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Liver transplantation is one of the main treatments of early hepatocellular carcinoma (HCC). The recurrence of HCC after liver transplantation severely affects the long-term survival rate of the recipients. Targeted therapy and immunotherapy play a critical role in HCC downstaging, preventing disease progression, reducing recurrence rate, prolonging the survival and improving the quality of life. However, no consensus has been reached on the application of targeted therapy and immunotherapy in recipients undergoing liver transplantation for HCC, including indications, timing and dosage. In this article, clinical research progresses on the indications and timing of targeted therapy and immunotherapy before and after liver transplantation for HCC were reviewed, aiming to provide reference for prolonging the survival of recipients after liver transplantation for HCC.
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BACKGROUND: Because of the specificity and complexity of hepatic portal, carcinoma of bile duct of the hepatic portal is a difficulty in the surgical treatment. OBJECTIVE: To evaluate the safety and feasibility of simultaneous pancreaticoduodenectomy and liver transplantation for the end-stage hilar cholangiocarcinoma. RESULTS AND CONCLUSION: Pathology demonstrated a middle or low differentiation of hilar cholangiocarcinoma, and left, right hepatic duct, together with lobus quadratus were invaded. The tumor metastasized to hilar and posterior pancreatic lymphonodes, without involving the head of pancreas, duodenum and stomach. The function of transplanted liver recovered smoothly, and the endocrine and exocrine functions of pancreas were kept well. CA19-9 dropped to the normal levels. The patient recovered and discharged at 1 month after surgery, and still survived after one year follow up. These suggest that simultaneous pancreaticoduodenectomy and liver transplantation as a treatment of hilar cholangiocarcinoma are safe and feasible.
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Objective To investigate the pathogentic factor of severe acute pancreatitis(SAP)-associated lung injury and the protective function of octreotide combined with alinastatin on SAP-associated lung injury in rats.Methods Eighty SD rats were randomly divided into 5 groups.Sham operative(S)group,SAP group,(octreotide)(O)group,ulinastatin(U)group and octreotide + ulinastatin (O+U)group,and each group was divided into 6h,12h sub-groups.After AP models were induced,the serum concentration of amylase(AMY),tumor necrosis factor?(TNF-?),malondiadehyde(MDA),and the concentration of(myeloperoxidase)(MPO) in lung tissue were determined;and the pancreas and lung pathology were graded,the changes of the above-mentioned indexes after using octreotide and ulinastatin were compared.Results(1)Compared to SAP group,AMY,TNF-?,MDA,MPO,and pancreas pathology score were decreased significantly in each of the 3 therapy groups during the same period;and at 12h,in O+U sub-group,lung pathology score also decreased compared to SAP group(P
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0.05),but,serum AST and ALT were significantly decreased on the 12th hour in arterialization group(P