One of the most feared complications in liver transplantation is hepatic arterial thrombosis (HAT). The incidence of HAT in liver transplantation varies from 1.2% and 8%. One of the risk factors for this complication is anatomical complexity of hepatic arterial system. The focus of this short communication is to show our approach in dealing with aberrant left hepatic artery in settings of liver transplantation. This is a single center experience. Between January 2016 and June 2019, we procured and transplanted 357 adult liver allografts. Of these, there were 34 (9.5%) livers with aberrant left hepatic artery. All of them have been reconstructed on bench table. There was no incidence of HAT in the entire cohort with ALHA. The one-year graft survival for this patient cohort was 93.1%. Our surgical approach resulted in a low incidence of HAT of 1% with excellent graft survival.
2. Loukas M, Fergurson A, Louis RG et-al. Multiple variations of the hepatobiliary vasculature including double cystic arteries, accessory left hepatic artery and hepatosplenic trunk: a case report. Surg Radiol Anat. 2006;28 (5): 525-8. doi:10.1007/s00276-006-0138-4 - Pubmed citation ...
TY - JOUR. T1 - Clinical significance of reconstruction of the right hepatic artery for biliary malignancy. AU - Sakamoto, Yoshihiro. AU - Sano, Tsuyoshi. AU - Shimada, Kazuaki. AU - Kosuge, Tomoo. AU - Kimata, Yoshihiro. AU - Sakuraba, Minoru. AU - Yamamoto, Junji. AU - Ojima, Hidenori. PY - 2006/6. Y1 - 2006/6. N2 - Background and aims: The clinical significance of resectional surgery with reconstruction of the right hepatic artery for biliary malignancy remains unclear. Patients/methods: Between 1990 and 2004, six patients (5%) with cholangiocarcinoma and five patients (3%) with gallbladder carcinoma with possible involvement of the right hepatic artery underwent resectional surgery with reconstruction of the right-sided hepatic artery. The surgical procedures included extended left hemihepatectomy (n=4), left trisectionectomy (n=1), central bisegmentectomy (n=1), resection of anterior segment and inferior area of segment 4 (n=2), resection of segment 5 and inferior area of segment 4 (n=1), ...
The left and right hepatic arteries make up the two branches of the common hepatic artery and are used for supplying blood to the liver within the human body.
The common hepatic artery is the vessel which supplies oxygen-rich blood to a number of important organs: the liver, the duodenum, the pylorus, and the pancreas. This artery is a branch of the celiac artery; it divides into the gastroduodenal artery and the hepatic artery proper.. ...
Purpose: This study was designed to evaluate the safety of chemotherapeutic infusion or chemoembolization by way of the cystic artery in patients with hepatocellular carcinoma (HCC) supplied exclusively by the cystic artery. Methods: Between Jan 2002 and Dec 2011, we performed chemotherapeutic infusion or chemoembolization using iodized oil for the treatment of 27 patients with HCC supplied exclusively by the cystic artery. Computed tomography (CT) scans, digital subtraction angiograms, and medical records were retrospectively reviewed by consensus. Results: The cystic artery originated from the main right hepatic artery in 24 (89 %) patients, from the right anterior hepatic artery in 2 (7 %) patients, and from the left hepatic artery in 1 (4 %) patient. Selective catheterization of the cystic artery was achieved in all patients. Superselection of tumor-feeding vessels from the cystic artery was achieved in 7 patients (26 %). Chemotherapeutic infusion was performed in 18 patients (67 %), and ...
BACKGROUND: Hepatic artery complications are feared complications after liver transplantation and may compromise the biliary tract, graft, and patient survival. The objective of this systematic review and meta-analysis was to compare risk of hepatic artery and biliary complications after liver transplantation in patients who underwent neoadjuvant transarterial chemoembolization (TACE) versus no TACE. METHODS: Comprehensive searches were performed in Embase, MEDLINE OvidSP, Web of Science, Google Scholar, and Cochrane databases to identify studies concerning hepatocellular cancer patients undergoing preliver transplantation TACE. Quality assessment of studies was done by the validated checklist of Downs and Black. Meta-analyses were performed to evaluate the incidence of all hepatic artery complications, hepatic artery thrombosis, and biliary tract complications, using binary random-effect models. RESULTS: Fourteen retrospective studies, representing 1122 TACE patients, met the inclusion criteria.
Cystic artery is usually a branch of right hepatic artery given in the Calot s triangle. Variations in the origin of cystic artery have been reported but there is paucity of literature regarding these in Indian subjects. The present case describes the origin of cystic artery from the hepatic artery proper, with an unusual course, which was detected during routine cadaveric dissection. The development of biliary vasculature is quite complex and it accounts for many variations. Knowledge of cystic artery variability facilitates intraoperative identification of vessels in both classical and laparoscopic surgery of the bile ducts. This emphasises the importance of a thorough knowledge of the cystic arterial variations that often occur and may be encountered during both laparoscopic and open cholecystectomy. Uncontrolled bleeding from the cystic artery and its branches is a serious problem that may increase the risk of intraoperative lesions to vital vascular and biliary structures during ...
On the right side of the lesser curvature of the stomach, identify the right gastric artery, which is a branch of the proper hepatic artery. It lies along the lesser curvature of the stomach and anastomoses with the left gastric artery. The left gastric artery originates directly from the celiac trunk. It runs on the posterior wall of the lesser sac, covered by the gastropancreatic fold, to the superior aspect of the lesser curvature of the stomach Attempt to identify the esophageal branches of the left gastric artery which supply the abdominal portion of the esophagus. Along the anterior and posterior aspects of the lesser curvature of the stomach, identify the gastric branches of both the right and left gastric arteries (Figure 38.1).. Links and References: ...
Thrombosis of the hepatic artery is a complication after liver transplantation. Oh et al identified risk factors associated with both early and late thrombosis, which can help identify those patients requiring closer monitoring and prophylaxis. The authors are from the University of Virginia in Charlottesville.
Discharge Instructions for Hepatic Angiography You had a procedure called hepatic angiography. This is an X-ray study of the blood vessels that supply your liver. During the procedure, a catheter (thin, flexible tube) was inserted into one of your blood vessels through a small incision. A specially trained doctor called an interventional radiologist usually does the procedure. Heres what to do at home afterward.. Home care ...
Background: Hepatic artery thrombosis (HAT) following pediatric liver transplantation is associated with increased morbidity and risk of graft failure. In our clinical practice, we have observed a decrease in the rate of HAT in recent years. Here, we examine the HAT events over time as well as potential contributing recipient and donor risk factors.. Methods: We performed a retrospective chart review of primary deceased-donor liver transplant recipients who were ,25kg at time of transplant between 2003 and 2016. Multi-organ transplants were excluded. Period I (P1) was designated as from 2003 to 2009 and period II (P2) as 2010 to 2016.. Results: A total of 100 patients, 52 whole-liver (WL) and 48 split-liver (SL) graft recipients, with a median age of 1.1 years (range 10 days-10.4 years) were identified . P1 included 45 patients (23 WL, 22 SL) and P2 included 55 patients (29 WL, 26 SL). Fourteen patients experienced HAT. Overall, HAT was more frequent in WL than SL (21% vs. 6%, p=0.032). When ...
See also hepatic artery above for additional text and references.. Anson studied the cystic artery in detail and the results of that study follow:. The primary source of the cystic arteries is still of the classical variety, that is to say, they arise from the closest possible source (the right ramus of the hepatic artery proper). This form is the most common. Other sources occur - to make a total of twelve types encountered in a study of 800 specimens. The twelve types fall conveniently into four categories:. Group I. The cystic artery artery arises from a ramus of the proper hepatic artery, or from the latter at the point of division, or from the same vessel proximal to the point of division, or from the same vessel proximal to the point of bifurcation (a to d). In succession, and in the order of decreasing frequency, these are: from the right ramus of the hepatic proper in 63.9%; at the latter vessel at the point of bifurcation in 10.4%; from the left ramus in 5.5%; and from the hepatic ...
Transcatheter arterial chemo-embolization (TACE) is a therapeutic procedure to treat primary and metastatic liver cancer. It requires prior delineation of the hepatic arteries on magnetic resonance angiography (MRA) data and identification of the vessels supplying the tumor. Manual segmentation is extremely challenging and time consuming, thereby increasing the risk of wrongfully identifying the feeding vessels. We present a vascular path planning tool for TACE procedures by automatically segmenting the hepatic arteries on MRA. The proposed method first detects the celiac trunk from the aorta, then localizes and tags bifurcations throughout the arterial network for path planning. The algorithm is based on a multiple hypothesis tracking approach used to propagate deformable mesh surfaces. We validated the proposed framework on 20 liver-cancer-patients using abdominal MRA with 20 seconds delay after contrast injection. We show that the algorithm improves the selectivity of the arterial segments ...
1.Impaired vasoconstriction in animals with cirrhosis is maintained in isolated vessels in vitro, indicating an intrinsic alteration in function or structure of the cells in the vascular wall. This may be due to receptor down-regulation, a defect in post-receptor signal transduction or overproduction of vasodilator compounds. This investigation examined the role of these mechanisms in modulating α-adrenoceptor-mediated contraction in hepatic arteries from patients with advanced cirrhosis.. 2.Hepatic arteries were obtained from subjects with and without cirrhosis for functional investigation in vitro. Endothelial cell function was assessed using endothelium-dependent (acetylcholine) and independent (3′-morpholinosydnonimine) vasodilators. α-Adrenoceptor-mediated contraction was assessed by constructing cumulative concentration-response curves to the α1-selective agonist phenylephrine, the non-selective adrenoceptor agonist noradrenaline and the receptor-independent vasoconstrictor potassium ...
Kaplan-Meier analysis of PFS. Progression-free survival rate at 12 months after first embolization. PFS was defined as time from start of treatment until disease progression or death as a result of any cause. Response and progression endpoints refer specifically to hepatic metastases. Extrahepatic metastases were included for assessment of response and progression by RECIST version 1.0. Progressive Disease (PD): At least a 20% increase in the SLD of target lesions, taking as reference the smallest SLD recorded since the treatment started ...
The images of the tumor.Notes: (A) CT showed a low-intensity VX2 tumor (arrow) in the left liver lobe. (B) Selective left hepatic artery angiogram before TAE, s
The primary objective of the study is to increase by 15% the complete macroscopic resection rate of predominantly liver metastases from metastatic color
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Irinotecan (180 mg/m²) on day 2 as a 6 hour infusion, starting at 2:00, with a peak at 5:00. Oxaliplatin (85 mg/m²) in split daily doses for 3 days, starting on day 2. Daily sinusoidal infusion duration will last from 10:15 to 21:45, with peak delivery rate at 16:00.. 5-Fluorouracil (2800 mg/m²) in split daily doses for 3 days, alternating with oxaliplatin infusions, starting on day 2. Daily sinusoidal infusions will last from 22:15 to 9:45 , with peak delivery at 4:00.. Treatments will be repeated every 2 weeks. ...
In 15 to 20% of patients, the right hepatic artery will arise from the superior mesenteric artery and travel upward toward the liver along the posterior aspect of the head of the pancreas (referred to as a replaced right hepatic artery). It is important to look for this variation on preoperative computed tomographic (CT) scans and in the operating room (OR) so the replaced hepatic artery is recognized and injury is avoided. (See Schwartz 10th ed., p. 1345.) ...
Hepatic angiography uses X-rays to check the blood vessels that supply blood to your liver. Heres what you need to know if you are having this procedure.
Hepatic angiography uses X-rays to check the blood vessels that supply blood to your liver. Heres what you need to know if you are having this procedure.
You had a procedure called hepatic angiography. This is an X-ray study of the blood vessels that supply your liver. Heres what to do at home afterward.
You had a procedure called hepatic angiography. This is an X-ray study of the blood vessels that supply your liver. Heres what to do at home afterward.
Semantic Scholar extracted view of [Combined treatment by hepatectomy and postoperative chemotherapy via a catheter in the hepatic artery of metastatic liver tumors]. by Shinji Yamasaki et al.
An artery that distributes blood to the liver, pancreas and gallbladder as well as to the stomach and duodenal portion of the small intestine. * * * hepatic artery n the branch of the celiac artery that supplies the liver with arterial blood
THD is usually an outpatient procedure that involves indentifying the arteries that are sending blood to the swollen areas and cutting off that blood supply with a clip or ligature.
HAT is one of the most common and potentially most disastrous arterial complications (see images below). HAT is estimated to occur in 4-12% of adult OLTX patients and in 9-42% of pediatric transplanta... more
Embolization. For those who cant have surgery or a liver transplant, embolization or chemoembolization may be an option. The doctor inserts a tiny catheter into an artery in your leg and moves the catheter into the hepatic artery.. For embolization, the doctor injects tiny sponges or other particles into the catheter. The particles block the flow of blood through the artery. Depending on the type of particles used, the blockage may be temporary or permanent.. Without blood flow from the hepatic artery, the tumor dies. Although the hepatic artery is blocked, healthy liver tissue continues to receive blood from the hepatic portal vein.. For chemoembolization, the doctor injects an anticancer drug (chemotherapy) into the artery before injecting the tiny particles that block blood flow. Without blood flow, the drug stays in the liver longer.. Targeted Therapy. People with liver cancer who cant have surgery or a liver transplant may receive a drug called targeted therapy. Sorafenib (Nexavar) ...
For those who cant have surgery or a liver transplant, embolization or chemoembolization may be an option. The doctor inserts a tiny catheter into an artery in your leg and moves the catheter into the hepatic artery.. For embolization, the doctor injects tiny sponges or other particles into the catheter. The particles block the flow of blood through the artery. Depending on the type of particles used, the blockage may be temporary or permanent.. Without blood flow from the hepatic artery, the tumor dies. Although the hepatic artery is blocked, healthy liver tissue continues to receive blood from the hepatic portal vein.. For chemoembolization, the doctor injects an anticancer drug (chemotherapy) into the artery before injecting the tiny particles that block blood flow. Without blood flow, the drug stays in the liver longer.. ...
Biliary necrosis refers to the death of the intra-hepatic bile ducts epithelium commonly seen as a complication of hepatic artery thrombosis. Pathology Different from the liver parenchyma that has dual supply, portal vein and hepatic artery, t...
HCC is one of the deadliest types of cancers, with a mortality of almost 100 % [36]. The mortality of HCC remains high because the disease is typically diagnosed when it is already at an advanced stage, when most potential curative therapies such as resection and transplantation are of limited efficacy. Recent studies reported that different therapies including surgery [5-7], hepatic artery ligation [37], insufficient radiofrequency ablation [38-40], and sublethal heat treatment [41] promoted residual tumor progression. It is especially important to investigate the underlying mechanism. Our research team has developed a safe and reliable method of palliative HCC resection in an orthotopic nude mouse model, and reported that palliative resection enhances metastatic potential of residual HCC in liver [5]. In the present study, using this method, we investigated the precise mechanism mediating this metastasis.. Data from our institution (1958-2008, unpublished) revealed that in HCC patients who ...
Albert NM, Hancock K, Murray T, Karafa M, Runner JC, Fowler SB, Nadeau CA, Rice KL, Krajewski S. Cleaned, ready-to-use, reusable electrocardiographic lead wires as a source of pathogenic microorganisms. Am J Crit Care. 2010 Nov;19(6):e73-e80.. Alberts SR, Roh MS, Mahoney MR, OConnell MJ, Nagorney DM, Wagman L, Smyrk TC, Weiland TL, Lai LL, Schwarz RE, Molina R, Dentchev T, Bolton JS. Alternating systemic and hepatic artery infusion therapy for resected liver metastases from colorectal cancer: a North Central Cancer Treatment Group (NCCTG)/ National Surgical Adjuvant Breast and Bowel Project (NSABP) phase II intergroup trial, N9945/CI-66. J Clin Oncol. 2010 Feb 10;28(5):853-858.. Anderson HV, Rosenfield KA, White CJ, Ho KK, Spertus JA, Jones PG, Tang F, Cates CU, Jaff MR, Koroshetz WJ, Katzan IL, Hopkins LN, Rumsfeld JS, Brindis RG. Clinical features and outcomes of carotid artery stenting by clinical expert consensus criteria: a report from the CARE registry. Catheter Cardiovasc Interv. 2010 ...
Primary liver cell carcinoma is often difficult to diagnose, and the efficacy of celiac arteriography in demonstrating this tumor has been evaluated. Selective catheterization and injection of the celiac axis and hepatic artery was performed, with utilization of a serial magnification technic allowing definition of fine vessels. Characteristic vascular changes were found in nine patients, and the presence of hepatoma was confirmed histologically.. Hepatoma is a vascular tumor and is recognized by abnormal tumor vessels that exhibit a disorganized and chaotic pattern. The hepatic artery supplying the tumor is usually wider than normal, and the intrahepatic branches are displaced. Marked ...
The SIRT procedure delivers radiation to the liver in minuscule spheres about the size of a speck of flour. The spheres, which contain radioactive yttrium-90, are injected into the main hepatic artery and delivered directly to the cancer tumor. Since healthy liver tissue draws most of its blood from the portal vein, the spheres delivered through the hepatic artery target the cancerous tumor growth in the liver. These spheres are just large enough to get stuck in the blood vessels of the tumor and directly irradiate it. This ability to direct the radiation limits the amount of radiation that reaches healthy liver tissue and other parts of the body. To determine the amount of radioactive spheres that will reach the tumor, radiologists inject a similar solution of radioactive particles that allows them to view a snapshot of the particle distribution, explains Ronald Weiner, a radiopharmacist and associate professor of diagnostic imaging at the Health Center. We can see how much of the ...
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臺大位居世界頂尖大學之列,為永久珍藏及向國際展現本校豐碩的研究成果及學術能量,圖書館整合機構典藏(NTUR)與學術庫(AH)不同功能平台,成為臺大學術典藏NTU scholars。期能整合研究能量、促進交流合作、保存學術產出、推廣研究成果。. To permanently archive and promote researcher profiles and scholarly works, Library integrates the services of NTU Repository with Academic Hub to form NTU Scholars.. ...
The liver is a common site of metastases from a variety of organs such as lung, breast, colon and rectum. When liver metastases occur at the time of initial diagnosis of the primary tumor, they are described as synchronous. If detected after the initial diagnosis, they are described as metachronous. The liver is frequently involved since it receives blood from the abdominal organs via the portal vein. Malignant cells detach from the primary cancer, enter the bloodstream or lymphatic channels, travel to the liver, and grow independently. We do not understand the mechanism of how a tumor cell can leave the primary site and grow in specific organs. Potentially, the environment of the liver is suitable to the growth of certain tumor cells. Once a tumor begins to grow in the liver, it receives its blood supply from the hepatic artery ...
SDBPs theoretically must bind to DNA to exhibit their dysopsonin activity. However, when DNA is directly injected into the bloodstream, SDBPs do not have enough time to bind the DNA because the DNA will be quickly taken up by the liver and eliminated from blood. Presumably, if the binding condition is provided for SDBPs, their in vivo dysopsonin activity should be observed. We, therefore, designed in vivo studies to confirm the activity of serum diminishing liver uptake of DNA. The first study was to preincubate DNA with serum before the injection. Compared with a control, the DNA preincubated with serum (SDBPs/DNA) had a decrease in percentage taken up by the liver and an increase of percentage in the blood. The second study was to provide a retention time for SDBPs binding the injected DNA (see Materials and Methods), in which the DNA, after the injection, was allowed to circulate in blood for a few minutes but was not passed through the liver. By blocking the hepatic artery and portal vein, ...
Saad, WEA; Davies, MG; Saad, NEA; Westesson, KE; Patel, NC; Sahler, LG; Lee, DE; Kitanosono, T.; Sasson, T.; Waldman, DL. Trans-Catheter Thrombolysis of Thrombosed Hepatic Arteries in Liver Transplant Recipients: Predictors of Definitive Endoluminal Success and the Role of Pre-Operative Thrombolysis. Vasc Endovasc Surg. 2007; 41(2).. 9/2006 ...
CYP3A5, a member of the cytochrome P450 superfamily of enzymes, is involved in the metabolism of drugs, exogenous carcinogens, and endogenous molecules such as steroids (20). Previous studies about CYP3A5 have mainly focused on two major aspects, the potential relationship of CYP3A5 polymorphism and cancer risk or drug metabolism (9-11, 21-26). Moreover, Tsunedomi R concluded that the expression of CYP3A5 was drastically decreased in conjunction with venous invasion and might serve as a marker of progression and molecular target for treatment of HCV-associated HCC (27). Similar findings were also reported in some earlier articles (28, 29). Importantly, the expression of CYP3A5 was declined from early to late hepatic cirrhosis. In our current study, CYP3A5 expression was found frequently downregulated in tumor tissues and was negatively associated with several malignant characteristics and poor prognosis in patients with HCC. Ectopic expression of CYP3A5 attenuated cell migration, invasion, and ...
hepatic - MedHelps hepatic Center for Information, Symptoms, Resources, Treatments and Tools for hepatic. Find hepatic information, treatments for hepatic and hepatic symptoms.
Vascular variations in the abdomen are common and mostly asymptomatic. Knowledge of these variations are of tremendous clinical importance in patients undergoing invasive endovascular interventions such as liver transplantation, renal transplantation, and vascular reconstruction for congenital and acquired lesions and trans-arterial chemoembolization for the hepatic tumors. During regular dissection classes for the medical undergraduates, we encountered concurrent vascular variations in an elderly male cadaver. In the present case, we report multiple vascular anomalies involving the right hepatic artery and the right renal vein. The right hepatic artery branched off from superior mesenteric artery, and it was identified as a replaced right hepatic artery. The right kidney was drained by three renal veins, the uppermost among the three twisted around the superior branch of the right renal artery before terminating into the inferior vena cava. In addition, the left kidney was supplied by two renal ...
Figure 5. Advantages and Disadvantages. Advantages of the technique can be resumed as follows:. 1) Avoiding the immediate tying of the running suture at several mucopexy sites allows a better identification of the major arterial branches, since the distance between the Doppler probe and the artery is represented only by the thickness of the rectal mucosa which is not folded in multiple layers (Fig. 3 a, b). This is true for the initial identification of the arteries at the main points of dearterialization (1,3,5,7,9 and 11 oclock) as for any vessel residual to the major branch dearterialization that should be localised and sutured, if present.. 2) The six mucosal-submucosal running sutures starting from the upper z stitch toward 1 cm from the dentate line are easier to place since there is no mucosal folding between the threads, resulting in a more straight mucopexy with no risk of over-suturing and with an easier identification of the rectal mucosa.. 3) The avoidance of mucosal pocket ...
Hemorrhoids are normal vascular cushions found in the anal canal. 15% of a humans continence mechanism is attributed to the hemorrhoidal plexus. When a person coughs, for instance, the hemorrhoids will engorge with blood and increase ones ability to hold gas and stool. They are termed internal and external based on their positioning to an embryological line termed the pectinate line. Hemorrhoids above the pectinate line are considered internal and those below it external.[2] Hemorrhoids are fed by arteries and drained by veins. The arterial blood supply is based on the superior rectal (hemorrhoidal) artery. Just as veins in the leg weaken and become prominent, hemorrhoidal veins also may become varicose, resulting in internal hemorrhoids or piles. Internal hemorrhoids are divided into four grades. Grade I hemorrhoids are composed of prominent vessels, without protrusion. Grade II hemorrhoids demonstrate prolapse upon straining, with spontaneous reduction. Grade III hemorrhoids ...
HEPATIC ARTERY STENOSIS IN ORTHOTOPIC LIVER TRANSPLANTATION (LTX): SINGLE CENTER EXPERIENCE IN A SERIES OF 527 PATIENTS. . Hepatic artery complications after liver transplantation are uncommon- improved techniques.However, they represent an important cause of morbidity and mortality and are a m...
TY - JOUR. T1 - Intrahepatic biliary strictures without hepatic artery thrombosis after liver transplantation. T2 - An analysis of 1,113 liver transplantations at a single center. AU - Nakamura, Noboru. AU - Nishida, Seigo. AU - Neff, Guy R.. AU - Vaidya, Anil. AU - Levi, David M.. AU - Kato, Tomoaki. AU - Ruiz, Phillip. AU - Tzakis, Andreas G.. AU - Madariaga, Juan R.. PY - 2005/2/27. Y1 - 2005/2/27. N2 - Background. Intrahepatic biliary strictures (IHBS) without hepatic artery thrombosis (HAT) is a serious complication and known to increase the risk of graft failure after liver transplantation. This manuscript describes the incidence, risk factors, clinical pictures, management, and outcomes. Methods. Between 1994 and 2002, 1,113 liver transplantations were performed in 974 adult patients. Data was retrospectively analyzed in terms of incidence, risk factors, clinical pictures (type of strictures), management (radiologic, surgical management), and outcomes. Results. Sixteen (1.4%) grafts had ...
TY - JOUR. T1 - Hepatic artery aneurysm within focal nodular hyperplasia. AU - Schlieman, Michael. AU - Stein, Moni. AU - McVicar, John. AU - Bold, Richard J. PY - 2002. Y1 - 2002. UR - http://www.scopus.com/inward/record.url?scp=0036171679&partnerID=8YFLogxK. UR - http://www.scopus.com/inward/citedby.url?scp=0036171679&partnerID=8YFLogxK. U2 - 10.1016/S0168-8278(01)00247-1. DO - 10.1016/S0168-8278(01)00247-1. M3 - Article. C2 - 11830345. AN - SCOPUS:0036171679. VL - 36. SP - 302. JO - Journal of Hepatology. JF - Journal of Hepatology. SN - 0168-8278. IS - 2. ER - ...
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Embolization is done in stages (usually 2 treatments several weeks apart) if there is bilobar disease. Many patients experience a post-embolization syndrome that includes abdominal pain, fever, nausea, and ileus. Hepatic enzymes are often elevated transiently. Rarely, cholecystitis or pancreatitis occurs due to inadvertent embolization of the cystic or gastroduodenal arteries. The most feared complications of HAE are liver abscess and liver necrosis, which are rare. Most patients are discharged from the hospital within 3-5 days. The procedure may be repeated several times over the course of months to years.. There are only a few reported series of HAE for metastatic GIST. In one report, 14 patients with intestinal leiomyosarcoma (presumably most of which were GIST) metastatic to the liver were embolized in either the left or right hepatic artery with polyvinyl alcohol sponge particles mixed with cisplatin. Then, a 2 hour intraarterial infusion of vinblastine was administered.1 One month later, ...
We investigate the efficacy of lipiodol+degradable starch microspheres (DSM)-transarterial infusion chemotherapy (TAI) using miriplatin for advanced HCC in a
The combination of hepatic artery infusion (HAI) of irinotecan, 5-fluorouracil and oxaliplatin with intravenous cetuximab has safely achieved prolonged survival in colorectal cancer patients with extensive liver metastases and prior treatment. Systemic exposure to the drugs or their main metabolites was determined during the first course of chronomodulated triplet HAI in 11 patients and related to toxicities after one or three courses. Consistent trends were found between the area under the plasma concentration-time curve (AUC) values of irinotecan, 7-ethyl-10-hydroxycamptothecin (SN38; a bioactive metabolite), total oxaliplatin and platinum ultrafiltrate (P-UF), on the one hand, and subsequent leukopenia severity, on the other hand. Moreover, the maximum plasma concentration (C max) and the AUC of P-UF significantly predicted grades of diarrhoea (p = 0.004 and 0.017, respectively) and anaemia (p = 0.001 and 0.008, respectively) after the first course. Systemic drug exposure helps explain both ...
In support of improving patient care, Audio Digest Foundation is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team. The Audio Digest Foundation designates this enduring material for a maximum of {{CurrentLecture.Lecture.Credits , number:2}} AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to {{CurrentLecture.Lecture.Credits}} MOC points [and patient safety MOC credit] in the American Board of Internal Medicines (ABIM) Maintenance of Certification (MOC) program. Participants will earn MOC points equivalent to the amount of CME credits claimed for the activity. It is the ...
Background Whether hepatic arterial infusion (HAI) of oxaliplatin influences the rates of complete pathologic response (CPR) and severe oxaliplatin-related lesions (SOxL) in patients with colorectal...
The aim of this study is to evaluate the effectiveness of 111In-DTPA-Phe1-octreotide infusions after selective catheterization of the hepatic artery in inoperable metastasised liver, sst2 receptor-pos
This phase II trial compared the efficacy of postoperative adjuvant hepatic arterial infusion of fluorouracil with or without antineoplaston A10 +
Moreno, C., Sabaté, A., Figueras, J., Camprubí, I., Dalmau, A., Fabregat, J., Koo, M., Ramos, E., Lladó, L. and Rafecas, A. (2006), Hemodynamic profile and tissular oxygenation in orthotopic liver transplantation: Influence of hepatic artery or portal vein revascularization of the graft. Liver Transpl, 12: 1607-1614. doi: 10.1002/lt.20794 ...
Evidence-based recommendations on chemosaturation via percutaneous hepatic artery perfusion and hepatic vein isolation for primary or metastatic liver cancer
2 of 2) The hepatoduodenal ligament contains the proper hepatic artery, common bile duct, and portal vein. These three structures collectively are also known as the portal triad. These structures will be cleaned and identified later.. Links and References: ...
Although flow through portal vein and hepatic artery is readily accessible using Doppler sonography, (22,23) in vivo studies on human hepatic (parenchymal) perfusion are limited due to the often (highly) invasive methodology required. Indirect methods for measuring hepatic blood flow have been used and include the assessment of clearance or dilution of a dye or marker (gas or microspheres), which have a wider range of clinical applicability than the direct methods (38). Moreover, noninvasive measurements of hepatic perfusion using PET with the freely diffusible flow tracer [15O]H2O have been shown to provide reliable estimates of hepatic blood flow, when taking into account the dual input from hepatic artery and vena porta (27,28). In the current study, decreased hepatic parenchymal perfusion was observed in type 2 diabetic patients with increased liver triglyceride content but not in those type 2 diabetic patients with low liver triglyceride content, as compared with control subjects, implying ...
The liver has three vascular systems: the portal vein, the hepatic vein, and the hepatic artery. The vascular disorders that will be presented in this talk can be divided into disorders of the inflow and disorders of the outflow. Disorders of the inflow are hepatic artery thrombosis and portal vein trhombosis, that can be divided into acute, subacute and chronic. Arteriovenous shunts are among the causes of transient hepatic perfusion disorders and may simulate a hypervascular hepatic lesion on arterial-phase imaging. A more common cause of hepatic perfusion disorders is occlusion of a portal venous branch with compensatory increased arterial flow, causing arterial phase hyperenhancement. These perfusion pseudolesions can usually be distinguished from tumor by their peripheral location, wedge shape, lack of mass effect, and isoattenuation with liver on all other phases. Cavernous transformation of the portal vein occurs with long-standing portal vein thrombosis due to the development of periportal,
TACE is the combination of two procedures, an infusion of the mixture of chemotherapeutic agents (e.g. doxorubicin, cysplatin, or mytomycin C) and hepatic artery embolization in which particles such as polyvinyl alcohol or gelfoam, are injected simultaneously into selected branches of the hepatic artery supplying the tumor. Hepatocellular carcinoma is rarely seen before the age of 40 years and reaches a peak at around 70 years of age. Owing to its multicentricity, large tumor size and pre-existing cirrhosis most of these tumors were deemed unrespectable at the time of diagnosis. The purpose of this study was to evaluate the tumor size, site and number of lesions that is acquired on hepatic angiogram during TACE of the liver, and compare it with the information provided by pre-interventional contrast enhanced CT images as there is a possibility that CT may not show smaller lesions. This study was carried out in the Department of Angiography, Sindh Institute of Urology and Transplantation (SIUT) ...
Arterial Chemotherapy is designed to improve chemotherapy benefits for liver cancer by increasing the amount of chemotherapy delivered to the site of the tumor.
Failed Allografts. The reasons for liver allograft failure vary with the time since transplantation(1-6). Primary dysfunction because of ischemic/preservation injury and hepatic artery thrombosis and subsequent bile duct necrosis are the most common causes of liver within the first several weeks. Humoral and severe acute cellular rejection also occur during this time, but they are uncommon causes of early allograft failure. Frequently, a combination of the above factors ultimately contribute to deterioration of graft function(1-6). Between 2-3 weeks and 6 months after transplantation, delayed complications of early technical problems, such as the biliary sludge syndrome from ischemic cholangitis(7, 8), acute rejection and rapidly developing cases of chronic rejection(9, 10) are the major causes of graft failure. There are still graft failures that occur more than 6 months after transplantation, as a result of delayed technical complications. These usually involve the hepatic artery and ...
TY - JOUR. T1 - Orthotopic liver transplantation in patients over 60 years old. AU - He, Xiao Shun. AU - Zeng, Ji Xiao. AU - Zhu, Xiao Feng. AU - Ma, Y.. AU - Wang, Dong Ping. AU - Ju, Wei Qiang. AU - Wu, Lin Wei. AU - Huang, Jie Fu. PY - 2007/8/1. Y1 - 2007/8/1. N2 - OBJECTIVE: To investigate the outcome and relative problems of patients over 60 years old underwent orthotopic liver transplantation (OLT). METHODS: Data of patients over 60 years old (,or= 60 years old group, n = 59) patients recipients who were 18 to 59 years old (, 60 years old group, n = 500) were reviewed retrospectively. RESULTS: Overall patients survival at 1 year was not significantly different among ,or= 60 years old group (66%) and , 60 years group (76%). There were no differences in the operation time, the quantity of blood lost during operation, the days of hospitalization and the incidence of hepatic artery thrombosis between the two groups. The incidence rate of acute rejection reaction in ,or= 60 years old group was ...
Purpose Hepatic metastases derive most of their blood supply from the hepatic artery; therefore, for patients with hepatic metastases from colorectal cancer, hepatic arterial infusion (HAI) of chemotherapy may improve outcome. Methods In a multi-institutional trial, 135 patients were randomly assigned to receive HAI versus systemic bolus fluorouracil and leucovorin. The primary end point was survival; secondary end points were response, recurrence, toxicity, quality of life, cost, and the influence of molecular markers. Results Overall survival was significantly longer for HAI versus systemic treatment (median, 24.4 v 20 months; P = .0034), as were response rates (47% and 24%; P = .012) and time to hepatic progression (THP; 9.8 v 7.3 months; P = .034). Time to extrahepatic progression (7.7 v 14.8 months; P = .029) was significantly shorter in the HAI group. Quality-of-life measurements showed improved physical functioning in the HAI group at the 3- and 6-month follow-up assessments. Toxicity ...
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There are several treatment options for GIST liver metastases. The first choice is Imatinib therapy. Other options that may be useful in combination with Imatinib, or if the tumor is resistant to imatinib or other agents,include: radiofrequency ablation (RFA), hepatic artery embolization, and surgery. RFA is the insertion of a metal probe into a tumor in order to heat it and thereby kill it. RFA can be performed through the skin with the patient slightly sedated or during laparoscopy or open operation. We usually only use RFA when there are less than 6 tumors, the tumors are less than 5 cm in size, and the tumors are not near vital structures within the liver.. Embolization is a procedure performed by an interventional radiologist. A small tube is placed into the artery in your leg and fed upwards into the artery supplying your liver. Microscopic particles are then injected into the tumors to try to cut off their blood supply. Liver resection (surgery) is another option. In general, up to 80% of ...
OBJECTIVE: To investigate whether the selective iNOS-inhibition using 1400W is able to attenuate the decrease of excretory liver function in a clinically relevant model of long-term, hyperdynamic porcine endotoxemia. DESIGN AND SETTING: Prospective experimental study in the animal laboratory in a university hospital. SUBJECTS: twenty-one domestic pigs. INTERVENTIONS: Pigs were anaesthetized, mechanically ventilated, and instrumented. After 12 h of continuous i.v. endotoxin (LPS) infusion pigs received either no drug (ETX, n = 12) or 1400W, titrated to maintain mean arterial pressure (MAP) at pre-endotoxin level (n = 9). Measurements were obtained before, 12 h and 24 h after starting LPS infusion. MEASUREMENTS AND RESULTS: Excretory liver function was assessed by quantitative bile excretion, biliary ICG excretion, biliary HCO3 excretion and PDR of ICG. Our measurements included also the portal venous and hepatic arterial blood flow, the regional O2-exchange and the expiratory NO amount. Despite ...
Dear Editor,. We report the case of a 47-year-old male with multiple myeloma who had received three previous hematopoietic cell transplants (HCT). Due to disease recurrence, a new HCT was performed after an appropriate conditioning therapy. Two days later he presented with ascites, jaundice and hepatomegaly. The ultrasound findings were hepatosplenomegaly and moderate ascites. Doppler examination showed signs of hepatic congestion with a slower portal flow, increased resistance in the hepatic artery (Fig. 1) and decreased liver compliance with a single-phase wave of the suprahepatic veins. The diagnosis was confirmed by a transjugular liver biopsy that showed extravasation of red blood cells, edema and subendothelial fibrosis in the centrolobuliary veins. Treatment with defibrotide was initiated and the patient improved on a clinical and analytical level. Hepatic vascularization and perfusion also improved, the portal vein exhibited a normal diameter, and velocity and flow and the hepatic artery ...
Since the portal vein brings much more blood to the liver than does the hepatic artery, each branch of the portal vein is typically much larger than the associated branch of the hepatic artery. The relative sizes of the paired vessels in a portal area thus differ from those of a typical vein / artery pair in other parts of the body, where the artery delivers the same volume of blood that the vein subsequently returns. ...
Impact of performing multiple liver transplants (LT) in a short period of time is unknown. Consecutively performed LT potentially increase complication rates through team fatigue and overutilization of resources and increase ischemia time. We analyzed the impact of undertaking consecutive LT (Consecutive liver transplant, CLT; LT preceded by another transplant performed not more than 12 h before, both transplants grouped together) on outcomes. Of 1702 LT performed, 314 (18.4%) were CLT. Outcome data was compared with solitary LT (SLT; not more than one LT in 12-h period). Recipient, donor, and graft characteristics were evenly matched between SLT and CLT; second LT of CLT group utilized younger donors grafts with longer cold ischemic times (P = 0.015). Implantation and operative time were significantly lower in CLT recipients on intergroup analysis (P = 0.0001 and 0.002, respectively). Early hepatic artery thrombosis (E-HAT) was higher in CLT versus SLT (P = 0.038), despite absolute number of ...
taken care by these plates and plays a vital role in formation of the lobules in liver. Within each lobule a central vein pass by. The peripheral edge of each lobule comprises of a branch of hepatic Portal vein and hepatic artery. This results in a wide space between each and every hepatic plate. The GI tract serves the function of absorption and the process is hosted by the portal venous blood ...
Liver triad. Fluorescence deconvolution micrograph of a section through liver tissue, showing a portal triad. This is a collection of vessels that includes the hepatic artery and bile duct (small vessels, upper right) and the much larger hepatic portal vein (diagonal, black). Cellular proteins are highlighted with fluorescent markers: g-actin (red), f-actin (green), and cell nuclei (blue). Magnification: x200 when printed at 10 centimetres across. - Stock Image C019/7830
comes in contact with the blood. The structuring aspect is taken care by these plates and plays a vital role in formation of the lobules in liver. Within each lobule a central vein pass by. The peripheral edge of each lobule comprises of a branch of hepatic portal vein and hepatic artery. This results in a wide space between each and every hepatic plate. The GI tract serves the function of ...
In order to find the most effective hepatitis treatment you will need to mention that different viruses impact the liver diversely. To be aware of the way the virus is transmitted we must mention first how a liver works. The liver may be the largest body organ that weights about 3 pounds, and is also the central spot for many body functions. It is located in the upper right side from the abdomen beneath the cover of the ribs and is also comprised of many hexagonal structures called liver lobules. The liver creates the bile that stops working fat in foods and receives blood from two sources: from your portal vein, which comes in the intestine loaded with nutrients for that liver to process; and one-third through the hepatic artery. The liver converts food into energy; stores nutrients, fat and vitamins; makes proteins for blood plasma; and detoxifies the body. Her largest and a lot complex bloody availability of any organ in the body. We have an artery to provide it with oxygenated blood and ...
The spleen is located under the left side of the diaphragm and near the stomach, pancreas, liver and the heart. The inferior vena cava and the hepatic artery, coming from the heart, are located to...
INDICAŢIILE OLT După Registrul American de transplant hepatic: 1.CH postvirusală C 2.CH alcoolică 3.CH criptogenetică 4.CBP 5.Isuficienţa hepatică acută 6.CH autoimună 7.CH mixtă alcoolică şi postvirusală 8.Colangita sclerozantă
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ŞANDRU, S.; BALTAGA, R.; BELÎI, A.; COBÂLEŢCHI, S.; GUZUN, N.; ROJNOVEANU, Gh. Managementul anestezic la pacienţii cu traumă hepatică. În: Săndesc D., Bedreag O., Păpurică M. Recomandări şi protocoale în anestezie. Terapie intensivă şi medicină de urgenţă, Timişoara, 2012, p.169-181. ISBN 978-973-52-1260- ...
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