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| 1 | Hepatocellular carcinoma: Advances in diagnosis, management, and long term outcome显示文摘Hepatocellular carcinoma(HCC) remains a common and lethal malignancy worldwide and arises in the setting of a host of diseases. The incidence continues to increase despite multiple vaccines and therapies for viruses such as the hepatitis B and C viruses. In addition, due to the growing incidence of obesity in Western society, there is anticipation that there will be a growing population with HCC due to non-alcoholic fatty liver disease. Due to the growing frequency of this disease, screening is recommended using ultrasound with further imaging using magnetic resonance imaging and multi-detector computed tomography used for further characterization of masses. Great advances have been made to help with the early diagnosis of small lesions leading to potential curative resection or transplantation. Resection and transplantation maybe used in a variety of patients that are carefully selected based on underlying liver disease. Using certain guidelines and clinical acumen patients may have good outcomes with either resection or transplantation however many patients are inoperable at time of presentation. Fortunately, the use of new locoregional therapies has made down staging patients a potential option making them potential surgical candidates. Despite a growing population with HCC, new advances in viral therapies, chemotherapeutics, and an expanding population of surgical and transplant candidates might all contribute to improved long-term survival of these patients. | Adam S Bodzin Ronald W Busuttil | 2015 | World Journal of Hepatology2015，7，9： | 22 |
| 2 | Liver transplantation for hepatocellular carcinoma:an update显示文摘BACKGROUND: Hepatocellular carcinoma (HCC) is a heterogeneous malignancy with multiple etiologies, high incidence, and high mortality. The standard surgical management for patients with HCC consists of locoregional ablation, surgical resection, or liver transplantation, depending on the background state of the liver. Eighty percent of patients initially presenting with HCC are unresectable, either due to the extent of tumor or the level of underlying hepatic dysfunction. While in patients with no evidence of cirrhosis and good hepatic function resection has been the surgical treatment of choice, it is contraindicated in patients with moderate to severe cirrhosis. Liver transplantation is the optimal surgical treatment. DATA SOURCES: PubMed search of recent articles (from January 2000 to March 2011) was performed looking for relevant articles about hepatocellular carcinoma and its treatment. Additional articles were identified by evaluating references from selected articles. RESULTS: Here we review criteria for transplantation, the types, indications, and role of locoregional therapy in treating the cancer and in downstaging for possible later transplantation. We also summarize the contribution of immunosuppression and adjuvant chemotherapy in the management and prevention of HCC recurrence. Finally we discuss recent advances in imaging, tumor biology, and genomics as we delineate the remaining challenges for the diagnosis and treatment of this disease. CONCLUSIONS: Much can be improved in the diagnosis and treatment of HCC. A great challenge will be to improve patient selection to criteria based on tumor biology. Another will be to incorporate systemic agents post-operatively in patients at high risk for recurrence, paying close attention to efficacy and safety. The future direction of the effort in treating HCC will be to stimulate prospective trials, develop molecular imaging of lymphovascular invasion, to improve recipient selection, and to investigate biomarkers of tumor biology. | Ali Zarrinpar Fady Kaldas Ronald W Busuttil | 2011 | Hepatobiliary & Pancreatic Diseases International2011，10，3： | 8 |
| 3 | Nationwide trends and predictors of inpatient mortality in 83884 transjugular intrahepatic portosystemic shunt显示文摘AIM: To evaluate and validate the national trends and predictors of in-patient mortality of transjugular intrahepatic portosystemic shunt(TIPS) in 15 years.METHODS: Using the National Inpatient Sample which is a part of Health Cost and Utilization Project, we identified a discharge-weighted national estimate of 83884 TIPS procedures performed in the United States from 1998 to 2012 using international classification of diseases-9 procedural code 39.1. The demographic, hospital and co-morbility data were analyzed using a multivariant analysis. Using multi-nominal logistic regression analysis, we determined predictive factors related to increases in-hospital mortality. Comorbidity measures are in accordance to the Comorbidity Software designed by the Agency for Healthcare Research and Quality.RESULTS: Overall, 12.3% of patients died during hospitalization with downward trend in-hospitalmortality with the mean length of stay of 10.8 ± 13.1 d. Notable, African American patients(OR = 1.809 vs Caucasian patients, P < 0.001), transferred patients(OR = 1.347 vs non-transferred, P < 0.001), emergency admissions(OR = 3.032 vs elective cases, P < 0.001), patients in the Northeast region(OR = 1.449 vs West, P < 0.001) had significantly higher odds of inhospital mortality. Number of diagnoses and number of procedures showed positive correlations with in-hospital death(OR = 1.249 per one increase in number of procedures). Patients diagnosed with acute respiratory failure(OR = 8.246), acute kidney failure(OR = 4.359), hepatic encephalopathy(OR = 2.217) and esophageal variceal bleeding(OR = 2.187) were at considerably higher odds of in-hospital death compared with ascites(OR = 0.136, P < 0.001). Comorbidity measures with the highest odds of in-hospital death were fluid and electrolyte disorders(OR = 2.823), coagulopathy(OR = 2.016), and lymphoma(OR = 1.842).CONCLUSION: The overall mortality of the TIPS procedure is steadily decreasing, though the length of stay has remained relatively constant. Specific patient ethnicity, location, transfer status, primary diagnosis and comorbidities correlate with increased odds of TIPS in-hospital death. | Edward Wolfgang Lee Andrew Kuei Sammy Saab Ronald W Busuttil Francisco Durazo Steven-Huy Han Mohamed M El-Kabany Justin P Mc Williams Stephen T Kee | 2016 | World Journal of Gastroenterology2016，22，25： | 7 |
| 4 | Dangerous dietary supplements: Garcinia cambogia-associated hepatic failure requiring transplantation显示文摘Commercial dietary supplements are marketed as a panacea for the morbidly obese seeking sustainable weight-loss. Unfortunately, many claims cited by supplements are unsupported and inadequately regulated. Most concerning, how ever, are the associated harmful side effects, often unrecognized by consumers. Garcinia cambogia extract and Garcinia cambogia containing products are some of the most popular dietary supplements currently marketed for weight loss. Here, we report the first known case of fulminant hepatic failure associated with this dietary supplement. One active ingredient in this supplement is hydroxycitric acid, an active ingredient also found in weight-loss supplements banned by the Food and Drug Administration in 2009 for hepatotoxicity. Heightened awareness of the dangers of dietary supplements such as Garcinia cambogia is imperative to prevent hepatoxicity and potential fulminant hepatic failure in additional patients. | Keri E Lunsford Adam S Bodzin Diego C Reino Hanlin L Wang Ronald W Busuttil | 2016 | World Journal of Gastroenterology2016，22，45： | 3 |
| 5 | Hepatic ischemia/reperfusion injury—a fresh look显示文摘 | Constantino Fondevila Ronald W Busuttil Jerzy W Kupiec-Weglinski | 2003 | Experimental and Molecular Pathology2003，，2： | 1 |
| 6 | Hepatic ischemia/reperfusion injury—a fresh look显示文摘 | Constantino Fondevila Ronald W Busuttil Jerzy W Kupiec-Weglinski | 2003 | Experimental and Molecular Pathology2003，，2： | 1 |
| 7 | Hepatic ischemia/reperfusion injury—a fresh look显示文摘 | Constantino Fondevila Ronald W Busuttil Jerzy W Kupiec-Weglinski | 2003 | Experimental and Molecular Pathology2003，，2： | 1 |
| 8 | Surgical anatomy of the hepatic arteries in 1000 cases显示文摘 | Hitta Jonathan R Gabbay Joubin Busuttil Ronald W | 1994 | Annals of Surgery1994，220，： | 1 |
| 9 | Surgical anatomy of the hepatic arteries in 1000 cases显示文摘 | Hitta Jonathan R Gabbay Joubin Busuttil Ronald W | 1994 | Annals of Surgery1994，220，： | 1 |
| 10 | Hepatic ischemia/reperfusion injury-a fresh look显示文摘 | Constantino F Ronald W Busuttil | 2003 | Exp Mol Pathol2003，74，2： | 1 |
| 11 | Hepatic ischemia/reperfusion injury-a fresh look显示文摘 | Constantino Fondevila Ronald W Busuttil Jerzy W Kupiec-Weglinski | 2003 | Experiment and Molecular Pathology2003，74，： | 1 |
| 12 | A novel strategy against ischemia and reperfusion injury: cytoprotection with heme oxygenase system显示文摘 | Masamichi Katori Dean M Anselmo Ronald W Busuttil Jerzy W Kupiec-Weglinski | 2002 | Transplant Immunology2002，，2： | 1 |
| 13 | Hepatic ischemia/reperfusion injury-a fresh look显示文摘 | Constantino F Ronald W Busuttil | 2003 | Exp Mol Pathol2003，74，2： | 1 |
| 14 | Usefulness of intra-procedural cone-beam computed tomography in modified balloon-occluded retrograde transvenous obliteration of gastric varices显示文摘AIM:To evaluate whether intra-procedural conebeam computed tomography(CBCT)performed during modified balloon-occluded retrograde transvenous obliteration(mB RTO)can accurately determine technical success of complete variceal obliteration.METHODS:From June 2012 to December 2014,15 patients who received CBCT during m BRTO for treatment of portal hypertensive gastric variceal bleeding were retrospectively evaluated.Three-dimensional(3D)CBCT images were performed and evaluated prior to the end of the procedure,and these were further analyzed and compared to the pre-procedure contrast-enhanced computed tomography to determine the technical success of m BRTO including:Complete occlusion/obliteration of:(1)gastrorenal shunt(GRS);(2)gastric varices;and(3)afferent feeding veins.Post-mB RTO contrast-enhanced CT was used to confirm the accuracy and diagnostic value of CBCT within 2-3 d.RESULTS:Intra-procedural 3D-CBCT images were 100% accurate in determining the technical success of m BRTO in all 15 cases.CBCT demonstrated complete occlusion/obliteration of GRS,gastric varices,collaterals and afferent feeding veins during m BRTO,which was confirmed with post-m BRTO CT.Two patients showed incomplete obliteration of gastric varices and feeding veins on CBCT,which therefore required additional gelfoam injections to complete the procedure.No patient required additional procedures or other interventions during their follow-up period(684 ± 279 d).CONCLUSION:CBCT during mB RTO appears to accurately and immediately determine the technical success of mB RTO.This may improve the technical and clinical success/outcome of m BRTO and reduce additional procedure time in the future. | Edward Wolfgang Lee Naomi So Ryan Chapman Justin P McWilliams Christopher T Loh Ronald W Busuttil Stephen T Kee | 2016 | World Journal of Radiology2016，8，4： | 0 |
| 15 | Adjuvant chemotherapy after liver transplantation for hepatocellular carcinoma显示文摘In this issue,Lin et al^([1])presented a well-written metaanalysis regarding the use of adjuvant chemotherapy in orthotopic liver transplant(OLT)recipients with hepatocellular carcinoma(HCC).They highlighted the need for further investigation about the post-OLT management of HCC.The treatment of advanced HCC remains a difficult challenge as there is | Adam S Bodzin Richard S Finn Ronald W Busuttil | 2015 | Hepatobiliary & Pancreatic Diseases International2015，14，3： | 0 |
| 16 | Liver transplantation and sleeve gastrectomy in the medically complicated obese: New challenges on the horizon显示文摘In the last 30 years, operative, technical and medical advances have made liver transplantation(LT) a lifesaving therapy that is used worldwide today. Global industrialization has been a contributor to morbid obesity and this has brought about the metabolic syndrome along with many downstream complications of such. Non-alcoholic steatohepatitis(NASH) has become a recognized hepatic manifestation of the metabolic syndrome and NASH cirrhosis is predicted to be the primary indication for LT in the United States by 2025. Several case series and database reviews have begun analyzing the efficacy of weight reduction surgery in the LT recipient. These data have reasonably demonstrated that weight reduction surgery in the LT recipient is a feasible endeavor. However, several questions have been raised regarding the type of weight reduction surgery, timing of surgery in relation to LT, patient and allograft survival and post-LT maintenance of weight loss to name a few. We look forward to a time when weight reduction surgery will work to improve the technical conduct of LT, improve perioperative benchmarks such as blood transfusions, intensive care unit length of stay and help to prevent recurrence of NASH cirrhosis in the medically complicated obese patient. In the meantime, well-designed prospective clinical trials that focus on the issues highlighted will help guide us in the care of these complicated patients who will soon account for the majority of the patients in our clinics. | Diego C Reino Keri E Weigle Erik P Dutson Adam S Bodzin Keri E Lunsford Ronald W Busuttil | 2015 | World Journal of Hepatology2015，7，21： | 0 |
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