Role of radiofrequency ablation in the treatment of colorectal liver metastases

Surgical resection is the standard of care for colorectal metastases isolated to the liver. However, only 10-25% are eligible for resection because of extent and location of the disease in the liver or concurrent medical conditions. Severe series have shown that radiofrequency ablation [RFA] can result in tumor eradication in properly selected candidates. The purpose of this study was to determine the efficacy of RFA for treatment of such lesions. Thirty patients with documented colorectal liver metastases who met the following criteria were considered for RFA: metastases confined to the liver; judged irresectable due to technical considerations or co-morbidity, number of metastatic deposits no greater than 5; and size less than 10 cm. Median follow-up was 26 [range 9-63] months. Overall 1-and 2-year survival rates were 76 and 61% respectively. Median survival was 32 months. Disease-free survival at 1 year was 35% at 2 years 7%. Six patients developed recurrence at the site of RFA; given that the total number of RFA-treated lesions was 69 the local recurrence rate was 9%. RFA can achieve effective local treatment for patients with colorectal liver metastases who were considered unsuitable for surgical treatment

Eyolution of living doner liver transplantation in Egypt

To date, cadaveric organ donation is illegal in Egypt. Therefore, Egypt recently introduced living donor liver transplantation [LDLT], aiming to save those who are suffering from end stage liver disease. Herein, we study the evolution of LDLT in Egypt. In Egypt, between August 2001 and February 2004, we approached all centers performing LDLT through personal communication and sent a questionnaire to each center asking for limited information regarding their LDLT experience. We identified and approached 7 LDLT centers, which collectively performed a total of 130 LDLT procedures, however, 3 major centers performed most of the cases [91%]. Overseas surgical teams, mainly from Japan, France, Korea, and Germany, either performed or supervised almost all procedures. Out of those 7 LDLT centers, 5 centers agreed to provide complete data on their patients including a total of 73 LDLT procedures. Out of those 73 recipients, 50 [68.5%] survived after a median follow-up period of 305 days [range 15-826 days]. They reported single donor mortality. Hepatitis C virus cirrhosis, whether alone or mixed with schistosomiasis, was the main indication for LDLT. Egypt recently introduced LDLT with reasonable outcomes; yet, it carries considerable risks to healthy donors, it lacks cadaveric back up, and is not feasible for all patients. We hope that the initial success in LDLT will not deter the efforts to legalize cadaveric organ donation in Egypt