Long-term Outcomes for Liver Transplant Recipients in Terms of Hepatic Encephalopathy.

BACKGROUND: Liver transplantation (LT) is thought to resolve cognitive deficit due to hepatic encephalopathy (HE). The aim of this study was to determine the factors associated with the outcomes of patients with HE after LT. METHODS: The authors reviewed the medical records of 388 patients with HE who underwent LT from 1996 to 2014. RESULTS: There were 282 patients with grade 1-2 HE and 106 patients classified as grade 3-4. Patients in the latter group had a tendency for a more decompensated hepatic condition than patients with grade 1-2 HE. HE sequelae were only associated with grade 3-4 HE with borderline significance (P = .05). The cumulative 1-, 3-, and 5-year overall survival (OS) of patients with grade 1-2 HE were 81.9%, 77.3%, and 74.6%, whereas those of in patients with grade 3-4 HE were 77.4%, 73.3%, and 72.2%, respectively (P = .75). CONCLUSION: The sequelae of HE were only associated with the grade 3-4 HE. Aggressive treatment of HE prior to LT may prevent patients from deteriorating into high-grade HE, which could further contribute to improving the outcomes after LT.

The outcomes after surgical resection in pancreatic endocrine tumors: an institutional experience.

AIM: Sporadic pancreatic endocrine tumors (PET) can be managed surgically with excellent outcomes. The aim of this study was to analyze surgical outcomes and factors influencing survival. METHODS: Between 1995 and 2007, 96 patients with sporadic PET who underwent surgery at our institution were retrospectively reviewed for clinicopathologic variables and outcomes according to the World Health Organization (WHO) classifications. RESULTS: Thirty-nine patients had well-differentiated tumors (WDT) with benign behavior, 23 had uncertain behavior, 27 had low-grade carcinoma, and 7 were diagnosed with high-grade carcinoma. R0 resection was performed in 84 patients. No recurrence was observed in WDT regardless of its behavior or curability but 16 of 34 patients with carcinoma had recurrence. Five-year overall survival (OS) for R0-resected patients with carcinoma was 57%, and OS at 3 years for R1/R2-resected patients was 23% (P = 0.012). The WHO classification and R0 resection were independent prognostic factors in multivariate analysis. CONCLUSIONS: This single institutional experience demonstrated that surgical resection is curative for WDT and recurrences are frequent in spite of curative resection for malignant PET. The WHO classification and R0 resection remained independent prognostic factor.

[The significance and state of pre-S2 and antibodies to pre-S2 in 30 cases of acute viral hepatitis type B].

Determination of time sequence of pre-S2 and its antibody response during the symptomatic phase of acute viral hepatitis type B, as well as their relationship to the HBV-markers, was carried out in 30 subjects after the onset of liver damage by means of monoclone antibody-captured enzyme immunoassay were analysed. The results showed that anti-pre-S2 were positive in 80.3% of patients recovering from acute viral hepatitis type B, being higher than the percentage during maximal liver damage (P less than 0.001). Such antibodies were absent in cases showing chronic evolution and were found in less than 8% of chronic hepatitis B cases, with no relation to liver damage. Anti-pre-S2 were detected after the immune clearance of HBsAg and HBV-DNA, and thereafter the anti-HBs were present in 80% of patients after recovery (P less than 0.001). Our observations significantly suggest that anti-pre-S2 may be valuable as a marker of the favourable prognosis of acute viral hepatitis type B and of HBV clearance. They did not play any role in the pathogenesis of HBV-related liver damage. The continuous presence of pre-S2 with the absence of anti-pre-S2, on the contrary, is considered as a characteristic sign and a new information of chronic viral hepatitis type B.