Complications Associated With Liver Transplantation in Recipients With Body Mass Index >35 kg/m(2): Would It Be a Poor Prognosis Predictive Factor?

Background: Obesity is a global epidemic that continues to increase in a great number of countries, and it has become a major public health problem in Spain. Unfortunately, the impact of obesity on survival in liver transplantation (LT) recipients is underestimated and controversial. The aim of this study was to determine if obesity is a risk factor for morbidity and mortality after LT.

Role of Transarterial Chemoembolization to Downstage Hepatocellular Carcinoma Within the Milan Criteria.

The practice of treating candidates for liver transplantation (LT) for hepatocellular carcinoma (HCC), with locoregional therapies, is common in most transplantation centers. We present our results using transarterial chemoembolization (TACE) as a neo-adjuvant treatment in our center between 2002 and 2013 to determine its effectiveness in downstaging (DS) HCC within the Milan criteria (MC). Clinical variables were recorded of both donors and recipients, such as diagnosis and treatment, variables related to its etiology, the use of TACE as a neo-adjuvant treatment, immunosuppressive therapy, toxicity, recurrence of disease, exitus, and others.

Immunosuppression Strategies in the Treatment of Hepatocellular Carcinoma in Virgen de las Nieves University Hospital.

Background: We describe an observational, retrospective study that included patients who underwent a liver transplantation (LT) for hepatocellular carcinoma (HCC) in our center between 2004 and 2012.

Methods: Clinical variables were recorded for donors and recipients as diagnosis and treatment, immunosuppressive therapy, toxicity, graft dysfunction, recurrence, and exitus. Fifty-eight patients were analyzed.

Liver transplantation using low-weight recipients from a graft split program.

We present our experience with a split liver (SL) program shared with the children's liver transplantation (LT) program from 2 different hospitals in the use of partial grafts from cadaver donors in brain death. We describe an observational, retrospective study, which included patients who underwent a SL transplantation in our center between January 2006 and December 2012. Clinical variables were recorded of both donors and recipients and their data were analyzed using SPSS 19.

Experience of the transplant unit from Virgen de las Nieves Hospital in using liver grafts from asystolic donors.

Given the shortage of donors, it has become increasingly necessary to use alternative sources to meet the growing demand for organs, and evolution in the use of asystolic donors is proving to be an important resource in helping to meet those needs. The goal of this study is to describe the initial results of our experience with Type II asystolic donation. An observational retrospective study was conducted to analyze the variables of four cases in this type of donation.

[Multicentre study on hepatic adenomas].

Introduction: Hepatic adenomas (HA) are benign tumours which can present serious complications, and as such, in the past all were resected. It has now been shown that those smaller than 3 cm not expressing β-catenin only result in complications in exceptional cases and therefore the therapeutic strategy has been changed.

Material And Method: Retrospective study in 14 HPB units.

Liver transplantation for hepatocellular carcinoma: results of a multicenter study with common priorization criteria.

Objective: To evaluate the results of liver transplantation (OLT) performed for hepatocellular carcinoma (HCC) among a multicenter cohort of patients with predefined common inclusion and priorization criteria.

Patients And Methods: Over a 5-year period (January 2002-December 2006), 199 HCC patients underwent OLT in four centers in Andalusia. The morphological (Milan) inclusion criteria were priorized in two consecutive periods, according to the Model for End-stage Liver Disease score: group I, 53 patients (HCC < 2 cm = 24 points; > or = 2 cm or multinodular = 29 points) and group II, 146 cases (HCC < 3 cm without priorization; HCC > or = 3 cm or multinodular = 18 points).

[Xiphoid metastasis from duodenal cancer].

Duodenal cancer has a low prevalence in the general population. Metastases from this neoplasm usually affect the lymph nodes, liver or lung. Bone metastases from duodenal cancer are highly infrequent and xiphoid localization is exceptional.

[Mirizzi syndrome and gallbladder cancer].

Mirizzi syndrome (MS) has a low incidence in patients with gallbladder disease. The coexistence of gallbladder cancer seems to be more frequent in patients with MS than in those with gallstones only. We present two patients with MS type II and gallbladder cancer (stages T4N1M0 and T3NxMx).

Time course of intraoperative cytokine levels in liver transplant recipients.

We evaluated the levels of several cytokines (interleukin [IL]-2, IL-4, IL-6, IL-10, tumor necrosis factor [TNF]-alpha, and interferon [IFN]-gamma) in plasma samples obtained before surgical intervention (T0) and during intraoperative liver transplantation: after induction of anesthesia (I-1), 15 minutes of anhepatic phase (I-2), 5 minutes before reperfusion (I-3), 10 minutes after reperfusion (I-4), 20 minutes after reperfusion (I-5), 60 minutes after reperfusion (I-6), and 1 hour after liver transplantation (I-7). Cytokine levels were determined using a technique which combines ELISA technique and flow cytometry. The study was approved by the local clinical research (ethics) committee.

Early postoperative response of cytokines in liver transplant recipients.

We evaluated the early postoperative response of several cytokines (IL-2, IL-4, IL-6, IL-10, TNF-alpha, IFN-gamma) prior to liver transplantation (T(0)) as well as 1, 6, and 12 hours and 1, 2, 3, 5, and 7 days afterward. Cytokine concentrations were correlated with serum levels of bilirubin as a predictor of postoperative complications. Cytokine levels were determined in plasma samples from 16 liver transplant recipients (13 men, 3 women) aged 43 to 61 years.

Gallbladder tuberculosis: false-positive PET diagnosis of gallbladder cancer.

Gallbladder tuberculosis (GT) is an extremely rare disease, and very few cases have been reported in the literature. The first case of GT was described in 1870 by Gaucher. A correct preoperative diagnosis of GT is unusual, and it is frequently confused with various gallbladder diseases.

Indications and therapeutical options in hepatolithiasis.

Objective: to present our experience with the treatment of hepatolithiasis.

Experimental Design: a retrospective study. Every patient operated on during 2002-2004.

[Hepatocarcinoma in noncirrhotic liver].

Hepatocellular carcinoma (HCC) usually develops in patients with liver cirrhosis or chronic liver disease. These tumors are highly infrequent in patients without precipitating factors. We present a series of four patients with nonfibrolamellar HCC arising in healthy liver.

[Benign solid liver tumors].

Benign solid liver tumors are a heterogeneous group of lesions (adenoma, focal nodular hyperplasia, hemangioma, etc.) with highly varied epidemiological characteristics. Advances in diagnostic methods have improved preoperative diagnosis.

[Duodenal adenocarcinoma].

Introduction: Duodenal adenocarcinoma is an infrequent neoplasm. Consequently, there are no large series that would allow conclusions to be reached on its diagnosis and treatment.

Patients And Method: A retrospective study (1999-2003) of five patients diagnosed with duodenal adenocarcinoma in our service was performed.

[Distal pancreatectomy: one technique with several indications].

Introduction: Distal pancreatectomy (DP) is performed for various pancreatic processes. This procedure has become less frequent since it ceased to be systematically used in oncologic gastric surgery and it is now performed mainly in patients with chronic pancreatitis. We present a series of patients who underwent DP and discuss technical features and surgical indications.

[Surgical treatment of liver metastases from breast cancer].

Introduction: A small number of patients with breast cancer develop liver metastases (LM) as the sole site of regional dissemination. In these patients, surgical resection seems to be the best therapeutic option. We present our experience of LM from breast cancer and discuss the indications for resection.

Time course of antioxidant enzyme activities in liver transplant recipients.

Reactive oxygen species (ROS) play a central role in ischemia-reperfusion injury after organ transplantation. They are degraded by endogenous radical scavengers such as antioxidant enzymes. The purpose of this study was to evaluate the temporal variations of antioxidant enzyme activities in liver transplant recipients.

Postlaparoscopic cholecystectomy bile leak secondary to an accessory duct of Luschka.

Complications produced by the sectioning of a nonvisualized duct of Luschka are uncommon during laparoscopic cholecystectomy. From 1999 through 2003, we performed 1351 laparoscopic cholecystectomies in our department and observed 2 cases (0.15%) of bile leakage due to duct of Luschka injury.

Surgical options for malignant left-sided colonic obstruction.

Purpose: We evaluated the clinical results of different techniques of resection for malignant left-sided colonic obstruction.

Methods: The subjects of this prospective nonrandomized study were 63 consecutive patients who underwent surgery between 1995 and 2000 at a single institution. Patients with nonprimary colonic tumors, lesions located proximally to splenic flexure, peritonitis, perforation, or cecal necrosis were excluded.