scholarly journals Milan Criteria and UCSF Criteria: A Preliminary Comparative Study of Liver Transplantation Outcomes in the United States

2012 ◽  
Vol 2012 ◽  
pp. 1-7 ◽  
Author(s):  
Supriya S. Patel ◽  
Amanda K. Arrington ◽  
Shaun McKenzie ◽  
Brian Mailey ◽  
Michelle Ding ◽  
...  
Keyword(s):  
Liver Transplantation ◽  
Overall Survival ◽  
Survival Rates ◽  
Hepatocellular Cancer ◽  
The United States ◽  
Milan Criteria ◽  
Ucsf Criteria ◽  
Number Of Patients ◽  
Transplantation Outcomes

The application of orthotopic liver transplantation (OLT) for patients with hepatocellular cancer (HCC) necessitates highly selective criteria to maximize survival and to optimize allocation of a scarce resource. The objective of this study was to compare the outcomes of OLT for HCC in patients transplanted under Milan and UCSF criteria. The United Network of Organ Sharing (UNOS) database was queried for patients who had undergone OLT for HCC from 2002 to 2007, and 1,972 patients (Milan criteria,n=1,913; UCSF criteria,n=59) were identified. Patients were stratified by pretransplant criteria (Milan versus UCSF), and clinical and pathologic factors and overall survival were compared. There were no differences in age, gender, diabetes mellitus, body mass index, and hepatitis B, or C status between the two groups. Overall survival was similar between the Milan and UCSF cohorts (1-, 2-, 3-, and 4-year survival rates: 88%, 81%, 76%, and 72% versus 91%, 80%, 68% and 51%, respectively,P=0.21). Although the number of patients within UCSF criteria was small, our results nevertheless suggest that patients with HCC may have equivalent survival when transplanted under Milan and UCSF criteria. Long-term followup may better determine whether UCSF criteria should be widely adopted.

Long-term trends in chronic hepatitis B virus infection associated liver transplantation outcomes in the United States

2017 ◽  
Vol 24 (9) ◽  
pp. 789-796 ◽  
Author(s):  
K. Young ◽  
B. Liu ◽  
T. Bhuket ◽  
Z. Younossi ◽  
S. Saab ◽  
...  
Keyword(s):  
United States ◽  
Liver Transplantation ◽  
Chronic Hepatitis ◽  
The United States ◽  
Hepatitis B Virus Infection ◽  
Chronic Hepatitis B Virus ◽  
B Virus ◽  
Long Term Trends ◽  
Transplantation Outcomes

scholarly journals Milan criteria in the MELD era – Is it justifiable to extend the limits for orthotopic liver Transplantation?

2020 ◽  
Author(s):  
Mehmet Haluk Morgül ◽  
Philipp Felgendreff ◽  
Andreas Kienlein ◽  
Ulrich Gauger ◽  
Katrin Semmling Semmling ◽  
...  
Keyword(s):  
Liver Transplantation ◽  
Survival Rates ◽  
Meld Score ◽  
Long Term Results ◽  
Milan Criteria ◽  
Free Survival ◽  
The Individual ◽  
Histopathological Results

Abstract BackgroundThe Milan criteria (MC) are widely used for the indication of liver transplantation (LTx) in hepatocellular carcinoma (HCC). Good long-term results have also been reported following LTx for patients exceeding the MC. In this article, we compare the overall and recurrence-free survival of our patients fulfilling and exceeding the MC according to the posttransplant histopathological results.Patients and MethodsData from 120 patients with HCC (22 females and 98 males) were analyzed. The median patient age was 61 years (Q1, Q3: 54.7, 65.4), and the median MELD score was 11 (Q1, Q3: 8, 15). The median follow-up period was 53 months (Q1, Q3: 16.6, 78). Patients were categorized into established criteria (MC, up-to-seven (UTS), Asan criteria, AFP score), and the outcome of the individual groups was compared.ResultsSeventy-four of 120 patients fulfilled the MC, 86 patients met the UTS criteria, 85 patients fulfilled the Asan criteria, and 79 patients had an AFP score less than or equal to 2. The 1- and 5-year survival rates of all patients were 76.7% and 55.6%, respectively. In total, 14.2% of all patients (5.4% of patients who met the MC, 7% of patients who met the UTS criteria, 5.9% of patients who met the Asan criteria, and 6.3% of patients who had an AFP score less than 2) experienced recurrence.ConclusionsThe outcomes of the patients were comparable to those reported in the current literature. In our population, similar recurrence and survival rates of the patients were noted for patients fulfilling the UTS criteria irrespective of fulfilling or exceeding the MC. Consequently, we consider using UTS criteria as the extended criterion for LTx indication.

scholarly journals Milan criteria in the MELD era – Is it justifiable to extend the limits for orthotopic liver transplantation?

2020 ◽  
Author(s):  
Mehmet Haluk Morgül ◽  
Philipp Felgendreff ◽  
Andreas Kienlein ◽  
Ulrich Gauger ◽  
Katrin Semmling Semmling ◽  
...  
Keyword(s):  
Liver Transplantation ◽  
Survival Rates ◽  
Meld Score ◽  
Long Term Results ◽  
Milan Criteria ◽  
Free Survival ◽  
The Individual ◽  
Histopathological Results

Abstract Background: The Milan criteria (MC) are widely used for the indication of liver transplantation (LTx) in hepatocellular carcinoma (HCC). Good long-term results have also been reported following LTx for patients exceeding the MC. In this article, we compare the overall and recurrence-free survival of our patients fulfilling and exceeding the MC according to the posttransplant histopathological results.Patients and Methods: Data from 120 patients with HCC (22 females and 98 males) were analyzed. The median patient age was 61 years (Q1, Q3: 54.7, 65.4), and the median MELD score was 11 (Q1, Q3: 8, 15). The median follow-up period was 53 months (Q1, Q3: 16.6, 78). Patients were categorized into established criteria (MC, up-to-seven (UTS), Asan criteria, AFP score), and the outcome of the individual groups was compared.Results: Seventy-four of 120 patients fulfilled the MC, 86 patients met the UTS criteria, 85 patients fulfilled the Asan criteria, and 79 patients had an AFP score less than or equal to 2. The 1- and 5-year survival rates of all patients were 76.7% and 55.6%, respectively. In total, 14.2% of all patients (5.4% of patients who met the MC, 7% of patients who met the UTS criteria, 5.9% of patients who met the Asan criteria, and 6.3% of patients who had an AFP score less than 2) experienced recurrence.Conclusions: The outcomes of the patients were comparable to those reported in the current literature. In our population, similar recurrence and survival rates of the patients were noted for patients fulfilling the UTS criteria irrespective of fulfilling or exceeding the MC. Consequently, we consider using UTS criteria as the extended criterion for LTx indication

scholarly journals Alpha-fetoprotein-adjusted-to-HCC-size criteria are associated with favourable survival after liver transplantation for hepatocellular carcinoma

2020 ◽  
pp. 205064062094866
Author(s):  
Tobias Meischl ◽  
Susanne Rasoul-Rockenschaub ◽  
Georg Györi ◽  
Bernhard Scheiner ◽  
Michael Trauner ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Liver Transplantation ◽  
Overall Survival ◽  
Survival Rate ◽  
Median Overall Survival ◽  
Early Recurrence ◽  
Alpha Fetoprotein ◽  
Milan Criteria ◽  
Number Of Patients ◽  
The Impact

Background The Milan criteria are recommended to select hepatocellular carcinoma (HCC) patients for liver transplantation (LT). The utility of other selection criteria, such as the alpha-fetoprotein-adjusted-to-HCC-size (AFP-UTS) criteria, is still unclear. Objective We investigated, in HCC patients who underwent LT, the survival and the recurrence after LT according to AFP-UTS and Milan criteria, the impact of early recurrence and the correlation between radiological and pathological staging. Methods Adult HCC patients undergoing deceased donor LT at the Medical University of Vienna between 1997 and 2014 were retrospectively analysed. Results Among 166 patients included, the number of patients who fulfilled Milan or AFP-UTS criteria was the same (139 [84%] each), although not all of them were the same individuals; 127 patients (77%) fulfilled both Milan and AFP-UTS criteria. Median overall survival of patients within AFP-UTS was 126.9 months vs. 34.2 months outside AFP-UTS (5-year survival rate 71% vs. 43%; p = 0.104). The 5-year recurrence rate was significantly lower in patients fulfilling the AFP-UTS criteria (18%) than in those exceeding AFP-UTS (64%; p<0.001). Of the 139 patients within Milan criteria on imaging, 24 (17%) had microvascular invasion and 47 (34%) were outside Milan according to explant histology. Early recurrence correlated with AFP-UTS and was associated with dismal survival (median overall survival 17.2 vs. 122.1 months, p = 0.002). Conclusions The overall survival of patients within AFP-UTS criteria was favourable with a 5-year survival rate above 70%. Early recurrence is associated with worse survival after LT. The AFP-UTS criteria may be more suitable to exclude patients at high risk of (early) recurrence than Milan criteria.

scholarly journals Long-term trends and drought: spatiotemporal variation in juvenile sex ratios of North American ducks

2021 ◽  
Author(s):  
Sage Ellis ◽  
Madeleine Lohman ◽  
James Sedinger ◽  
Perry Williams ◽  
Thomas Riecke
Keyword(s):  
United States ◽  
North American ◽  
Sex Ratios ◽  
Survival Rates ◽  
The United States ◽  
Avian Communities ◽  
Eastern United States ◽  
Bird Populations ◽  
Long Term Trends

Sex ratios affect population dynamics and individual fitness, and changing sex ratios can be indicative of shifts in sex-specific survival at different life stages. While climate- and landscape-change alter sex ratios of wild bird populations, long-term, landscape scale assessments of sex ratios are rare. Further, little work has been done to understand changes in sex ratios in avian communities. In this manuscript, we analyse long-term (1961-2015) data on five species of ducks across five broad climatic regions of the United States to estimate the effects of drought and long-term trends on the proportion of juvenile females captured at banding. As waterfowl have a 1:1 sex ratio at hatch, we interpret changes in sex ratios of captured juveniles as changes in sex-specific survival rates during early life. Seven of twelve species-region pairs exhibited evidence for long-term trends in the proportion of juvenile females at banding. The proportion of juvenile females at banding increased for duck populations in the western United States and typically declined for duck populations in the eastern United States. We only observed evidence for an effect of drought in two of the twelve species-region pairs, where the proportion of females declined during drought. As changes to North American landscapes and climate continue and intensify, we expect continued changes in sex-specific juvenile survival rates. More broadly, we encourage further research examining the mechanisms underlying long-term trends in juvenile sex ratios in avian communities.

scholarly journals Long term survival of liver transplantation for hepatocelular carcinoma meeting milan criteria

HPB ◽  
2019 ◽  
Vol 21 ◽  
pp. S830
Author(s):  
M. Prieto ◽  
A. Valdivieso ◽  
M. Gastaca ◽  
J. Bustamante ◽  
A. Ventoso ◽  
...  
Keyword(s):  
Liver Transplantation ◽  
Milan Criteria ◽  
Term Survival ◽  
Long Term Survival

scholarly journals Long-term efficacy of imatinib mesylate in patients with advanced Tenosynovial Giant Cell Tumor

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
F. G. M. Verspoor ◽  
M. J. L. Mastboom ◽  
G. Hannink ◽  
R. G. Maki ◽  
A. Wagner ◽  
...  
Keyword(s):  
Giant Cell ◽  
Imatinib Mesylate ◽  
Locally Advanced ◽  
Survival Rates ◽  
Progression Free Survival ◽  
Complete Response ◽  
The United States ◽  
Long Term Effects ◽  
Giant Cell Tumors

Abstract Tenosynovial giant cell tumors (TGCT), are rare colony stimulating factor-1(CSF-1)-driven proliferative disorders affecting joints. Diffuse-type TGCT often causes significant morbidity due to local recurrences necessitating multiple surgeries. Imatinib mesylate (IM) blocks the CSF-1 receptor. This study investigated the long term effects of IM in TGCT. We conducted an international multi-institutional retrospective study to assess the activity of IM: data was collected anonymously from individual patients with locally advanced, recurrent or metastatic TGCT. Sixty-two patients from 12 institutions across Europe, Australia and the United States were identified. Four patients with metastatic TGCT progressed rapidly on IM and were excluded for further analyses. Seventeen of 58 evaluable patients achieved complete response (CR) or partial response (PR). One- and five-year progression-free survival rates were 71% and 48%, respectively. Thirty-eight (66%) patients discontinued IM after a median of 7 (range 1–80) months. Reported adverse events in 45 (78%) patients were among other edema (48%) and fatigue (50%), mostly grade 1–2 (89%). Five patients experienced grade 3–4 toxicities. This study confirms, with additional follow-up, the efficacy of IM in TGCT. In responding cases we confirmed prolonged IM activity on TGCT symptoms even after discontinuation, but with high rates of treatment interruption and additional treatments.

scholarly journals Genetic or Autoimmune: POLG-Related Epilepsy Initially Treated as an Autoimmune Encephalitis, a Case Report

2020 ◽  
Vol 11 (1) ◽  
pp. 80-83
Author(s):  
Suma Shah ◽  
Abigail Berezoski ◽  
Shareena Rahman ◽  
Christopher Eckstein ◽  
Matthew Luedke
Keyword(s):  
Valproic Acid ◽  
Liver Transplantation ◽  
Autoimmune Encephalitis ◽  
Healthy Person ◽  
Autoimmune Epilepsy ◽  
Number Of Patients ◽  
Autoimmune Processes ◽  
Refractory Seizures ◽  
New Onset

Hospital neurologists participate at the forefront of managing fulminant acute and subacute onset epilepsy, frequently attributed to autoimmune encephalitis (AE). As the recognition of antibody-mediated AE grows, there is a growing number of patients who are treated as antibody-negative AE. While antibody-negative autoimmune processes should be considered in the setting of acute and subacute onset of fulminant epilepsy, other causes must be considered before subjecting patients to long-term immunomodulatory treatments and other potential therapeutic toxicities. We present the case of a previously healthy young man who presented with new-onset refractory seizures treated with escalating doses of anti-epileptic drugs as well as immunosuppression for presumed autoimmune epilepsy. He developed valproic acid induced hepatotoxicity requiring liver transplantation and was later found to have a POLG mutation. We discuss the presentation of POLG mutations as well as the diagnosis of seronegative autoimmune encephalitis. We highlight the need for a broad differential when evaluating new onset refractory seizures in an otherwise healthy person.

scholarly journals Liver Transplantation from Voluntary Organ Donor System in China: A Comparison between DBD and DCD Liver Transplants

2019 ◽  
Vol 2019 ◽  
pp. 1-7
Author(s):  
Wei Chen ◽  
Dipesh Kumar Yadav ◽  
Xueli Bai ◽  
Jianying Lou ◽  
Risheng Que ◽  
...  
Keyword(s):  
Liver Transplantation ◽  
Organ Donation ◽  
Survival Rates ◽  
Organ Donor ◽  
Long Term Outcomes ◽  
Significant Difference ◽  
Short And Long Term ◽  
Donor System

Background. In China, the cases of liver transplantation (LT) from donation after citizens’ death have rose year by year since the citizen-based voluntary organ donor system was initiated in 2010. The objective of our research was to investigate the early postoperative and late long-term outcomes of LT from donation after brain death (DBD) and donation after circulatory death (DCD) according to the current organ donation system in China. Methods. Sixty-two consecutive cases of LT from donation after citizens’ death performed in our hospital between February 2012 and June 2017 were examined retrospectively for short- and long-term outcomes. These included 35 DCD LT and 27 DBD LT. Result. Subsequent median follow-up time of 19 months and 1- and 3-year graft survival rates were comparative between the DBD group and the DCD group (81.5% and 66.7% versus 67.1% and 59.7%; P=0.550), as were patient survival rates (85.2% and 68.7% versus 72.2% and 63.9%; P=0.358). The duration of ICU stay of recipients was significantly shorter in the DBD group, in comparison with that of the DCD group (1 versus 3 days, P=0.001). Severe complication incidence (≥grade III) after transplantation was identical among the DBD and DCD groups (48.1% versus 60%, P=0.352). There was no significant difference in postoperative mortality between the DBD and DCD groups (3 of 27 cases versus 5 of 35 cases). Twenty-one grafts (33.8%) were lost and 18 recipients (29.0%) were dead till the time of follow-up. Malignancy recurrence was the most prevalent reason for patient death (38.8%). There was no significant difference in incidence of biliary stenosis between the DBD and DCD groups (5 of 27 cases versus 6 of 35 cases, P=0.846). Conclusion. Although the sample size was small to some extent, this single-center study first reported that LT from DCD donors showed similar short- and long-term outcomes with DBD donors and justified the widespread implementation of voluntary citizen-based deceased organ donation in China. However, the results should be verified with a multicenter larger study.

Influence of Donor Obesity on Long-Term Liver Transplantation Outcomes

2019 ◽  
Vol 51 (1) ◽  
pp. 62-66 ◽  
Author(s):  
A. Molina Raya ◽  
A. Vílchez Rabelo ◽  
M. Domínguez Bastante ◽  
Y. Fundora Suarez
Keyword(s):  
Liver Transplantation ◽  
Transplantation Outcomes
Sign in / Sign up

Export Citation Format

Share Document