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| 1 | Impact of small-for-size liver grafts on medium-term and long-term graft survival in living donor liver transplantation: A meta-analysis显示文摘BACKGROUND Small-for-size grafts (SFSGs) in living donor liver transplantation (LDLT) could optimize donor postoperative outcomes and also expand the potential donor pool. Evidence on whether SFSGs would affect medium-term and long-term recipient graft survival is lacking. AIM To evaluate the impact of small-for-size liver grafts on medium-term and longterm graft survival in adult to adult LDLT. METHODS A systematic review and meta-analysis were performed by searching eligible studies published before January 24, 2019 on PubMed, EMBASE, and Web of Science databases. The primary outcomes were 3-year and 5-year graft survival. Incidence of small-for-size syndrome and short term mortality were also extracted. RESULTS This meta-analysis is reported according to the guidelines of the PRISMA 2009 Statement. Seven retrospective observational studies with a total of 1821 LDLT recipients were included in the meta-analysis. SFSG is associated with significantly poorer medium-term graft survival. The pooled odds ratio for 3-year graft survival was 1.58 [95% confidence interval 1.10-2.29, P = 0.014]. On the other hand, pooled results of the studies showed that SFSG had no significant discriminatory effect on 5-year graft survival with an odds ratio of 1.31 (95% confidence interval 0.87-1.97, P = 0.199). Furthermore, incidence of small-for-size syndrome detected in recipients of SFSG ranged from 0-11.4% in the included studies. CONCLUSION SFSG is associated with inferior medium-term but not long-term graft survival. Comparable long-term graft survival based on liver graft size shows that smaller grafts could be accepted for LDLT with appropriate flow modulatory measures. Close follow-up for graft function is warranted within 3 years after liver transplantation. | Ka Wing Ma Kelly Hiu Ching Wong Albert Chi Yan Chan Tan To Cheung Wing Chiu Dai James Yan Yue Fung Wong Hoi She Chung Mau Lo Kenneth Siu Ho Chok | 2019 | World Journal of Gastroenterology2019，25，36： | 3 |
| 2 | Role of C11-FDG dual-tracer PET-CT scan in metastatic screening of hepatocellular carcinoma-a cost-effectiveness analysis显示文摘Background:We aimed to identify predictive factors for positron emission tomography(PET)-detected hepatocellular carcinoma(HCC)metastasis and a cost-effective approach to preoperative PET-computed tomography(CT)for detecting metastasis.Methods:Clinicopathological and survival data of HCC patients having PET-CT with 18F-fludeoxyglucose(FDG)and 11C-acetate(ACT)following contrast-enhanced CT/magnetic resonance imaging(MRI)for preoperative tumor staging were reviewed.Binary logistic regression was performed to identify predictive factors for PET-detected metastasis.A cost-benefit analysis model was built for the incurred costs and the impact of PET-CT findings on treatment strategy was studied.Results:Totally 152 patients were analyzed.Dual-tracer PET-CT detected metastasis in 17 patients(11%).By multivariate analysis,alpha-fetoprotein(AFP)≥400 ng/mL[relative risk(RR):4.30,95%confidence interval(CI):1.41-13.15,P=0.011]and bilobar disease(RR:3.94,95%CI:1.24-12.52,P=0.014)were independent predictive factors for PET-detected metastasis.PET-CT findings altered the treatment strategy for 12 patients(7.9%);three partial hepatectomies,eight episodes of transarterial chemoembolization(TACE)and one episode of ablation were avoided,with an estimated cost-saving of US$91,000,$150,000 and$10,600 respectively.Had the PET-CT been performed only for patients with AFP≥400 ng/mL or bilobar disease(n=74),metastasis would have been confirmed in 14 patients(18.9%),and the cost-saving per patient was estimated at US$1,070.Conclusions:Dual-tracer PET-CT is cost-effective and useful for preoperative HCC staging in patients with AFP≥400 ng/mL or bilobar disease.Its routine use in preoperative workup for all HCC patients is not recommended.Unilobar disease with AFP<400 ng/mL can achieve good negative predictive value for PET-detected metastasis.Screening patients with either factor can avoid unnecessary procedures and is thus cost-effective for preoperative HCC workup. | Kevin K.W.Chu Albert C.Y.Chan Ka Wing Ma Wong Hoi She Wing Chiu Dai Kenneth S.H.Chok Tan To Cheung Chung Mau Lo | 2021 | Hepatobiliary Surgery and Nutrition2021，10，3： | 2 |
| 3 | Liver transplantation:would it be the best and last chance of cure for hepatocellular carcinoma with major venous invasion?显示文摘Background:Hepatocellular carcinoma(HCC)with portal vein tumour thrombus(PVTT)signifies advanced disease,whether LT confers any survival superiority over resection remains uncertain.Methods:A propensity score matched(PSM)analysis of liver transplantation(LT)and liver resection(LR)for HCC with PVTT was performed.Results:A consecutive series of 88 patients who received either LT(10 DDLTs and 3 LDLTs)or LR(n=75)respectively were recruited.Before PSM,the LT group has a higher MELD score(17.3 vs.7.8,P<0.001),lower serum AFP levels(96 vs.2,164 ng/mL,P=0.017)and smaller tumour size(4 vs.10 cm,P<0.001).The 5-year overall survival for LT and LR were 55.4%and 15.9%respectively(P=0.007).After matching for serum AFP levels and tumour size,1-,3-and 5-year overall survival for LT were 81 ng/mL,3.9 cm,80%,70%and 70%and the corresponding rates for LR were 1,417 ng/mL,5.3 cm,51.8%,19,6%and 9.8%(P value=0.12,0.27 and 0.009 respectively).Conclusions:LT is associated with significantly better oncological outcomes in HCC patients with PVTT involving the lobar or segmental level.A modest expansion of selection criteria to include small HCC with segmental PVTT should be considered. | Ka Wing Ma Albert Chi Yan Chan Kenneth Siu Ho Chok Wong Hoi She Tan To Cheung Wing Chiu Dai James Yan Yue Fung Chung Mau Lo | 2021 | Hepatobiliary Surgery and Nutrition2021，10，3： | 2 |
| 4 | Validated model for prediction of recurrent hepatocellular carcinoma after liver transplantation in Asian population显示文摘BACKGROUND Liver transplantation(LT) is regarded as the best treatment for both primary and recurrent hepatocellular carcinoma(HCC). Post-transplant HCC recurrence rate is relatively low but significant, ranging from 10%-30% according to different series. When recurrence happens, it is usually extrahepatic and associated with poor prognosis. A predictive model that allows patient stratification according to recurrence risk can help to individualize post-transplant surveillance protocol and guidance of the use of anti-tumor immunosuppressive agents.AIM To develop a scoring system to predict HCC recurrence after LT in an Asian population.METHODS Consecutive patients having LT for HCC from 1995 to 2016 at our hospital were recruited. They were randomized into the training set and the validation set in a60:40 ratio. Multivariable Cox regression model was used to identity factors associated with HCC recurrence. A risk score was assigned to each factor according to the odds ratio. Accuracy of the score was assessed by the area under the receiver operating characteristic curve.RESULTS In total, 330 patients were eligible for analysis(183 in training and 147 invalidation). Recurrent HCC developed in 14.2% of them. The median follow-up duration was 65.6 mo. The 5-year disease-free and overall survival rates were78% and 80%, respectively. On multivariate analysis, alpha-fetoprotein > 400 ng/mL [P = 0.012, hazard ratio(HR) 2.92], sum of maximum tumor size and number(P = 0.013, HR 1.15), and salvage LT(P = 0.033, HR 2.08) were found to be independent factors for disease-free survival. A risk score was calculated for each patient with good discriminatory power(c-stat 0.748 and 0.85, respectively,in the training and validation sets). With the derived scores, patients were classified into low-(0–9), moderate-(> 9–14), and high-risk groups(> 14), and the risk of HCC recurrence in the training and validation sets was 10%, 20%, 54%(cstat 0.67) and 4%, 22%, 62%(c-stat 0.811), accordingly. The risk stratification model was validated with chi-squared goodness-of-fit test(P = 0.425).CONCLUSION A validated predictive model featuring alpha-fetoprotein, salvage LT, and the sum of largest tumor diameter and total number of tumor nodule provides simple and reliable guidance for individualizing postoperative surveillance strategy. | Ka Wing Ma Wong Hoi She Albert Chi Yan Chan Tan To Cheung James Yan Yue Fung Wing Chiu Dai Chung Mau Lo Kenneth Siu Ho Chok | 2019 | World Journal of Gastrointestinal Oncology2019，11，4： | 2 |
| 5 | Emergence of scaling in random networks显示文摘 | Albert-László Barabási and Réka Albert | 1999 | Science1999，286，5439： | 1 |
| 6 | Perfusion abnormalities in prodromal AD显示文摘 | Johnson KA Albert MS | 2000 | Neurobiol Aging2000，21，2： | 1 |
| 7 | Open tital fractures: faster union after unreamed nailing than external fixation显示文摘 | Alberts KA Loohagen G Einarsdottir H | 1999 | Injury1999，30，8： | 1 |
| 8 | Emergence of scaling in random networks显示文摘 | Albert-László Barabási Réka Albert | 1999 | Science1999，286，： | 1 |
| 9 | Diameter of the World-Wide Web显示文摘 | Réka Albert Hawoong Jeong Barabási A-L | 1999 | Nature1999，401，： | 1 |
| 10 | Evidence for decreased DARPP-32 in the prefrontal cortex of patients with schizophrenia显示文摘 | Albert KA Hemmings HC Jr Adamo AI | 2002 | Arch Gen Psychiatry2002，59，8： | 1 |
| 11 | Errorand attack tolerance of complex networks 显示文摘 | R^ka Albert Hawoong Jeong and Albert-L6szl6 Barab6si | 2000 | Nature 4062000，，6794： | 1 |
| 12 | Topology of evolving networks:local events and universality显示文摘 | Réka Albert Albert-László Barabási | 2000 | Phys Rev Lett2000，85，24： | 1 |
| 13 | Topology of evolving networks:local events and universality显示文摘 | Réka Albert and Albert-László Barabási | 2000 | Phys Rev Lett2000，，85： | 1 |
| 14 | High prevalence and level of resistance to metronidazole, but lack of resistance to other antimicrobials in Helicobacter pylori, isolated from a multira cial population in Kuwait显示文摘 | Albert MJ Mekhaizeem KA nell L | 2006 | Aliment Pharmacol Ther2006，24，9： | 1 |
| 15 | Attack and error tolerance in complex networks显示文摘 | Réka Albert Hawoong Jeong Barabási Albert-László | 2000 | Nature2000，406，： | 1 |
| 16 | Open tibial fractures:faster union after unreamed nailing than external fixation显示文摘 | Alberts KA Loohagen G Einarsdottir H | 1999 | Injury1999，30，8： | 1 |
| 17 | Open tibial fractures:faster union after undreamed nailing than exteral fixation 显示文摘 | Alberts KA Loohagen G Einarsdottir H | 1999 | J Injury1999，30，8： | 1 |
| 18 | Effects of pump versus twice- daily injection delivery of synthetic parathyroid hormone 1-34 in children with severe congenital hypoparathyroidism 显示文摘 | Winer KK Fulton KA Albert PS | 2014 | J Pediatr2014，165，3： | 1 |
| 19 | Open tibial fractures:faster u- nion after undreamed nailing than external fixation显示文摘 | Alberts KA Loohagen G Einarsdottir H | 1999 | Injury1999，30，8： | 1 |
| 20 | Prognostic accuracy of preperative and postoperative scintimetry after femoral neck fracture 显示文摘 | Alberts KA | 1990 | Clin Orthop1990，250，： | 1 |
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