new-thrombectomy-technique-for-total-portal-vein-thrombosis-liver

New Thrombectomy Technique for Total Portal Vein Thrombosis in Liver Transplantation

Portal vein thrombosis is present in approximately 5-16% of patients with end-stage liver disease who undergo liver transplantation. In this report, we ...

Hospital das Clínicas da Faculdade de Medicina de São Paulo (HC-FMUSP)

Faculdade de Medicina da Universidade de São Paulo (FMUSP)

Non-alcoholic fatty liver disease encompasses a spectrum of liver diseases, including simple steatosis, steatohepatitis, liver fibrosis and cirrhosis and hepatocellular carcinoma. Non-alcoholic fatty liver disease is currently the most dominant chronic liver disease in Western countries due to the fact that hepatic steatosis is associated with insulin resistance, type 2 diabetes mellitus, obesity, metabolic syndrome and drug-induced injury. A variety of chemicals, mainly drugs, and diets is known to cause hepatic steatosis in humans and rodents. Experimental non-alcoholic fatty liver disease models rely on the application of a diet or the administration of drugs to laboratory animals or the exposure of hepatic cell lines to these drugs. More recently, genetically modified rodents or zebrafish have been introduced as non-alcoholic fatty liver disease models. Considerable interest now lies in the discovery and development of novel non-invasive biomarkers of non-alcoholic fatty liver disease, with specific focus on hepatic steatosis. Experimental diagnostic biomarkers of non-alcoholic fatty liver disease, such as (epi)genetic parameters and '-omics'-based read-outs are still in their infancy, but show great promise. In this paper, the array of tools and models for the study of liver steatosis is discussed. Furthermore, the current state-of-art regarding experimental biomarkers such as epigenetic, genetic, transcriptomic, proteomic and metabonomic biomarkers will be reviewed.

Strategies, models and biomarkers in experimental non-alcoholic fatty liver disease research.

An optimal allocation system for scarce resources should simultaneously ensure maximal utility, but also equity. The most frequent principles for allocation policies in liver transplantation are therefore criteria that rely on pre-transplant survival (sickest first policy), post-transplant survival (utility), or on their combination (benefit). However, large differences exist between centers and countries for ethical and legislative reasons. The aim of this study was to report the current worldwide practice of liver graft allocation and discuss respective advantages and disadvantages.

Allocation of liver grafts worldwide - Is there a best system?

Combined liver-kidney transplantation is a life-saving procedure for patients with end-stage liver disease and underlying chronic kidney disease, or prolonged acute kidney injury. Due to physiologic changes secondary to portal hypertension in patients with end-stage liver disease, kidney injury is common, and combined liver-kidney transplantation accounts for 10% of all the liver transplants performed in the United States. Recently implemented policy in the United States standardizes the medical criteria for eligibility, and introduces a 'safety net' for those who are transplanted with a liver graft alone, in order to be able to receive a kidney graft later. Increasing number of combined liver-kidney transplants provides a large cohort of patients to be studied in detail for identification of factors (both donor and recipient-related) associated with better outcomes. Data regarding the safety and efficacy of delaying the kidney transplant part of the combined liver-kidney transplantation, and the immunologic benefits of the multi-organ transplantations including the liver are emerging. Here, we review the most recent analyses, and provide our opinion regarding the best practices in combined liver-kidney transplantation based on the evidence.

Current status of combined liver-kidney transplantation.

Perihilar cholangiocarcinoma (phCCC) is a dismal malignancy. There is no consensus regarding the best treatment for patients with unresectable phCCC. The present review aimed to gather the current pieces of evidence for liver transplantation and liver resection as a treatment for phCCC and to build better guidance for clinical practice.

Liver transplantation as an alternative for the treatment of perihilar cholangiocarcinoma: A critical review.

Hepatic resection (HR) and liver transplantation (LT) are potentially curative treatments for Hepatocellular carcinoma (HCC). The aim of this study was to analyze the survival of patients with HCC and indications for surgical treatment (HR or LT) in a high-volume center.

Article	Year
Strategies, models and biomarkers in experimental non-alcoholic fatty liver disease research. Progress in lipid research\| PubMed ID: 26073454	2015
Allocation of liver grafts worldwide - Is there a best system? Journal of hepatology\| PubMed ID: 31199941	2019
Current status of combined liver-kidney transplantation. International journal of surgery (London, England)\| PubMed ID: 32084547	2020
Liver transplantation as an alternative for the treatment of perihilar cholangiocarcinoma: A critical review. Hepatobiliary & pancreatic diseases international : HBPD INT\| PubMed ID: 38310060	2024
Analysis of the survival of patients with hepatocellular carcinoma and indications for liver transplantation or hepatic resection. BMC surgery\| PubMed ID: 40251550	2025

Wellington Andraus

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