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| 1 | High-intensity focused ultrasound ablation:An effective bridging therapy for hepatocellular carcinoma patients显示文摘AIM:To analyze whether high-intensity focused ultrasound(HIFU) ablation is an effective bridging therapy for patients with hepatocellular carcinoma(HCC).METHODS:From January 2007 to December 2010,49 consecutive HCC patients were listed for liver transplantation(UCSF criteria).The median waiting time for transplantation was 9.5 mo.Twenty-nine patients received transarterial chemoembolization(TACE) as a bringing therapy and 16 patients received no treatment before transplantation.Five patients received HIFU ablation as a bridging therapy.Another five patients with the same tumor staging(within the UCSF criteria) who received HIFU ablation but not on the transplant list were included for comparison.Patients were comparable in terms of Child-Pugh and model for end-stage liver disease scores,tumor size and number,and cause of cirrhosis.RESULTS:The HIFU group and TACE group showed no difference in terms of tumor size and tumor number.One patient in the HIFU group and no patient in the TACE group had gross ascites.The median hospital stay was 1 d(range,1-21 d) in the TACE group and two days(range,1-9 d) in the HIFU group(P < 0.000).No HIFU-related complication occurred.In the HIFU group,nine patients(90%) had complete response and one patient(10%) had partial response to the treatment.In the TACE group,only one patient(3%) had response to the treatment while 14 patients(48%) had stable disease and 14 patients(48%) had progressive disease(P = 0.00).Seven patients in the TACE group and no patient in the HIFU group dropped out from the transplant waiting list(P = 0.559).CONCLUSION:HIFU ablation is safe and effective in the treatment of HCC for patients with advanced cirrhosis.It may reduce the drop-out rate of liver transplant candidate. | Tan To Cheung Sheung Tat Fan See Ching Chan Kenneth SH Chok Ferdinand SK Chu Caroline R Jenkins Regina CL Lo James YY Fung Albert CY Chan William W Sharr Simon HY Tsang Wing Chiu Dai Ronnie TP Poon Chung Mau Lo | 2013 | World Journal of Gastroenterology2013,19,20: | 23 |
| 2 | Modulation of graft vascular inflow guided by flowmetry and manometry in liver transplantation显示文摘BACKGROUND:Survival of the partial graft after living donor liver transplantation owes much to its tremendous regenerative ability.With excellent venous outflow capacity,a graft within a wide range of graft-to-standard-liver-volume ratios can cope with portal hypertension that is common in liver transplant recipients.However,when the ratio range is exceeded,modulation of graft vascular inflow becomes necessary for graft survival.The interplay between graft-to-standard-liver-volume ratio and portal pressure,in the presence of portosystemic shunt or otherwise,requires individualized modulation of graft portal and arterial inflows.Boosting of portal inflow by shunt ligation can be guided by transonic flowmetry,whereas muting of portal inflow by splenic artery ligation can be monitored by portal electronic manometry.METHOD:We describe four cases to illustrate the above.RESULTS:One patient had hepatic artery thrombosis resulting from splenic artery steal syndrome which was the sequela of small-for-size syndrome.Emergency splenic artery ligation and re-anastomosis of the hepatic artery successfully muted the portal inflow and boosted the hepatic arterial inflow.Another patient with portal vein thrombosis underwent thrombendvenectomy.Portal inflow was boosted with ligation of portosystemic shunt,which is often present in these patients with portal hypertension.The coexistence of splenic aneurysm and splenorenal shunt required ligation of both in the third patient.The fourth patient,with portal pressure and flow monitoring,avoided ligation of a coronary vein which became a main portal inflow after portal thrombendvenectomy.CONCLUSION:Management of graft inflow modulation guided selectively by transonic flowmetry or portal manometry was described. | See Ching Chan Chung Mau Lo Kenneth SH Chok William W Sharr Tan To Cheung Simon HY Tsang Albert CY Chan Sheung Tat Fan | 2011 | Hepatobiliary & Pancreatic Diseases International2011,10,6: | 5 |
| 3 | Entecavir Monotherapy Is Effective in Suppressing Hepatitis B Virus After Liver Transplantation显示文摘 | James Fung Cindy Cheung See–Ching Chan Man–Fung Yuen Kenneth S.H. Chok William Sharr Wing–Chiu Dai Albert C.Y. Chan Tan–To Cheung Simon Tsang Banny Lam Ching–Lung Lai Chung–Mau Lo | 2011 | Gastroenterology2011,,4: | 3 |
| 4 | Clinical factors affecting rejection rates in liver transplantation显示文摘BACKGROUND: With improvements in survival, liver transplant recipients now suffer more morbidity from long-term immunosuppression. Considerations were given to develop individualized immunosuppression based on their risk of rejection. METHOD: We retrospectively analyzed the data of 788 liver transplants performed during the period from October 1991 to December 2011 to study the relationship between acute cellular rejection(ACR) and various clinical factors. RESULTS: Multivariate analysis showed that older age(P=0.04,OR=0.982), chronic hepatitis B virus infection(P=0.005, OR=0.574), living donor liver transplantation(P=0.02, OR=0.648) and use of interleukin-2 receptor antagonist on induction(P<0.001, OR=0.401) were associated with fewer ACRs. Patients with fulminant liver failure(P=0.004, OR=4.05) were more likely to develop moderate to severe grade ACR. CONCLUSIONS: Liver transplant recipients with older age,chronic hepatitis B virus infection, living donor liver transplantation and use of interleukin-2 receptor antagonist on induction have fewer ACR. Patients transplanted for fulminant liver failure are at higher risk of moderate to severe grade ACR.These results provide theoretical framework for developing individualized immunosuppression. | Kin Pan Au See-Ching Chan Kenneth Siu-Ho Chok William Wei Sharr Wing-Chiu Dai Sui-Ling Sin Tiffany Cho-Lam Wong Chung-Mau Lo | 2015 | Hepatobiliary & Pancreatic Diseases International2015,14,4: | 3 |
| 5 | High-intensity focused ultrasound ablation as a bridging therapy for hepatocellular carcinoma patients awaiting liver transplantation显示文摘The scarcity of liver grafts in Asia leads to a significant dropout of patients from liver transplant waiting lists, particularly patients with hepatocellular carcinoma and a low model for end-stage liver disease score. In order to reduce dropping out, different bridging therapies are employed. We report the use of high-intensity focused ultrasound ablation as a bridging therapy for a patient with hepatocellular carcinoma of stage two and an extremely low platelet count (20×10 9 /L). The ablation was successful. Blood tests showed that his liver function was similar before and after the treatment. No adhesion was encountered in the liver transplantation performed six months later. | Tan To Cheung Kenneth SH Chok Regina CL Lo William W Sharr See Ching Chan Ronnie TP Poon Sheung Tat Fan Chung Mau Lo | 2012 | Hepatobiliary & Pancreatic Diseases International2012,11,5: | 3 |
| 6 | Bile duct anastomotic stricture after adult‐to‐adult right lobe living donor liver transplantation显示文摘 | Kenneth Siu Ho Chok See Ching Chan Tan To Cheung William Wei Sharr Albert Chi Yan Chan Chung Mau Lo Sheung Tat Fan | 2011 | Liver Transpl2011,,1: | 2 |
| 7 | Retrohepatic vena cava deroofing in living donor liver transplantation for caudate hepatocellular carcinoma显示文摘The removal of tumor together with the native liver in living donor liver transplantation for hepatocellular carcinoma is challenged by a very close resection margin if the tumor abuts the inferior vena cava.This is in contrast to typical deceased donor liver transplantation where the entire retrohepatic inferior vena cava is included in total hepatectomy.Here we report a case of deroofing the retrohepatic vena cava in living donor liver transplantation for caudate hepatocellular carcinoma.In order to ensure clear resection margins,the anterior portion of the inferior vena cava was included.The right liver graft was inset into a Dacron vascular graft on the back table and the composite graft was then implanted to the recipient inferior vena cava.Using this technique,we observed the no-touch technique in tumor removal,hence minimizing the chance of positive resection margin as well as the chance of shedding of tumor cells during manipulation in operation. | See Ching Chan William W Sharr Tan To Cheung Albert CY Chan Simon HY Tsang Kenneth SH Chok Kin Chung Leung Chung Mau Lo | 2013 | Hepatobiliary & Pancreatic Diseases International2013,12,5: | 2 |
| 8 | Tmmr PI)-L1 co-sfirmlates p human CD8 + cytotoxic T cells modified to express a PD1 : CD28 chimeric receptor显示文摘 | Prtser ME Brown CE Sharr/AF | 2012 | Mol Immunol2012,51,34: | 1 |
| 9 | Radiological prognosticators of hepatocellular carcinoma treated by hepatectomy显示文摘BACKGROUND: Hepatectomy is the main curative treatment for hepatocellular carcinoma (HCC), but postoperative long- term survival is poor. Preoperative radiological features of HCC displayed by computed tomography or magnetic resonance imaging could serve as additional prognostic factors. This study aimed to identify preoperative radiological features of HCC that may be of prognostic significance in hepatectomy. METHODS: Ninety-two patients who underwent hepatectomy for HCC were included in this study. Preoperative radiological features including tumor number, size, location (peripheral, middle, central), portal vein invasion, hepatic vein invasion, and presence of pseudo-capsule were analyzed in relation to survival. RESULTS: With a median follow-up period of 41.7 months, the 1-, 3- and 5-year overall survival rates were 85%, 65% and 58%, respectively. Univariate analysis showed that portal vein invasion and absence of pseudo-capsule were significant prognostic factors for overall survival, while all the examined radiological features were prognostic factors for disease-free survival. Multivariate analysis for overall survival found no significant factor. On multivariate analysis for disease-free survival, patients who had tumors with portal vein invasion had poorer survival with a hazard ratio of 2.26 (95% CI, 1.05-4.91; P=0.038) and patients with single nodular HCC or pseudo-capsulated HCC had better survival with a hazard ratio of 0.50 (95% CI, 0.27-0.94; P=0.032) and 0.38 (95% CI, 0.14-0.99; P=0.048), respectively. CONCLUSIONS: Demonstrable pseudo-capsule of HCC and solitary HCC on imaging and absence of portal vein invasionare features associated with better disease-free survival after hepatectomy. These features may guide treatment planning for HCC. | Kevin KW Chu See Ching Chan Sheung Tat Fan Kenneth SH Chok Tan To Cheung William W Sharr Albert CY Chan Chung Mau Lo | 2012 | Hepatobiliary & Pancreatic Diseases International2012,11,6: | 1 |
| 10 | Neurocytoma of the toracic spinal cord显示文摘 | Martin A J Sharr M M Teddy P J | 2002 | Acta Neurochir2002,144,: | 1 |
| 11 | An unusual case of acute labyrinthine failure显示文摘 | Mehta JS Sharr MM | | 0,,: | 1 |
| 12 | Primary intracranial choriocarcinoma显示文摘 | Doshi B Sharr MM | 1986 | J Neurol Neurosurg Psychiatry1986,49,: | 1 |
| 13 | Bile duct anastomotic stricture after pediatric living donor liver transplantation显示文摘 | Kenneth S.H. Chok See Ching Chan Kwong Leung Chan William W. Sharr Paul K.H. Tam Sheung Tat Fan Chung Mau Lo | 2012 | Journal of Pediatric Surgery2012,,7: | 1 |
| 14 | Spinal meningiomas : a 20 -year review 显示文摘 | King AT Sharr MM Gullan RW | 1998 | Br J Neurosurg1998,12,6: | 1 |
| 15 | Phase progression:cyclinon cue显示文摘 | Charles J Sharr G | 1994 | Cell1994,79,: | 1 |
| 16 | Entecavir Monotherapy Is Effective in Suppressing Hepatitis B Virus After Liver Transplantation显示文摘 | James Fung Cindy Cheung See–Ching Chan Man–Fung Yuen Kenneth S.H. Chok William Sharr Wing–Chiu Dai Albert C.Y. Chan Tan–To Cheung Simon Tsang Banny Lam Ching–Lung Lai Chung–Mau Lo | 2011 | Gastroenterology2011,,4: | 1 |
| 17 | Primary intracranial choriocareinoma 显示文摘 | Page R Doshi B Sharr MM | 1986 | J Neurol Neurosurg Psychiatry1986,49,: | 1 |
| 18 | Entecavir Monotherapy Is Effective in Suppressing Hepatitis B Virus After Liver Transplantation显示文摘 | James Fung Cindy Cheung See–Ching Chan Man–Fung Yuen Kenneth S.H. Chok William Sharr Wing–Chiu Dai Albert C.Y. Chan Tan–To Cheung Simon Tsang Banny Lam Ching–Lung Lai Chung–Mau Lo | 2011 | Gastroenterology2011,,4: | 1 |
| 19 | Neurocytoma of the thoracic spinal cord显示文摘 | Martin AJ Sharr MM Teddy PJ | 2002 | Acta Neurochir(Wien)2002,46,11: | 1 |
| 20 | Prime sequenes:Quasi-optimal sequences for channel code division multiplexingp 显示文摘 | Sharr A A Davis P A | 1983 | Electron Lett1983,19,88: | 1 |