Publications by authors named "Faisal Dar"

Background: Among primary liver tumors, hepatocellular carcinoma (HCC) is considered the most common hepatic tumor. Liver transplantation is one of the curative treatment options for HCC. However, the risk of HCC recurrence after liver transplantation varies and is influenced by various factors.

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Introduction And Importance: The curative options for locally advanced hepatocellular carcinomas involving the vessels are very limited. Ex vivo liver resection and auto transplantation (ERAT) is a novel surgical method, which has been used in the management of such complex liver space occupying lesions, which are rendered conventionally unresectable. This technique involves a complete hepatectomy, extracorporeal hepatic resection on the backbench, and then reimplantation of the remnant hepatic parenchyma.

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Article Synopsis
  • - New guidelines suggest a 5-year survival rate of at least 60% for hepatocellular carcinoma (HCC) patients receiving living donor liver transplants, and this study looks at outcomes for those who meet expanded criteria.
  • - The study included 208 patients, reporting 5-year and 10-year survival rates of 67% and 61% respectively, with a recurrence risk of about 20.5% at 5 years and 22.5% at 10 years; larger tumors and higher AFP levels correlated with increased recurrence risk.
  • - Patients classified as low-risk for HCC based on tumor size and AFP levels had a 5-year recurrence risk similar to those meeting the traditional Milan criteria,
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There is no consensus on the utility of para-aortic lymph node dissection (PALND) in patients undergoing pancreaticoduodenectomy (PD) for periampullary cancer. The objective of this study was to assess survival in patients who underwent PD with PALND for pancreatic (PAC) and non-pancreatic (non-PAC) adenocarcinoma. All patients who underwent PD and PALND between 2011 and 2019 were reviewed ( = 114).

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Article Synopsis
  • A consensus meeting of national hepatobiliary experts took place on May 26, 2023, at PKLI & RC, aiming to develop guidelines for managing hilar cholangiocarcinoma (hCCA).
  • The meeting emphasized the need for a multidisciplinary approach to manage hCCA effectively, highlighting diagnostic methods like CT and MRI for staging, as well as the importance of surgical resection for potentially curative treatment.
  • For patients with unresectable hCCA, options include liver transplantation and palliative chemotherapy, with guidelines suggesting personalized treatment plans based on local discussions.
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Introduction: Liver transplantation (LT) has emerged as a lifesaving modality for many liver diseases in children. Pediatric LT is an established treatment in the Western world but is relatively a new procedure in resource-limited countries like Pakistan. The study aims to highlight the outcomes and survival of pediatric recipients from the first pediatric liver transplant center in Pakistan.

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Calcifying nested stromal-epithelial tumor is a rare hepatic malignancy with approximately 50 cases reported in the literature. Its clinical presentation is nonspecific, and the diagnosis is mainly based on histology which shows nests of spindle and epithelioid cells along with a desmoplastic myofibroblastic stroma containing variable calcification and ossification. In this report, we present a case of a 24-year-old woman with a history of abdominal pain, distension, and dyspepsia.

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Background: Living donor liver transplantation (LDLT) has become a popular treatment option because some countries lack a deceased organ program and the growing demand for liver transplants. Although postoperative outcomes are similar to deceased donor liver transplants, there is still an element of risk to the donor. The Clavien-Dindo classification system has been used to standardize reporting across different institutions and surgeons to categorize surgical outcomes.

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Purpose: Living donor liver transplantation (LDLT) is a widely accepted option to address the lack of a deceased liver program for transplantation. Understanding vascular and biliary anatomy and their variants is crucial for successful and safe graft harvesting. Anatomic variations are common, particularly in the right hepatic lobe.

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Purpose: Thromboembolic complications remain a significant concern in postoperative patients, particularly those who have undergone liver transplantation. Warfarin has been the standard oral anticoagulant. Direct oral anticoagulants (DOACs) have several advantages over warfarin, including rapid onset of action and standardized dose guidelines.

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Background: The outcomes of dual graft living donor liver transplantation (DGLDLT) in high acuity patients remain underreported. The objective of this study was to report long-term outcomes from a single center in this select group of patients.

Methods: This was a retrospective review of patients who underwent DGLDLT between 2012 and 2017 (n = 10).

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Living donor liver transplant in addition to its lifesaving therapy is a cost-effective alternate to long-term disease management in patients with chronic liver disease. Financial constraint is the biggest hurdle faced by patients in developing countries in availing the liver transplantation. So, we conducted this study to report a government-funded financial support system for liver transplant services.

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Backgrounds/aims: Locally advanced gallbladder cancer (GBC) is associated with survival limited to a few months. Extended resections (ER) are occasionally performed in this group and outcomes remain inconclusive. This study assessed outcomes after ER for locally advanced GBC.

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Introduction And Importance: Primary squamous cell carcinoma (PSCC) of liver is quite rare and very few cases reported in literature. It has high metastatic rate with poor prognosis. The pathogenesis is unclear, but is generally considered to be correlated with the long-term inflammation or metaplasia of biliary epithelial cells or congenital cyst of the liver.

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Hepatocellular carcinoma (HCC) is a rare pediatric tumor. It differs from its adult counterpart in many ways like etiology, biological behavior, and association with cirrhosis. Treating HCC requires a multidisciplinary team involving pediatric gastroenterology, oncology, hepatobiliary surgery, and interventional radiology.

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Background: Biliary atresia (BA) is the most common cause of neonatal cholestatic syndrome. The true incidence of BA in Pakistan is largely unknown.

Aim: This study aimed to report the clinical features, age at diagnosis and outcomes of biliary atresia from the first pediatric liver transplant center in Pakistan.

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BACKGROUND Wilson disease (WD) is a rare genetic disorder with vast clinical presentations and a higher incidence in areas where consanguinity is common. Most patients can be treated with oral chelation, but some require advanced surgical intervention, like liver transplantation (LT). This study aims to review outcomes of WD patients presenting to a tertiary care center over a period of 10 years.

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Very few centers in Pakistan have all established treatments for hepatocellular carcinoma (HCC) available under one roof. With a dedicated hepato-pancreato-biliary surgery and liver transplant unit, we have gathered one of the largest data on HCC in our population. The objective of the current study was to assess the clinical spectrum of HCC in Pakistani patients.

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Objective: To report long-term outcomes after pancreaticoduodenectomy from a single centre.

Methods: The retrospective study was conducted at Shifa International Hospital, Islamabad and comprised pancreaticoduodenectomy procedures performed by four surgeons at a single centre from January 2011 to June 2019. Outcome was assessed on the basis of morbidity, in-hospital mortality and survival.

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Background: The indications for liver transplantation (LT) in patients with hepatocellular carcinoma (HCC) continue to evolve. The aim of this study was to report outcomes in patients who underwent living donor liver transplantation (LDLT) for HCC outside traditional criteria including macrovascular invasion (MVI).

Methods: We reviewed outcomes in patients who met the University of California San Francisco (UCSF) criteria (n = 159) and our center-specific criteria (UCSF+) (largest tumor diameter ≤ 10 cm, any tumor number, AFP ≤ 1000 ng/ml) (n = 58).

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The role of preoperative biliary stenting (PBS) before pancreaticoduodenectomy (PD) in patients with obstructive jaundice is debatable. The objective of the current study was to assess PD outcomes after upfront surgery or PBS and determine the impact of stent to surgery duration on PD outcomes. We reviewed patients who underwent PD between 2011 and 2019.

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Article Synopsis
  • LDLT is a viable treatment for hepatocellular carcinoma (HCC), but traditional criteria focus on optimizing organ use while minimizing recurrence risks, with a target of 50% recurrence-free survival (RFS) at four years.
  • The study analyzed 898 LDLTs between 2012 and 2019, examining preoperative factors in 242 confirmed HCC cases to identify those at risk for poor RFS.
  • Key findings indicate that elevated AFP levels (>600 ng/ml) and microvascular invasion (MVI) are strong predictors of poor outcomes, suggesting that patients with lower AFP levels have better survival rates, while those with high levels should undergo biopsy for better selection.
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