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    Arely Villa Rodriguez
    This study retrospectively analyzed 106 patients who received liver transplants over one year to assess the sensitivity of pre-transplant screening tests for hepatocellular carcinoma (HCC). Ultrasound (US), computerized tomography (CT), and serum alpha-fetoprotein (AFP) levels were evaluated within 6 months prior to transplantation and compared to explant pathology results. The study found that 19 patients had HCC identified in explant pathology. Both high-risk US and high-risk CT exams had high negative predictive values but moderate positive predictive values for HCC detection. Using either high-risk US or CT improved sensitivity but reduced specificity. All screening tests missed small HCCs <4cm. The study concluded that

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    Abstracts

    Uploaded by

    Arely Villa Rodriguez
    20 views1 page
    This study retrospectively analyzed 106 patients who received liver transplants over one year to assess the sensitivity of pre-transplant screening tests for hepatocellular carcinoma (HCC). Ultrasound (US), computerized tomography (CT), and serum alpha-fetoprotein (AFP) levels were evaluated within 6 months prior to transplantation and compared to explant pathology results. The study found that 19 patients had HCC identified in explant pathology. Both high-risk US and high-risk CT exams had high negative predictive values but moderate positive predictive values for HCC detection. Using either high-risk US or CT improved sensitivity but reduced specificity. All screening tests missed small HCCs <4cm. The study concluded that

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    This study retrospectively analyzed 106 patients who received liver transplants over one year to assess the sensitivity of pre-transplant screening tests for hepatocellular carcinoma (HCC). Ultrasound (US), computerized tomography (CT), and serum alpha-fetoprotein (AFP) levels were evaluated within 6 months prior to transplantation and compared to explant pathology results. The study found that 19 patients had HCC identified in explant pathology. Both high-risk US and high-risk CT exams had high negative predictive values but moderate positive predictive values for HCC detection. Using either high-risk US or CT improved sensitivity but reduced specificity. All screening tests missed small HCCs <4cm. The study concluded that

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
    20 views1 page

    Abstracts

    Uploaded by

    Arely Villa Rodriguez
    This study retrospectively analyzed 106 patients who received liver transplants over one year to assess the sensitivity of pre-transplant screening tests for hepatocellular carcinoma (HCC). Ultrasound (US), computerized tomography (CT), and serum alpha-fetoprotein (AFP) levels were evaluated within 6 months prior to transplantation and compared to explant pathology results. The study found that 19 patients had HCC identified in explant pathology. Both high-risk US and high-risk CT exams had high negative predictive values but moderate positive predictive values for HCC detection. Using either high-risk US or CT improved sensitivity but reduced specificity. All screening tests missed small HCCs <4cm. The study concluded that

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    of 1

    Morbidity and mortality in cirrhotic patients undergoing anesthesia and surgery

    Several studies have demonstrated increased morbidity and mortality in patients with cirrhosis
    undergoing anesthesia and surgery. Cirrhosis is a chronic liver disease, which may affect all body
    systems. The severity of the disease, assessed by the Child-Pugh classification, has a substantial
    effect on patient outcome. The extent of surgery and co-morbid conditions also have a major
    impact. In the past few years, changes have been made in the diagnosis, preoperative preparation,
    surgical and anesthetic management and perioperative care of patients with liver disease. The aim
    of this review is to examine whether these changes have resulted in improved perioperative
    outcomes.

    Sensitivity of commonly available screening tests in detecting hepatocellular carcinoma in


    cirrhotic patients undergoing liver transplantation

    Abstract

    OBJECTIVE: Recognition of hepatocellular carcinoma (HCC) is important in the management of


    patients awaiting liver transplantation. HCCs >5 cm in diameter are at high risk to recur after
    transplant. The goal of this study was to assess the sensitivity of the diagnostic tests employed in a
    pretransplant screening program.

    METHODS: The study is a retrospective analysis of charts of 106 consecutive adults transplanted
    over a 1-yr period. All patients had ultrasonography (US), computerized tomography (CT), and
    serum alpha fetoprotein (AFP) testing within 6 months of transplantation. Radiographic reports
    were subdivided into low-risk and high-risk groups, based upon level of suspicion for HCC. The
    results were compared to explant pathology.

    RESULTS: Pathological analysis of 106 explants revealed HCC in 19 patients. High-risk US exams
    had a positive predictive value (PPV) of 0.69 and a negative predictive value (NPV) of 0.91 in the
    diagnosis of HCC. High-risk CT exams had a PPV of 0.67 and an NPV of 0.90. When patients had
    either a high-risk US or a high-risk CT, there was a PPV of 0.59 and an NPV of 0.83. Of the 19
    patients with HCC, three had high-risk US and low-risk CT; two had high-risk CT and low-risk US.
    Four patients, all with HCC <4 cm, had low-risk US, CT, and serum AFP.

    CONCLUSIONS: US, CT, and serum AFP, as single tests, are insensitive for detection of HCC in the
    cirrhotic liver. However, they are highly specific. Sensitivity and specificity for US are comparable
    to those for CT. Given its lower cost, US is preferable to CT for routine screening of HCC in patients
    with end-stage liver disease undergoing liver transplantation.

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