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Boga I, Ozemri Sag S, Duman N, Ozdemir SY, Ergoren MC, Dalci K, Mujde C, Parsak CK, Rencuzogullari C, Sonmezler O, Yalav O, Alemdar A, Aliyeva L, Bozkurt O, Cetintas S, Cubukcu E, Deligonul A, Dogan B, Ornek Erguzeloglu C, Evrensel T, Gokgoz S, Senol K, Tolunay S, Akyurek E, Basgoz N, Gökçe N, Dundar B, Ozturk F, Taskin D, Demirtas M, Cag M, Diker O, Olgun P, Tug Bozdogan S, Dundar M, Bisgin A, Temel SG. A Multicenter Study of Genotype Variation/Demographic Patterns in 2475 Individuals Including 1444 Cases With Breast Cancer in Turkey. Eur J Breast Health 2023; 19:235-252. [PMID: 37415649 PMCID: PMC10320635 DOI: 10.4274/ejbh.galenos.2023.2023-2-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Accepted: 05/30/2023] [Indexed: 07/08/2023]
Abstract
Objective Breast cancer (BC) is the most common cancer type in women and may be inherited, mostly in an autosomal dominant pattern. The clinical diagnosis of BC relies on the published diagnostic criteria, and analysis of two genes, BRCA1 and BRCA2, which are strongly associated with BC, are included in these criteria. The aim of this study was to compare BC index cases with non-BC individuals in terms of genotype and diagnostic features to investigate the genotype/demographic information association. Materials and Methods Mutational analyses for the BRCA1/BRCA2 genes was performed in 2475 individuals between 2013-2022 from collaborative centers across Turkey, of whom 1444 with BC were designated as index cases. Results Overall, mutations were identified in 17% (421/2475), while the percentage of mutation carriers in cases of BC was similar, 16.6% (239/1444). BRCA1/BRCA2 gene mutations were detected in 17.8% (131/737) of familial cases and 12% (78/549) of sporadic cases. Mutations in BRCA1 were found in 4.9%, whereas 12% were in BRCA2 (p<0.05). Meta-analyses were performed to compare these results with other studies of Mediterranean-region populations. Conclusion Patients with BRCA2 mutations were significantly more common than those with BRCA1 mutations. In sporadic cases, there was a lower proportion with BRCA1/BRCA2 variants, as expected, and these results were consistent with the data of Mediterranean-region populations. However, the present study, because of the large sample size, revealed more robust findings than previous studies. These findings may be helpful in facilitating the clinical management of BC for both familial and non-familial cases.
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Affiliation(s)
- Ibrahim Boga
- Cukurova University AGENTEM (Adana Genetic Diseases Diagnosis and Treatment Center), Adana, Turkey
- Department of Medical Genetics, Cukurova University Faculty of Medicine, Adana, Turkey
| | - Sebnem Ozemri Sag
- Department of Medical Genetics and Genetic Diseases Diagnosis Center, Bursa Uludag University Faculty of Medicine, Bursa, Turkey
| | - Nilgun Duman
- Department of Medical Genetics, Bezmialem Vakif University, Dragos Hospital, Istanbul, Turkey
| | - Sevda Yesim Ozdemir
- Department of Medical Genetics, Uskudar University Faculty of Medicine, Istanbul, Turkey
| | - Mahmut Cerkez Ergoren
- Department of Medical Genetics, Near East University Faculty of Medicine, Nicosia, Cyprus
- Near East University, DESAM Institute, Nicosia, Cyprus
| | - Kubilay Dalci
- Department of General Surgery, Cukurova University Faculty of Medicine, Adana, Turkey
| | - Cem Mujde
- Cukurova University AGENTEM (Adana Genetic Diseases Diagnosis and Treatment Center), Adana, Turkey
| | - Cem Kaan Parsak
- Department of General Surgery, Cukurova University Faculty of Medicine, Adana, Turkey
| | - Cagla Rencuzogullari
- Cukurova University AGENTEM (Adana Genetic Diseases Diagnosis and Treatment Center), Adana, Turkey
| | - Ozge Sonmezler
- Cukurova University AGENTEM (Adana Genetic Diseases Diagnosis and Treatment Center), Adana, Turkey
| | - Orcun Yalav
- Department of General Surgery, Cukurova University Faculty of Medicine, Adana, Turkey
| | - Adem Alemdar
- Department of Translational Medicine, Bursa Uludag University Institute of Health Sciences, Bursa, Turkey
| | - Lamiya Aliyeva
- Department of Medical Genetics and Genetic Diseases Diagnosis Center, Bursa Uludag University Faculty of Medicine, Bursa, Turkey
| | - Ozlem Bozkurt
- Department of Medical Pathology, Bursa Uludag University Faculty of Medicine, Bursa, Turkey
| | - Sibel Cetintas
- Department of Radiation Oncology, Bursa Uludag University Faculty of Medicine, Bursa, Turkey
| | - Erdem Cubukcu
- Department of Medical Oncology, Bursa Uludag University Faculty of Medicine, Bursa, Turkey
| | - Adem Deligonul
- Department of Medical Oncology, Bursa Uludag University Faculty of Medicine, Bursa, Turkey
| | - Berkcan Dogan
- Department of Medical Genetics and Genetic Diseases Diagnosis Center, Bursa Uludag University Faculty of Medicine, Bursa, Turkey
- Department of Translational Medicine, Bursa Uludag University Institute of Health Sciences, Bursa, Turkey
| | - Cemre Ornek Erguzeloglu
- Department of Translational Medicine, Bursa Uludag University Institute of Health Sciences, Bursa, Turkey
| | - Turkkan Evrensel
- Department of Translational Medicine, Bursa Uludag University Institute of Health Sciences, Bursa, Turkey
- Department of Medical Oncology, Bursa Uludag University Faculty of Medicine, Bursa, Turkey
| | - Sehsuvar Gokgoz
- Department of General Surgery, Bursa Uludag University Faculty of Medicine, Bursa, Turkey
| | - Kazim Senol
- Department of General Surgery, Bursa Uludag University Faculty of Medicine, Bursa, Turkey
| | - Sahsine Tolunay
- Department of Medical Pathology, Bursa Uludag University Faculty of Medicine, Bursa, Turkey
| | - Esra Akyurek
- Department of Medical Genetics, Erciyes University Faculty of Medicine, Kayseri, Turkey
| | - Neslihan Basgoz
- Department of Medical Genetics, Erciyes University Faculty of Medicine, Kayseri, Turkey
| | - Nuriye Gökçe
- Department of Medical Genetics, Erciyes University Faculty of Medicine, Kayseri, Turkey
| | - Bilge Dundar
- Department of Medical Genetics, Erciyes University Faculty of Medicine, Kayseri, Turkey
- Department of Pathology, University of Iowa Carver College of Medicine, Iowa City, United States of America
| | - Figen Ozturk
- Department of Pathology, Erciyes University Faculty of Medicine, Kayseri, Turkey
| | - Duygu Taskin
- Department of Medical Genetics, Erciyes University Faculty of Medicine, Kayseri, Turkey
| | | | - Murat Cag
- Department of Vascular Surgery and Transplantation, Strasbourg University Nouvel Hospital, Strasbourg, France
| | - Omer Diker
- Department of Medical Oncology, Near East University Faculty of Medicine, Nicosia, Cyprus
| | - Polat Olgun
- Department of Medical Oncology, Near East University Faculty of Medicine, Nicosia, Cyprus
| | - Sevcan Tug Bozdogan
- Cukurova University AGENTEM (Adana Genetic Diseases Diagnosis and Treatment Center), Adana, Turkey
- Department of Medical Genetics, Cukurova University Faculty of Medicine, Adana, Turkey
| | - Munis Dundar
- Department of Medical Genetics, Erciyes University Faculty of Medicine, Kayseri, Turkey
| | - Atil Bisgin
- Cukurova University AGENTEM (Adana Genetic Diseases Diagnosis and Treatment Center), Adana, Turkey
- Department of Medical Genetics, Cukurova University Faculty of Medicine, Adana, Turkey
| | - Sehime Gulsun Temel
- Department of Medical Genetics and Genetic Diseases Diagnosis Center, Bursa Uludag University Faculty of Medicine, Bursa, Turkey
- Department of Translational Medicine, Bursa Uludag University Institute of Health Sciences, Bursa, Turkey
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Ozdemir Y, Cag M, Gul S, Yüksel Z, Ergoren MC. In Silico Analysis of a De Novo OTC Variant as a Cause of Ornithine Transcarbamylase Deficiency. Appl Immunohistochem Mol Morphol 2022; 30:153-156. [PMID: 34670952 DOI: 10.1097/pai.0000000000000979] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Accepted: 09/06/2021] [Indexed: 11/25/2022]
Abstract
Ornithine transcarbamylase deficiency (OTCD) is the most common X-linked hereditary disorder of urea cycle disorders that is caused by neonatal hyperammonemia. OTC gene sequence variations are common causes of OTCD. The current study presents a 28-month-old baby girl proband with phenotypical characteristics of OTCD such as irritability, somnolence, intermittent vomiting, and high levels of serum ammonium. Whole-exome sequencing revealed a de novo c.275G>A p.(Arg92Gln) variant within the OTC gene. In silico analysis revealed a possible differential affinity between wild-type and mutant OTCase, while Arg92Gln decreases the binding ability of OTCase to the substrate, which can disrupt the urea cycle and explains the molecular pathogenicity of clinical hyperammonemia. In light of the fact that the genotype and phenotype correlation of OTCD is still uncertain, the present in silico analysis outcome can enhance our knowledge on this complicated, rare, and severe genetic disorder.
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Affiliation(s)
- Yesim Ozdemir
- Medical Genetics Department, Medical Faculty, Uskudar University
| | - Murat Cag
- Generel Surgery Department, Memorial Bahcelievler Hospital, Istanbul, Turkey
| | - Seref Gul
- Department of Chemical and Biological Engineering, Faculty of Engineering, Koc University
| | - Zafer Yüksel
- Human Genetics, Bioscientia GmbH, Ingelheim, Germany
| | - Mahmut C Ergoren
- Department of Medical Genetics, Faculty of Medicine, Near East University
- DESAM Insitute, Near East University, Nicosia, Cyprus
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Ozdemir Y, Cag M, Colak E, Coskun N, Basgoz N, Sarici H, Kaan D, Dogan M, Deniz K, Inanc M, Ozkul Y. The Effect of Gene Mutations on Metastasis and Overall Survival in Metastatic and Nonmetastatic Colon Cancers. Asian Pac J Cancer Prev 2021; 22:3839-3846. [PMID: 34967562 PMCID: PMC9080374 DOI: 10.31557/apjcp.2021.22.12.3839] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2021] [Indexed: 11/25/2022] Open
Abstract
Objective: It is known that many genes are associated with colon cancer. We aimed to investigate the effect of gene mutations on metastasis and overall survival in metastatic and non metastatic colon cancers. Methods: A total of 50 patients with metastatic (n=25) and non metastatic (n=25) diagnosed with colon cancer between 2010 and 2018 were included in the study. APC, MUTYH, RAD50, MEN1, ATM, PALB2, NSH2, BRCA1, BRCA2, MLH1, BRIP1, TP53, PTEN, BARD1, MSH6, PMS2, NBN, and FAM175A gene mutations were evaluated using the next generation sequencing method. The effect of gene mutations on metastasis and overall survival were evaluated. Results: The mean age of patients with colon cancer without distant metastasis was 48.64±14.72 years and for patients with distance metases was 56.68±11.65. The mean survival time of colon cancer patients with distant organ metastasis after the metastasis date was 104.36±58.59 weeks. The presence of APC, MUTYH, and TP53 genetic mutations was observed with a higher rate in metastatic colon cancer (p<0.05). Conclusion: We showed that APC, MUTYH, and TP53 mutations are associated with distant organ metastasis.
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Audet M, Piardi T, Cag M, Navarro F, Ornis S, Cinqualbre J, Wolf P, Panaro F. Hepatitis C recurrence after liver transplantation: has the human leukocyte antigen mismatching at individual loci a role? J Gastroenterol Hepatol 2011; 26:1772-8. [PMID: 22097939 DOI: 10.1111/j.1440-1746.2011.06772.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
BACKGROUND AND AIM The objective of this 11-year cohort retrospective study conducted in adult patients with chronic hepatitis C virus (HCV) who underwent liver transplantation (LT) was to identify whether human leukocyte antigen (HLA) mismatching is associated with the recurrence of HCV and with the time to recurrence of HCV. METHODS Among the 181 patients (74% men; mean age: 54 years, range 25-71) who underwent a LT between 1995 and 2006 in the study center, 163 had relevant data in their medical chart documenting HCV recurrence, and 107 (65.64%) reported a histological evidence of HCV recurrence. RESULTS Survival was 78% at 5 years. There was no significant relationship between the total score of HLA-mismatches and the recurrence of HCV. Similarly, there was no significant relationship between the total score of HLA mismatches and the time to recurrence of HCV. For the analyses at each individual locus, a significant relationship between the individual scores of HLA-mismatches and the recurrence of HCV were observed. Out of the 40 patients who experienced a rejection, the rate of recurrence was not different according to the severity of the rejection (75% mild, 64% moderate and 64% for severe rejection). CONCLUSIONS In conclusion, this large study did not demonstrate any relationship between the total score of HLA mismatches and HCV-recurrence. Contrarily a significant relationship between the individual scores of HLA mismatches (HLA-A3, HLA-B35, HLA-DR3, HLA-DR7, HLA-DQ2, HLA-DQ2-0) and the recurrence of HCV were observed.
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Affiliation(s)
- Maxime Audet
- Department of Surgery, Multivisceral Transplant Centre, Hopital Hautepierre, University of Strasbourg, Strasbourg, France
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Abstract
BACKGROUND The surgical robotic system is superior to traditional laparoscopy in regards to 3-dimensional images and better instrumentation. Robotic surgery for hepatic resection has not yet been extensively reported. The aim of this article is to report the first known case of liver resection with the use of a robot in France. METHODS A 61-year-old male with hepatitis C liver cirrhosis and hepatocellular carcinoma was referred for surgical treatment. Preoperative clinical evaluation and laboratory data disclosed a Child-Pugh class A5 patient. Magnetic resonance imaging showed a 3.4-cm tumor in segment III. Liver size was normal, and there were not signs of portal hypertension. Five trocars were used. RESULTS Liver transection was achieved with Harmonic scalpel and bipolar forceps without pedicle clamping. Hemostasis of raw surface areas was accomplished with interrupted stitches. Operative time was 180 minutes. Blood loss was minimal, and the patient did not receive transfusion. The recovery was uneventful, and the patient was discharged on the fifth postoperative day without ascites formation. CONCLUSION The robotic approach may enable liver resection in patients with cirrhosis. The da Vinci robotic system allowed for technical refinements of laparoscopic liver resection due to 3-dimensional visualization of the operative field and instruments with wrist-type end-effectors.
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Affiliation(s)
- Fabrizio Panaro
- Centre de Chirurgie Viscérale et de Transplantation, Hôpital de Hautepierre, Hopitaux Universitaires de Strasbourg, Strasbourg, France.
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Cag M, Audet M, Saouli AC, Panaro F, Piardi T, Cinqualbre J, Wolf P. Does arterialisation time influence biliary tract complications after orthotopic liver transplantation? Transplant Proc 2011; 42:3630-3. [PMID: 21094829 DOI: 10.1016/j.transproceed.2010.08.061] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2009] [Revised: 07/28/2010] [Accepted: 08/19/2010] [Indexed: 10/18/2022]
Abstract
BACKGROUND In the cardiac death donor era, many reports deal with biliary tract complications and concerns about ischemic reperfusion injury owing to the exclusive arterial vascularization of the biliary tree, the warm ischemia time has been implicated as responsible for biliary lesions during organ procurement. We defined the arterialization time as the second warm ischemia time. Our purpose was to study the correlation between the arterialization time during liver implantation and the appearance of biliary lesions. METHODS We retrospectively collected data from the last 5-years of orthotopic liver transplantation: namely, indications, cold perfusion fluid, cold ischemia time, operative procedure times, and acute rejection events. We excluded split-liver transplantations, retransplantations, pediatric patients, transplantations for cholestatic disease, cases where hepatic artery thrombosis happened before biliary complications, or patients with posttransplant cytomegalovirus infection. We defined 2 groups: A) without biliary complications; and B) with biliary complications. We compared the mean arterialization time using Student t test to define whether the warm ischemic time during implantation was responsible for biliary tract complications. A P value of <.05 was considered to be significant. RESULTS Between 2004 and the end of 2008, we grafted 402 patients among whom 243 met the inclusion criteria: 198 in group A and 45 in group B. Only the cold ischemia time was significantly different between the 2 groups (P = .039). CONCLUSION After the anhepatic time, the surgeon may take time for the arterial anastomosis without fearing increased biliary damage.
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Affiliation(s)
- M Cag
- Pôle des Pathologies Digestives, Hépatiques et de la Transplantation, 1 avenue Molière, 67098 Strasbourg Cedex, France.
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Cag M, Audet M, Saouli AC, Odeh M, Ellero B, Piardi T, Woehl-Jaeglé ML, Cinqualbre J, Wolf P. Successful liver transplantation for Rendu-Weber-Osler disease, a single centre experience. Hepatol Int 2011; 5:834-40. [PMID: 21484125 DOI: 10.1007/s12072-011-9259-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2010] [Accepted: 01/25/2011] [Indexed: 11/26/2022]
Abstract
UNLABELLED BACKROUNDS/PURPOSE: Hereditary hemorrhagic telangiectasia or Rendu-Weber-Osler is an autosomal dominant inherited disorder characterized by arteriovenous malformations and telangiectasia that may affect the nose, skin, lungs, brain and gastrointestinal tract. Liver involvement of the disease has been described to be responsible of biliary tract necrosis, high cardiac output and portal hypertension, due to intra-hepatic vascular shunts. We aimed to present four cases of successful orthotopic liver transplantations in this indication performing our modified Piggy-back technique. PATIENTS AND METHODS Between 2002 and 2008, four patients have been diagnosed for Rendu-Weber-Osler disease and underwent liver transplantation. Three of them suffered from high cardiac output with heart failure, two presented HBV infection and one patient suffered from renal failure requiring a liver-kidney transplantation. We performed our modified Piggy-back technique for liver implantation, which consists to clamp selectively the hepatic veins during the hepatectomy, without venous bypass, the retro-hepatic vena cava is preserved. RESULTS No hemodynamic concerns disturbed the surgery and no massive transfusions were needed. The liver replacement corrected the cardiac insufficiency due to high cardiac output for the three patients. At present, the four patients are getting well. CONCLUSIONS Despite new advances in immunotherapy for the medical treatment of Rendu-Weber-Osler disease, liver transplantation remains the curative option for hepatic based-hereditary hemorrhagic telangiectasia.
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Affiliation(s)
- Murat Cag
- Pôle des Pathologies Digestives, Hépatiques et de la Transplantation, Hôpital de Hautepierre, Strasbourg, France,
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Audet M, Piardi T, Panaro F, Ghislotti E, Gheza F, Cag M, Jarzembowski T, Flicoteaux H, Wolf P, Cinqualbre J. Incidence and clinical significance of bacterial and fungal contamination of the preservation solution in liver transplantation. Transpl Infect Dis 2011; 13:84-8. [DOI: 10.1111/j.1399-3062.2010.00529.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Piardi T, Audet M, Panaro F, Gheza F, Cag M, Portolani N, Cinqualbre J, Wolf P. Incisional hernia repair after liver transplantation: role of the mesh. Transplant Proc 2010; 42:1244-7. [PMID: 20534272 DOI: 10.1016/j.transproceed.2010.03.085] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Patients undergoing orthotopic liver transplantation (OLT) show a high risk of developing an incisional hernia. The aim of this retrospective study was to establish the incidence and the factors influencing the outcomes of this complication. METHODS We reviewed 450 consecutive OLT performed in 422 adult recipient between January 2000 and December 2005. Herniae were analysed with aspect to localization, classification, repair technique, and recurrence. All treated herniae were followed for a median of 50.5 months. RESULTS Incisional herniae occurred in 36 patients (8.5%, Group 1). Their mean age OLT was 51.4 years with 94.4% male subjects. No significant difference was observed between affects and unaffected individuals for age, OLT indication, Child-Pugh score, albumin, comorbidities, operative time, transfusions, immunosuppressant regimen, and graft rejection episodes as well as for the incisional approach and hospital stay. Gender, body mass index (BMI), preoperative ascites, and pulmonary complications after OLT were significantly different (P < .01). Herniae were small (<5 cm; n = 12), medium (5-10 cm; n = 28), or large (> 10 cm; n = 2). Herniorrhaphy techniques included primary suture repair in 5 (13.9%) and mesh repair in 31 (86.1%) cases. In 3 patients with a primary repair and 1 patient with a mesh repair there were recurrences. CONCLUSIONS Preoperative ascites, gender, BMI, and pulmonary complications after OLT seemed to have significant influences on the formation of incisional herniae. Polypropylene mesh may be a first choice for the surgical treatment of there transplant recipients.
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Affiliation(s)
- T Piardi
- Multi-organ Transplant Centre of University Louis Pasteur of Strasbourg, Strasbourg, France.
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Audet M, Piardi T, Panaro F, Cag M, Habibeh H, Gheza F, Portolani N, Cinqualbre J, Jaeck D, Wolf P. Four hundred and twenty-three consecutive adults piggy-back liver transplantations with the three suprahepatic veins: was the portal systemic shunt required? J Gastroenterol Hepatol 2010; 25:591-6. [PMID: 19968745 DOI: 10.1111/j.1440-1746.2009.06084.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
BACKGROUND AND AIMS The aim of this study is to analyze a single-center experience in orthotopic liver transplantation with the piggy-back technique (PB) realized with a cuff of three veins without temporary portacaval shunt. Outcome parameters were graft and patient survival and the surgical complications. METHODS The records of 423 liver transplantation in 396 adult recipients were reviewed. PB was performed in all cases also in patients with transjugular intrahepatic portosystemic shunts and redo transplants without temporary portacaval shunt. No hemodynamic instability was observed during venous reconstruction. RESULTS Operation time, cold ischemia time and anhepatic phase were, respectively, 316, 606 and 82 min, respectively. The mean intraoperative transfusion of packed red blood cells was 3.2 (range 1-48). Surgical complications were observed in 25% of the orthotopic liver transplantation and 2% of these was related to caval anastomosis. No case of caval thrombosis was observed; a stenosis was noted in seven patients, always treated with an endovascular approach. A postoperative ascites was observed in seven cases. Retransplantation was required in 6.3% patients. Overall in-hospital mortality was 5.3%, but no patient died through technical problems or complications related to PB procedure. One-, 3- and 5-year grafts and patients were 94%, 83% and 75%, and 92%, 86% and 79%, respectively. CONCLUSION This experience indicates that our approach is feasible with a low specific risk and can be performed without portacaval shunt, with minimal outflow venous complications.
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Affiliation(s)
- Maxime Audet
- Department of Surgery, Multivisceral Transplant Centre, Hopital Hautepierre, University of Strasbourg, Strasbourg, France
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Audet M, Piardi T, Panaro F, Cag M, Ghislotti E, Habibeh H, Giulini S, Jaeck D, Wolf P. Liver transplantation in recipients over 65 yr old: a single center experience. Clin Transplant 2010; 24:84-90. [DOI: 10.1111/j.1399-0012.2009.00972.x] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
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Piardi T, Audet M, Odeh M, Panaro F, Cag M, El-ahmar J, Baiocchi GL, Schneider A, Wolf P. Liver transplantation exceeding UCSF criteria: case report of a late recurrence treated by surgery and review of the literature. ACTA ACUST UNITED AC 2009; 44:52-5. [PMID: 19996598 DOI: 10.1159/000264635] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2008] [Accepted: 07/20/2009] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Treatment of a recurrence of hepatocellular carcinoma (HCC) after liver transplantation. Surgery has seldom been considered in such a situation because HCC recurrences are generally considered as a systemic disease. PATIENT AND METHODS We describe a 47-year-old male patient who underwent liver transplantation in October 1999 for HCC exceeding the Milan and University of California, San Francisco (UCSF), criteria. RESULTS In 2007 (8 years after liver transplantation), the patient developed a cervical bone metastasis treated by surgery. In April 2008, HCC had disseminated to hepatic pedicle lymph nodes. An extended hepatic pedicle lymphadenectomy was then performed. Today, our patient is doing well, without signs of recurrence. DISCUSSION The risk of developing a tumor recurrence is the main argument against expanding the UCSF criteria. In case of an HCC recurrence, various treatments ranging from a change in the immunosuppression regimen to chemotherapy have been proposed. Surgical treatment has rarely been envisaged in the treatment of HCC recurrences because of the technical difficulties and the frequent dissemination of cancer.
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Affiliation(s)
- T Piardi
- Department of Surgery, Multivisceral Transplant Center, Hôpital Hautepierre, Louis Pasteur University of Strasbourg, FR-67000 Strasbourg, France.
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Meyer C, Riehm S, Perrot F, Cag M, Nizand G, Audet M, Veillon F, Jaeck D, Wolf P. Donor iliac artery used for arterial reconstruction in liver transplantation. Transplant Proc 2000; 32:2791. [PMID: 11134807 DOI: 10.1016/s0041-1345(00)01887-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Affiliation(s)
- C Meyer
- Centre de Chirurgie Viscérale et de Transplantation, Hôpitaux Universitaires de Strasbourg, 67098, Strasbourg Cedex, France
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