Media coverage of liver transplant events promotes donations from the deceased

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Management of recurrent hepatocellular carcinoma after liver transplant – a single center experience

Background: Hepatocellular carcinoma (HCC) recurs in 10-60% of patients after liver transplantation and carries very dismal prognosis. Optimal management of this condition has yet to be defined. Patients and Methods: All adult patients with HCC within the UCSF (University of California, San Francisco) criteria who underwent liver transplantation at Queen Mary Hospital during the period from July 1995 to September 2013 were reviewed. Two hundred and fifty-two patients were included in the analysis. They were divided into three groups for comparison: with intrahepatic recurrence (IR), with multiple or extrahepatic recurrence (MR), with no recurrence (NR). Results: HCC recurrence occurred in 35 (13.9%) patients, 3 with IR and 32 with MR. Patients in the IR and MR groups had a younger age (51 vs. 51 vs. 56 years; p=0.007), a higher pretransplant serum α-fetoprotein level (27 vs. 97.5 vs. 18 ng/mL; p=0.005), more tumor nodules (4 vs. 2 vs. 1; p=0.003) and a higher incidence of lymphovascular permeation (33% vs. 59% vs. 27%; p=0.001) than patients in the NR group. More patients in the IR and MR groups had tumors beyond the UCSF criteria on histopathology (67% vs. 56% vs. 17%) when compared with the NR group. Treatments for IR included hepatectomy, radiofrequency ablation and transarterial chemoembolization. One patient with IR remained alive 3 years after last treatment. Overall survival in the IR group was longer than that in the MR group (59 vs. 30.4 months; p<0.001). Time from transplant to recurrence was similar between the two groups (23.1 vs. 12 months; p=0.141). Conclusions: Recurrence of HCC after liver transplantation is not uncommon. Aggressive surgical treatment may prolong survival in patients with IR only. Prognosis for patients with MR is dismal. Effective systemic therapy is urgently needed.published_or_final_versio

New insights after the first 1000 liver transplantations at The University of Hong Kong

Background/objective: One thousand liver transplantations have been performed at the only liver transplant center in Hong Kong over a period of 22 years, which covered the formative period of living donor liver transplantation. These 1000 transplantations, which marked the journey of liver transplantation from development to maturation at the center, should be educational. This research was to study the experience and to reflect on the importance of technical innovations and case selection. Methods: The first 1000 liver transplantations were studied. Key technical innovations and surgical therapeutics were described. Recipient survival including hospital mortality was analyzed. Recipient survival comparison was made for deceased donor liver transplantation and living donor liver transplantation indicated by hepatocellular carcinoma and other diseases. Results: Among the 1000 transplantations, 418 used deceased donor grafts and 582 used living donor grafts. With the accumulation of experience, hospital mortality improved to < 2% in the past 2 years. In the treatment of diseases other than hepatocellular carcinoma, living donor liver transplantation was superior to deceased donor liver transplantation, with a 10-year recipient survival around 90%. Conclusion: Transplant outcomes have been improving consistently over the series, with a very low hospital mortality and a predictably high long-term survival. © 2015

前路右半肝切除術

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Liver transplantation for hepatitis B and hepatitis C

Oral Presentation香港移植學會周年學術會議, 香港, 2010年4月25日.The 2010 Annual Scientific Meeting and Annual General Meeting of the Hong Kong Society of Transplantation, Hong Kong, 25 April 2010

Right Spontaneous Retrobulbar Hemorrhage after Endoscopic Retrograde Cholangiopancreatogram (ERCP) in a Patient with Liver Cirrhosis

Abstract no. PO-445Topic: Eye Trauma and EmergenciesPoster presentationObjective/Purpose: Acute retrobulbar hemorrhage is a sigh-threatening complication of blunt eye trauma and orbital surgery, requiring prompt recognition and treatment.Spontaneous retrobulbar hemorrhage however is extremely uncommon. We describe a spontaneous retrobulbar hemorrhage occuring after endoscopic retrograde cholangiopancreatogram in a patient with coagulation abnormalities. Materials/Patients: A 45-year-old man, with chronic hepatitis B-related liver cirrhosis, underwent deceased donor liver transplantation on the 1st of January 2013. The procedure was complicated by biliary anastomotic stricture, presenting with biliary enzymes. Endoscopic retrograde cholangiopancreatogram (ERCP) was performed on day 37 after liver transplantation. 1 hour after procedure, the patient noted right eye pain and loss of vision. There was associated headache, nausea and vomiting. Methods: On ophthalmological assessment, Snellen Chart visual acuity was count fingers at half a metre in the right eye and 20/30 in the left eye. Intraocular pressure using tonopen was right eye > 55 mmHg and left eye 19 mmHg. The right eye was proptotic with complete ptosis. Pupils were equal and reactive to light with no relative afferent pupillary defect.Right eye movement was restricted in all directions with preservation of normal saccades. Emergency right lateral canthotomy and cantholysis was performed under local anesthesia by the bedside immediately. Results and Conclusion: Contrast CT scan of the orbit confirmed a large extraconal hematoma displacing the globe downwards and laterally.There was no evidence of abnormal vascular lesions in the brain or orbit. Screening for bleeding disorders revealed thrombocytopenia and prolonged APTT and PT, consistent with his underlying liver disease. In conclusion, ophthalmologists and general surgeons should be aware of this rare but devastating complication in patients with coagulation abnormalities. Prompt recognition and treatment is crucial to saving the eye.link_to_OA_fulltex

Primary treatment for hepatocellular carcinoma within UCSF criteria: comparing outcomes of deceased and living donor liver transplantation

This free journal suppl. entitled: Supplement: The 2011 Joint International Congress of ILTS, ELITA, and LICAGEPoster Session 1 - Malignancies: abstract no. P-101OBJECTIVES: To compare long term results of deceased donor (DDLT) and living donor liver transplantation (LDLT) as primary treatment for inoperable hepat…link_to_OA_fulltex

Advantage of primary liver transplantation for hepatocellular carcinoma within up-to-7 criteria with microvascular invasion

Concurrent Session: Malignancieslink_to_OA_fulltex