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Liver transplantation is the best treatment for acute and chronic liver failure. Nevertheless, liver transplantation is not a harmless treatment. Needed immunosuppression has significant side effects like tumors de novo. These tumors de novo have become a major long-term cause of mortality among patients with a functional graft. Methods: The aim of this study is to determine the prevalence of these tumors de novo in a population of adult liver recipients who have been transplanted at the Cliniques Universitaires Saint-Luc between 1984 to 2011 (minimal follow up of 5 years). Among 871 transplanted patients, 776 (89%) patients have survived more than 3 months after the transplantation. This study is centered on these 776 patients. The tumors de novo are classified in solid, hematologic and skin tumors. The results are then compared with the literature. Results: One hundred forty-seven patients (18.9%) were diagnosed with at least one TDN. Most frequent TON are: non melanoma skin cancers (26% of TON patients), Post-transplant lymphoproliferative diseases (PTLD) (17.8%), pulmonary TON (15%) and ENT tumors (11.6%). Patients with the biggest prevalence of TON are those with primary sclerosing cholangitis (SCCH) (9/33: 27.3%), alcoholic cirrhosis (43/174: 24.7%) and post viral C hepatitis (PHCC) (36/164: 22%). Patients with ALCI present essentially solid tumors (32/174: 18.4%) like ENT tumors (9/174: 5.2%) and pulmonary tumors (8/174: 4.6%). Mortality related to TON is significant, representing 13% (47/359) of death and 54% (47/87) of TON patient's mortality. These results concur with the literature. Conclusion: The prevalence of TDN increases among liver transpanted patients. The TDN are become a major long-term cause of mortality. It is crucial to recognize risk factors and to reduce immunosuppression. Transplanted patients must be screened carefully and suitably for these TDN. Prospective studies are necessary in order to measure an improvement of patient's survival with minimal immunosuppression. Introduction : La greffe hépatique (TRH) est le traitement de choix de l'insuffisance hépatique terminale aiguë et chronique. Cependant, la TRH n'est pas un traitement anodin. L'immunosuppression (IS) qu'elle requière présente des effets secondaires non négligeables dont les tumeurs de nova (TDN). Ces TDN sont devenues une cause de mortalité à long terme majeure de patients greffés avec greffon fonctionnel. Méthodes Le but de cette étude est de déterminer la prévalence des TDN dans une population de patients greffés hépatiques adultes aux Cliniques Universitaires Saint-Luc de 1984 jusqu'au 31/12/2011 (follow up minimal de 5 ans). Sur 871 patients greffés, 776 (89%) patients ont survécu plus de 3 mois après la greffe. L'étude portera sur ces 776 patients. Les TDN ont été classées en TDN cutanées, hématologiques et solides. Les résultats obtenus ont été comparés à ceux issus d'une revue de la littérature.Résultats Cent quarante-sept patients (18.9%) ont présenté au moins une TDN. Les TDN les plus fréquentes sont : cutanées non mélanome (26% des patients avec TDN (patients TDN)), les « Post­ transplant lymphoproliferative disease » (PTLD) (17.8%), pulmonaires (15%) et les tumeurs de la sphère ORL (ENT) (1 1.6%) Les patients ayant présenté le plus de TDN sont les patients avec cholangite sclérosante primitive (SCCH) (9/33 : 27.3%), cirrhose alcoolique (ALCI) (43/174 : 24.7%) et cirrhose virale C (PHCC) (36/164 : 22%). Les patients avec ALCI présentent essentiellement des tumeurs solides (32/174 : 18.4%) dont les TDN ENT (9/174 : 5.2%) et pulmonaires (8/174 : 4.6%). La mortalité liée à ces TDN est importante, représentant 13% (47/359) des décès et 54% (47/87) des décès chez les TDN patients. Ces résultats sont en accord avec la littérature.Conclusion : La prévalence des TDN est élevée chez les patients greffés hépatiques. Les TDN sont devenues une cause de mortalité à long terme majeure. Il est primordial de reconnaitre les facteurs de risques et de diminuer l'IS. Les patients greffés doivent faire, de ce fait, l'objet d'un dépistage adapté. Des études prospectives sont nécessaires afin de prouver une amélioration de survie chez les patients avec une IS minimale.

Acute-On-Chronic Liver Failure --- Liver Transplantation --- Adenoma

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In this Special Issue of the journal, advancements in the treatment of liver diseases are illustrated by international experts in the field. New treatment options for primary biliary cirrhosis and, hopefully, primary sclerosing cholangitis are discussed. Up-to-date pharmacological therapy for preventing liver cirrhosis decompensation and treating acute-on-chronic liver failure is highlighted. Furthermore, new treatments for cholangiocarcinoma, based on biological and tissue markers, will be available in the near future, aiming to surpass the current unsatisfactory results of traditional therapies. Immunotherapy has been applied to hepatocellular carcinoma (HCC). The new first-line treatment, combining atezolizumab plus bevacizumab for HCC in the intermediate and advanced stages, will allow for an increase in patient survival in the near future. Liver transplantation (LT) remains the preferred treatment for many patients with end-stage liver diseases and HCC. The selection criteria for LT in patients with HCC moved from morphological to dynamic criteria, such as those derived from the assessment of tumor responses to locoregional and/or systemic treatments before transplantation. This allowed many patients who would have been excluded from a transplantation with the old selection criteria to access one. Finally, a very interesting issue regarding new indications for liver transplantation is illustrated.

Public health & preventive medicine --- tolvaptan --- cirrhotic ascites --- survival rate --- furosemide --- primary biliary cholangitis --- autoantibodies --- ursodeoxycholic acid --- treatment response --- second line therapy --- primary biliary cholangitis (PBC) --- primary sclerosing cholangitis (PSC) --- clinical trials --- ursodeoxycholic acid (UDCA) --- Farnesoid X Receptor (FXR) agonist --- Pan-Peroxisome Proliferator-Activated Receptor (PPAR) agonists --- liver cancer --- systemic treatment --- immunotherapy --- real-world --- unresectable hepatocellular carcinoma --- cirrhosis --- decompensation --- bleeding --- varices --- survival --- infection --- alcoholic hepatitis --- acute-on-chronic liver failure --- cholangiocarcinoma --- colorectal cancer metastases --- hepatocellular carcinoma --- liver transplantation --- Milan criteria --- alpha-fetoprotein --- solid organ transplantation --- liver injury --- immunosuppressant --- SARS-CoV-2 --- humoral response --- vaccination --- portal-systemic shunt --- ammonia --- vigilance --- HBV --- HDV --- antivirals --- functional cure --- pharmacology --- acute-on-chronic liver failure (ACLF) --- liver transplantation (LT) --- decompensated cirrhosis --- portal hypertension --- ascites --- non-selective beta-blockers --- TIPS --- rifaximin --- human albumin --- statins --- targeted therapy --- effective hypovolemia --- anti-mineralocorticoids --- loop diuretics --- vaptans --- n/a

Choose an application

• Reference Manager
• EndNote
• RefWorks (Direct export to RefWorks)

In this Special Issue of the journal, advancements in the treatment of liver diseases are illustrated by international experts in the field. New treatment options for primary biliary cirrhosis and, hopefully, primary sclerosing cholangitis are discussed. Up-to-date pharmacological therapy for preventing liver cirrhosis decompensation and treating acute-on-chronic liver failure is highlighted. Furthermore, new treatments for cholangiocarcinoma, based on biological and tissue markers, will be available in the near future, aiming to surpass the current unsatisfactory results of traditional therapies. Immunotherapy has been applied to hepatocellular carcinoma (HCC). The new first-line treatment, combining atezolizumab plus bevacizumab for HCC in the intermediate and advanced stages, will allow for an increase in patient survival in the near future. Liver transplantation (LT) remains the preferred treatment for many patients with end-stage liver diseases and HCC. The selection criteria for LT in patients with HCC moved from morphological to dynamic criteria, such as those derived from the assessment of tumor responses to locoregional and/or systemic treatments before transplantation. This allowed many patients who would have been excluded from a transplantation with the old selection criteria to access one. Finally, a very interesting issue regarding new indications for liver transplantation is illustrated.

Public health & preventive medicine --- tolvaptan --- cirrhotic ascites --- survival rate --- furosemide --- primary biliary cholangitis --- autoantibodies --- ursodeoxycholic acid --- treatment response --- second line therapy --- primary biliary cholangitis (PBC) --- primary sclerosing cholangitis (PSC) --- clinical trials --- ursodeoxycholic acid (UDCA) --- Farnesoid X Receptor (FXR) agonist --- Pan-Peroxisome Proliferator-Activated Receptor (PPAR) agonists --- liver cancer --- systemic treatment --- immunotherapy --- real-world --- unresectable hepatocellular carcinoma --- cirrhosis --- decompensation --- bleeding --- varices --- survival --- infection --- alcoholic hepatitis --- acute-on-chronic liver failure --- cholangiocarcinoma --- colorectal cancer metastases --- hepatocellular carcinoma --- liver transplantation --- Milan criteria --- alpha-fetoprotein --- solid organ transplantation --- liver injury --- immunosuppressant --- SARS-CoV-2 --- humoral response --- vaccination --- portal-systemic shunt --- ammonia --- vigilance --- HBV --- HDV --- antivirals --- functional cure --- pharmacology --- acute-on-chronic liver failure (ACLF) --- liver transplantation (LT) --- decompensated cirrhosis --- portal hypertension --- ascites --- non-selective beta-blockers --- TIPS --- rifaximin --- human albumin --- statins --- targeted therapy --- effective hypovolemia --- anti-mineralocorticoids --- loop diuretics --- vaptans --- tolvaptan --- cirrhotic ascites --- survival rate --- furosemide --- primary biliary cholangitis --- autoantibodies --- ursodeoxycholic acid --- treatment response --- second line therapy --- primary biliary cholangitis (PBC) --- primary sclerosing cholangitis (PSC) --- clinical trials --- ursodeoxycholic acid (UDCA) --- Farnesoid X Receptor (FXR) agonist --- Pan-Peroxisome Proliferator-Activated Receptor (PPAR) agonists --- liver cancer --- systemic treatment --- immunotherapy --- real-world --- unresectable hepatocellular carcinoma --- cirrhosis --- decompensation --- bleeding --- varices --- survival --- infection --- alcoholic hepatitis --- acute-on-chronic liver failure --- cholangiocarcinoma --- colorectal cancer metastases --- hepatocellular carcinoma --- liver transplantation --- Milan criteria --- alpha-fetoprotein --- solid organ transplantation --- liver injury --- immunosuppressant --- SARS-CoV-2 --- humoral response --- vaccination --- portal-systemic shunt --- ammonia --- vigilance --- HBV --- HDV --- antivirals --- functional cure --- pharmacology --- acute-on-chronic liver failure (ACLF) --- liver transplantation (LT) --- decompensated cirrhosis --- portal hypertension --- ascites --- non-selective beta-blockers --- TIPS --- rifaximin --- human albumin --- statins --- targeted therapy --- effective hypovolemia --- anti-mineralocorticoids --- loop diuretics --- vaptans