Differences in insulin-like growth factor 1 (IGF-1) serum levels after liver transplantation according to (A) donor age and (B) extended criteria donor (ECD) score.

<p>Values are expressed as the mean ± standard error of the mean. Student’s t test for unpaired samples was employed to investigate significant differences between hormonal values at different time points. <b>Abbreviations:</b> IGF-1, insulin-like growth factor 1; LT, liver transplantation; ECD, extended criteria donor.</p

(A) Serum levels of growth hormone (GH) and (B) insulin-like growth factor 1 (IGF-1) before and after liver transplantation.

<p>Values are expressed as the mean ± standard error of the mean. Student’s t test for paired samples was employed to investigate significant differences in hormonal values over time. * p <0.05 compared with the previous value; ^<b>Ω</b> p <0.01 compared with the pre-LT value. <b>Abbreviations:</b> IGF-1, insulin-like growth factor 1; LT, liver transplantation; GH, growth hormone.</p

Baseline recipients’ and donors’ characteristics.

<p>Continuous values are expressed as the mean ± standard error of the mean. LT, liver transplantation; MELD, Model for End-Stage Liver Disease; PBC, primary biliary cirrhosis; ECD, extended criteria donor; DMELD, donor age x recipient MELD.</p

Univariate and multivariate analysis of risk factors affecting patient survival.

<p>IGF-1, insulin-like growth factor 1; LT, liver transplantation; ECD, extended criteria donor; DMELD, donor age x Model for End Stage Liver Disease; EAD, early allograft dysfunction; DRI, Donor Risk Index; HCV, hepatitis C virus; HCC, hepatocellular carcinoma; POD, postoperative day.</p

Actual 3-year survival analysis in patients showing normal (solid line) or low (dotted line) IGF-1 plasma levels on postoperative day 15.

<p>Survival differences were investigated by the Log Rank test. <b>Abbreviations:</b> IGF-1, insulin-like growth factor 1; LT, liver transplantation; POD, postoperative day.</p

Case #1.

<p>FLR before ALPPS-1 (A) and after 6 days (B) in a patient with pCCA.</p

ALPPS Procedure for Extended Liver Resections: A Single Centre Experience and a Systematic Review

<div><p>Aim</p><p>To report a single-centre experience with the novel Associating Liver Partition and Portal vein ligation for Staged hepatectomy (ALPPS) technique and systematically review the related literature.</p><p>Methods</p><p>Since January 2013, patients with extended primary or secondary liver tumors whose future liver remnant (FLR) was considered too small to allow hepatic resection were prospectively assessed for the ALPPS procedure. A systematic literature search was performed using PubMed, Scopus and the Cochrane Library Central.</p><p>Results</p><p>Until July 2014 ALPPS was completed in 9 patients whose mean age was 60±8 years. Indications for surgical resection were metastases from colorectal cancer in 3 cases, perihilar cholangiocarcinoma in 3 cases, intrahepatic cholangiocarcinoma in 2 cases and hepatocellular carcinoma without chronic liver disease in 1 case. The calculated FLR volume was 289±122 mL (21.1±5.5%) before ALPPS-1 and 528±121 mL (32.2±5.7%) before ALLPS-2 (p<0.001). The increase in FLR between the two procedures was 96±47% (range: 24–160%, p<0.001). Additional interventions were performed in 4 cases: 3 patients underwent Roux-en-Y hepaticojejunostomy, and one case underwent wedge resection of a residual tumor in the FLR. The average time between the first and second step of the procedure was 10.8±2.9 days. The average hospital stay was 24.1±13.3 days. There was 1 postoperative death due to hepatic failure in the oldest patient of this series who had a perihilar cholangiocarcinoma and concomitant liver fibrosis; 11 complications occurred in 6 patients, 4 of whom had grade III or above disease. After a mean follow-up of 17.1±8.5 months, the overall survival was 89% at 3–6 and 12 months. The recurrence-free survival was 100%, 87.5% and 75% at 3-6-12 months respectively. The literature search yielded 148 articles, of which 22 articles published between 2012 and 2015 were included in this systematic review.</p><p>Conclusion</p><p>The ALPPS technique effectively increased the resectability of otherwise inoperable liver tumors. The postoperative morbidity in our series was high in accordance with the data from the systematic review. Age, liver fibrosis and presence of biliary stenting were predisposing factors for postoperative morbidity and mortality.</p></div

FLR increase between the ALPSS-1 and ALPPS-2 procedures (7.4±2 days).

<p>FLR increase between the ALPSS-1 and ALPPS-2 procedures (7.4±2 days).</p

Effect of prolactin on the phosphorylation of Ca-dependent PKC isoforms

<p><b>Copyright information:</b></p><p>Taken from "Prolactin stimulates the proliferation of normal female cholangiocytes by differential regulation of Ca-dependent PKC isoforms"</p><p>http://www.biomedcentral.com/1472-6793/7/6</p><p>BMC Physiology 2007;7():6-6.</p><p>Published online 19 Jul 2007</p><p>PMCID:PMC1939715.</p><p></p> Immunoblots for PKC-α, PKC-β-I, PKC-β-II and PKC-γ in normal female cholangiocytes stimulated for 90 minutes at 37°C with 0.2% BSA (basal value) or prolactin (100 nM) with 0.2% BSA. When cholangiocytes were treated with prolactin, there was an increase in the phosphorylation of PKCβ-I and a marked decrease in PKCα phosphorylation; no significant changes in the phosphorylation of PKCβ-II and PKCγ were observed in normal female cholangiocytes treated with prolactin or 0.2% BSA. Data are mean ± SEM of 3 experiments. * p < 0.05 vs. corresponding basal values. PKC = protein kinase C

Measurement of the number of top panel PCNA- and lower panel CK-19-positive cholangiocytes in liver sections (5 μm, 3 slides analyzed per group) and c PCNA protein expression in purified female cholangiocytes from NaCl- or prolactin-treated rats

<p><b>Copyright information:</b></p><p>Taken from "Prolactin stimulates the proliferation of normal female cholangiocytes by differential regulation of Ca-dependent PKC isoforms"</p><p>http://www.biomedcentral.com/1472-6793/7/6</p><p>BMC Physiology 2007;7():6-6.</p><p>Published online 19 Jul 2007</p><p>PMCID:PMC1939715.</p><p></p> Administration of prolactin to normal female rats increased the number of PCNA-positive cholangiocytes (arrows) and CK-19-positive cholangiocytes compared with normal rats treated with NaCl. Orig. magn., ×20 (PCNA) and ×10 (CK-19). Data are mean ± SEM of 5 values obtained from the 3 slides evaluated per each group of animal. * p < 0.05 vs. the corresponding value of NaCl-treated rats