Hepato Gastroenterol
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Hepato Gastroenterol · Mar 1999
ReviewAn approach to the rational use of steatotic donor livers in liver transplantation.
Steatosis or fatty change is a common finding in donor liver biopsies during liver transplantation, and seems to be more frequent than in the general population. Fat can be stored in hepatocytes within macrovacuoles (macrosteatosis) or microvacuoles (microsteatosis), with different degrees of severity. Higher degrees of both macro and microsteatosis may increase the severity of the ischemia-reperfusion lesion producing an initial poor function in the recipient. ⋯ However, only severe macrosteatotic (> 60%) grafts have been associated with primary non-function, and are universally rejected for transplantation. While donor livers with any severity of microsteatosis do not influence recipient survival and can be safely implanted, donor livers with moderate to severe macrosteatosis (30-60%) have a relative risk of primary non-function and should be considered for transplantation in the absence of other known risk factors. A protocol with a rational use of these steatotic livers is suggested.
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Hepato Gastroenterol · Mar 1999
Comparative Study Clinical TrialPost-operative chemotherapy in non-curative gastrectomy for advanced gastric cancer.
The definitive effects of post-operative chemotherapy for prolonging survival in patients with non-curative gastrectomy for advanced gastric cancer have not been established. ⋯ Post-operative chemotherapy may contribute to prolonged survival in patients with non-curable advanced gastric cancer, even when patients had peritoneal dissemination. However, the long-term survival rate was not improved by post-operative chemotherapy. More aggressive chemotherapy may be needed to improve the long-term prognosis for such patients.
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Hepato Gastroenterol · Mar 1999
Survival after repeat hepatic resection for recurrent colorectal metastases.
This is a retrospective study examining survival of patients undergoing repeat hepatic resection for recurrent colorectal metastases. ⋯ In appropriately selected patients, repeat hepatic resection for colorectal metastases is a worthwhile treatment. Mortality, morbidity, and survival are similar to those following the initial resection.