real-Wo...

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8th International Conference on Intelligent Virtual Agents

作者： Rossen, Brent Johnsen, Kyle Deladisma, Adeline Lind, Scott Lok, Benjamin Univ Florida CISE Gainesville FL 32611 USA Med Coll Georgia Dept Surg Oncol Augusta GA 30912 USA

ISBN: (纸本)9783540854821

In this paper, we present results from a study that shows that a dark skin-tone VH agent elicits user behavior consistent with real world skin-tone biases. Results from a study with medical students (n=21), show participant empathy towards a dark skin-tone VH patient was predicted by their measured bias towards African-Americans. Real world bias was measured using a validated psychological instrument called the implicit association test (IAT). Scores on the IAT were significantly correlated to coders' ratings of participant empathy. This result indicates that VHs elicit realistic responses and could become an important component in cultural diversity training.

关键词： Virtual humans intelligent agents virtual reality human-centered computing user interfaces racial bias medicine computer graphics

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A modeling framework for evaluating effectiveness of smart-infrastructure crises management systems

A modeling framework for evaluating effectiveness of smart-i...

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IEEE Conference on Technologies for Homeland Security

作者： Mukherjee, Tridib Gupta, Sandeep K. S. Arizona State Univ Dept Comp Sci & Engn Impact Lab Sch Comp & Informat Tempe AZ 85287 USA

ISBN: (纸本)9781424419777

Crises management for smart-infrastructure - infused with sensors, actuators, and intelligent agent technologies for monitoring, access control, and crisis response - requires objective and quantitative evaluation to learn for future. The concept of criticality - characterizing the effect of crises on the inhabitants of smart-infrastructure - is used in this regard. This paper establishes a Criticality Response Modeling (CRM) framework to perform quantitative evaluation of criticality response. The framework can further be incorporated in any criticality-aware middleware for smart-infrastructure. An established stochastic model for criticality response is used from our previous work. The effectiveness of criticality response is measured in terms of the Manageability metric, characterized by the Q-value or Qualifiedness of the response actions. The CRM is applied to fire emergencies in an envisioned smart Oil & Gas Production Platforms (OGPP). A simulation based evaluation, using CRM over OGPP, show that high manageability is achieved with - i) fast criticality detection, ii) fast response actuation, and iii) non-obliviousness to any subsequent criticality during response actuation - verifying the applicability of Q-value as the manageability metric.

关键词： crisis response criticality stochastic model smart-infrastructure evaluation framework middleware human-centered computing

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Looking forward: New ideas, new opportunities

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IEEE Multimedia 2008年第1期15卷 C2页

作者： Panchanathan, Sethuraman Arizona State University Tempe AZ United States

No abstract available

关键词： human-centered computing multimedia special issues

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