Living donor liver transplantation without the use of blood products.

We report on two patients who presented with unresectable hepatocellular carcinoma complicating hepatitis B liver cirrhosis. After evaluation, both patients were accepted for liver transplantation. Being aware of the scarce availability of cadaveric liver grafts and the long waiting time, family members volunteered to be donors for the two patients. Living donor liver transplantation using right lobe liver grafts, including the middle hepatic vein, was subsequently performed without the use of blood products in both the donors and recipients. All involved recovered uneventfully from their respective operations.published_or_final_versio

Levels of HBV DNA and not HBsAg are associated with biochemical flares after HBeAg seroconversion

BACKGROUND: The role of HBsAg levels in predicting subsequent flares in chronic hepatitis B patients after HBeAg seroconversion is not known METHODS: Serum HBsAg and HBV DNA levels were determined in 224 CHB patients at 6-12 months after spontaneous HBeAg seroconversion. Serum HBV DNA levels were performed using Cobas Taqman assay. HBsAg titers were determined using Roche Elecsys HBsAg II ...postprin

Epitaxial growth of yttrium-stabilized HfO₂ high-k gate dielectric thin films on Si

2003-2004 > Academic research: refereed > Publication in refereed journalVersion of RecordPublishe

Study of interfacial reaction and its impact on electric properties of Hf-Al-O high-k gate dielectric thin films grown on Si

2002-2003 > Academic research: refereed > Publication in refereed journalVersion of RecordPublishe

Growth and characterization of Hf-aluminate high-k gate dielectric ultrathin films with equivalent oxide thickness less than 10 Å

Author name used in this publication: J. Y. DaiAuthor name used in this publication: K. H. WongAuthor name used in this publication: H. L. W. ChanAuthor name used in this publication: C. L. Choy2002-2003 > Academic research: refereed > Publication in refereed journalVersion of RecordPublishe

Effect of nucleos(t)ide analogues therapy on HBsAg, intrahepatic HBV DNA and covalently closed circular DNA levels

BACKGROUND: We aimed to study 1) the effects of 1-year nucleos(t)ide analogue (NA) therapy on HBsAg and covalently closed circular DNA (cccDNA) levels; and 2) the possible use of HBsAg reduction as a marker for cccDNA reduction. METHODS: We recruited 124 NA-treated patients with ...postprin

Perioperative nutritional support in patients undergoing hepatectomy for hepatocellular carcinoma

Background. Resection of hepatocellular carcinoma is associated with high rates of morbidity and mortality. Since intensive nutritional support can reduce the catabolic response and improve protein synthesis and liver regeneration, we performed a prospective study to investigate whether perioperative nutritional support could improve outcome in patients undergoing hepatectomy for hepatocellular carcinoma. Methods. We studied 124 patients undergoing resection of hepatocellular carcinoma. Sixty-four patients (39 with cirrhosis, 18 with chronic active hepatitis, and 7 with no associated liver disease) were randomly assigned to receive perioperative intravenous nutritional support in addition to their oral diet, and 60 patients (33 with cirrhosis, 12 with chronic active hepatitis, and 15 with no associated liver disease) were randomly assigned to a control group. The perioperative nutritional therapy consisted of a solution enriched with 35 percent branched-chain amino acids, dextrose, and lipid emulsion (50 percent medium-chain triglycerides) given intravenously for 14 days perioperatively. Results. There was a reduction in the overall postoperative morbidity rate in the perioperative-nutrition group as compared with the control group (34 percent vs. 55 percent; relative risk, 0.66; 95 percent confidence interval, 0.45 to 0.96), predominantly because of fewer septic complications (17 percent vs. 37 percent; relative risk, 0.57; 95 percent confidence interval, 0.34 to 0.96). There were also a reduction in the requirement for diuretic agents to control ascites (25 percent vs. 50 percent; relative risk, 0.57; 95 percent confidence interval, 0.37 to 0.87), less weight loss after hepatectomy (median loss, 0 kg vs. 1.4 kg; P = 0.01), and less deterioration of liver function as measured by the change in the rate of clearance of indocyanine green (-2.8 percent vs. -4.8 percent at 20 minutes, P = 0.05). These benefits were seen predominantly in the patients with underlying cirrhosis who underwent major hepatectomy. There were five deaths during hospitalization in the perioperative-nutrition group, and nine in the control group (P not significant). Conclusions. Perioperative nutritional support can reduce complications after major hepatectomy for hepatocellular carcinoma associated with cirrhosis.published_or_final_versio

Quality-adjusted life years: population-specific measurement of the quality component.

Key Message: A valid scoring algorithm was developed to translate local SF-36 datasets to quality-adjusted life years.published_or_final_versio

Portal vein embolisation prior to extended right-sided hepatic resection

Objectives. To determine whether preoperative portal vein embolisation improves the operative outcome of patients undergoing extended right-sided hepatic resection for hepatobiliary malignancy. Design. Prospective non-randomised study. Setting. University teaching hospital, Hong Kong. Patients. Ninety-two patients underwent extended right-sided hepatic resection for hepatobiliary malignancy during a 45-month period (January 2000 to September 2003). Among them, 15 (16%) underwent portal vein embolisation via a percutaneous ipsilateral approach (n=9) or through the ileocolic vein with a mini-laparotomy (n=6). The remaining 77 (84%) patients underwent hepatic resection without portal vein embolisation. Main outcome measures. Operative morbidity and mortality. Results. Patients undergoing portal vein embolisation were older (69 years vs 55 years; P=0.009), and had significantly worse preoperative renal function (creatinine, 96 μmol/L vs 86 μmol/L; P=0.039) and liver function (bilirubin, 23 μmol/L vs 12 μmol/L; P<0.001). Portal vein embolisation resulted in an increase in the future liver remnant of 9% (interquartile range, 7-13%) of the estimated standard liver volume. The operating time for patients receiving portal vein embolisation was significantly longer (medium, 660 min vs 420 min; P<0.001) with more complicated surgery performed in terms of concomitant caudate lobectomy and hepaticojejunostomy. There was no hospital mortality in patients who underwent portal vein embolisation whereas five without the treatment died (P=0.587). The operative morbidity of patients who underwent portal vein embolisation and those who did not was 20% and 30%, respectively (P=0.543). Conclusions. In older patients who have worse preoperative liver and renal functions, portal vein embolisation enhances the possibility to perform extended right-sided hepatic resection for hepatobiliary malignancies with potentially lower operative mortality and morbidity.published_or_final_versio

Hepatic resection for colorectal liver metastases: prospective study.

OBJECTIVE: To assess the operative and long-term survival outcomes of hepatic resection for colorectal liver metastases during an 11-year period in a tertiary referral centre in Hong Kong. DESIGN: Prospective study. SETTING: University teaching hospital, Hong Kong. SUBJECTS AND METHODS: Between January 1989 and December 1999, 72 patients underwent hepatic resection for colorectal liver metastases. Clinical, pathological, and outcome data were prospectively collected and analysed. Factors affecting long-term survival were also evaluated. RESULTS: Twenty-five (34.7%) patients were found to have synchronous hepatic metastasis at the time of colorectal resection. Fifty-two (72.2%) patients underwent major hepatic resection. The operative morbidity and hospital mortality rates were 19% and 4%, respectively. The 5-year survival rate after hepatectomy was 31.9%. The median disease-free survival and median overall cumulative survival were 18.5 months and 30.8 months, respectively. On multivariate analysis, a high preoperative serum carcinoembryonic antigen level (>200 ng/mL) and tumour involvement of the resection margin at histology were the two independent risk factors that adversely affected survival outcome. CONCLUSION: Hepatic resection for colorectal liver metastases can be performed safely, with minimal operative mortality and acceptable morbidity, and results in satisfactory survival. High preoperative serum carcinoembryonic antigen level and histological involvement of resection margin by cancer adversely affect the survival outcome.published_or_final_versio