BACKGROUND AND PURPOSE: It is controversial whether small size recipient is associated with adverse outcome in liver transplantation. This study aims to evaluate the outcomes of pediatric liver transplantation according to body weight of recipients. METHODS: Liver transplant recipients (age <18years, from 1993 to 2011) were studied retrospectively. They were categorized according to the body size at the time of transplantation (A: <6kg; B: between 6kg to 10kg; C: >10kg). RESULTS: A total of 113 patients (83 LDLTs and 30 DDLTs) were studied. Thirteen (11.5%) belonged to group A, 56 (49.6%) belonged to group B, and 44 (38.9%) belonged to group C. The best graft and patient survivals were found in group A (Figs. 1 and 2), and none of the patients required re-laparotomy for general surgical complications, while 32 patients (32%) in groups B and C did. Regarding transplant-related complications, although group A patients had the highest incidence of biliary tract complications (38.5%, n=5), the incidence of vascular complications (hepatic artery: 7%, portal vein: 0%, hepatic vein: 0%) in this group was the lowest among the three groups. CONCLUSION: Outcomes of small-sized recipients are not inferior. Less technical-related vascular complications, which may lead to early graft loss, were observed. This could be patient-related (less advanced cirrhosis) or surgeon-related (additional attention paid).
Body Weight , Liver Transplantation/adverse effects , Anastomosis, Surgical/adverse effects , Biliary Tract Diseases/etiology , Child , Child, Preschool , Clinical Competence , Female , Hepatic Artery/surgery , Hepatic Veins/surgery , Humans , Infant , Male , Portal Vein/surgery , Retrospective Studies , Treatment Outcome
BACKGROUND: This study was carried out to determine the role of plasma Epstein-Barr virus (pEBV)-DNA and positron-emission tomography (PET)-CT scan in predicting the outcome of nasopharyngectomy and cervical lymphadenectomy for recurrent nasopharyngeal carcinoma (NPC). METHODS: Between 2007 and 2009, we recruited patients who had local or regional recurrent NPC after radiotherapy. The relationship between preoperative pEBV-DNA level, maximal standard uptake value (SUVmax), and surgical outcome was analyzed. RESULTS: Forty-two patients had local tumor recurrence. Their median pEBV-DNA level and SUVmax were 348 copies and 4.7, respectively. Both values were significantly lower than those with palliative nasopharyngectomy. Twenty-two patients had regional failure. Their mean pEBV-DNA level and tumor SUVmax were 626 copies and 7.6, respectively. The metastatic lymph nodes with extracapsular spread had a significantly higher mean SUVmax. CONCLUSIONS: Preoperative pEBV-DNA and PET-CT predict the surgical outcome of nasopharyngectomy for recurrent NPC. Similarly, PET-CT scan predicts the presence of extracapsular spread of metastatic lymph nodes. These patients may warrant further postoperative adjuvant therapy.
Fluorodeoxyglucose F18 , Herpesvirus 4, Human/genetics , Nasopharyngeal Neoplasms/diagnostic imaging , Nasopharyngeal Neoplasms/surgery , Neoplasm Recurrence, Local/diagnostic imaging , Neoplasm Recurrence, Local/surgery , Adult , Aged , Aged, 80 and over , Cohort Studies , DNA, Viral/blood , Female , Follow-Up Studies , Humans , Male , Middle Aged , Multimodal Imaging/methods , Nasopharyngeal Neoplasms/blood , Nasopharyngeal Neoplasms/virology , Neoplasm Invasiveness/pathology , Neoplasm Recurrence, Local/blood , Neoplasm Recurrence, Local/virology , Neoplasm Staging , Pharyngectomy/methods , Positron-Emission Tomography , Predictive Value of Tests , Preoperative Care/methods , Retrospective Studies , Risk Assessment , Tomography, X-Ray Computed , Treatment Outcome
