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J Balsells

Publications and source records attributed to J Balsells.

33 records · Page 2Linked to original sources
PubMed1996

DNA ploidy study of resected hepatocellular carcinoma in cirrhotic liver.

BACKGROUND/AIMS: Results of several studies on DNA ploidy as a prognostic indicator in hepatocellular carcinoma are contradictory. The present study analysed the correlations between DNA ploidy of resected hepatocellular carcinoma and tumour characteristics, tumour recurrence, risk factors and survival. METHODS: Tumoural DNA ploidy of hepatocellular carcinomas from 37 patients with cirrhosis who underwent curative tumour resection was studied by flow cytometry. RESULTS: A diploid pattern was found in 23 hepatocellular carcinomas (62.2%) and an aneuploid pattern in 14 (37.8%). The tumour recurrence rate did not differ statistically between diploid (69.6%) and aneuploid (50%) hepatocellular carcinomas. The only prognostic variable with significant difference in DNA pattern was the histologic tumour type; the majority of non-trabecular tumours were aneuploid while most trabecular hepatocellular carcinomas had a diploid DNA pattern. Actuarial survival at 1, 2, 3 and 4 years of patients with diploid and aneuploid tumours was 69.6%, 40.6%, 16.2% and 0%, and 69.3%, 59.4%, 49.5% and 32.9%, respectively (log rank p = 0.1927). CONCLUSION: These results indicate that DNA ploidy has no prognostic value in hepatocellular carcinoma.

Adult↗
PubMed1994

Adverse impact of high panel-reactive antibody (PRA) and positive cytotoxic crossmatch in liver transplantation.

Of 91 liver transplants (LTX) performed from October 1988 to December 1992, 13 (14.2%) of the patients received a liver from a lymphocytotoxic-positive crossmatch (CM) donor. Severe early rejection resulting in graft floss occurred in seven positive CM patients. Three of the remaining positive CM patients suffered several rejection episodes leading to chronic rejection and FK 506 was required as rescue treatment. A significant difference in mean panel-reactive antibody (PRA) of 8.6% and 56.9% was found in negative and positive CM patients, respectively (P = 0.012). A higher mean PRA (67.7%) was found in positive CM patients with rejection compared with positive CM patients without rejection (PRA 38%). Overall graft and patient survival were 31.9% and 35% in positive CM patients compared with 57.0% and 61.9% in negative CM patients. These differences were statistically significant (P = 0.023). In our experience the risk of developing severe acute rejection with graft failure and chronic rejection is related to PRA > 60% and positive CM. We recommend that in patients with PRA > 60%, the result of CM should be awaited before proceeding to LTX.

Adult↗
PubMed1994

Recipient hepatectomy with preservation of inferior vena cava reduces the need for veno-venous bypass in liver transplantation.

Recipient hepatectomy with inferior vena cava (IVC) preservation, the piggy back (PGB) technique, was adopted as our routine option in the management of the anhepatic phase of orthotopic liver transplantation (OLT) to avoid the use of veno-venous bypass (VV-BP). In the last 5 years, 119 OLT in adult patients have been performed in our unit. In the first period (47 OLT), VV-BP was used in 59% of the cases and cross-clamping in the rest. In the second period, following the introduction of the PGB technique, 72 OLT were performed. VV-BP was used in 5.5% of the cases, PGB technique in 87.5% and cross-clamping in 6.9%. There was a significant reduction in the need for VV-BP in the second period. Operating time and blood transfusion were significantly greater in the VV-BP group. No PGB technique related complications were observed. In conclusion, the PGB technique reduced the need for VVBP with consequent savings in time, blood transfusion and the cost of OLT.

Adult↗
PubMed1993

Adenocarcinoma in Caroli's disease treated by liver transplantation.

Caroli's disease is characterized by congenital cystic dilatation of the intrahepatic bile ducts. In 7% of cases a malignant tumor develops complicating the course of the disease. We report the case of a 25 year-old woman in whom Caroli's disease was diagnosed at the age of 11. From that time on, she had several episodes of cholangitis. In 1989, the abdominal ultrasound and CT scan showed dilatation of the intrahepatic bile ducts, intracystic lithiasis and a solid mass. FNA cytology showed a papillary adenocarcinoma. At laparotomy a tumor was found occupying both hepatic lobes, and intraoperative US showed another two nodules in the left lobe. The tumor was considered unresectable. Examination of the hilar lymph nodes was tumor-negative. Two weeks later, the patient underwent an orthotopic liver transplantation (OLT). The pathological examination confirmed Caroli's disease with adenocarcinoma. Two years after OLT, the patient is alive with normal liver function and no evidence of disease. To our knowledge this is the first case report of adenocarcinoma in Caroli's disease treated by OLT.

Adenocarcinoma, Papillary↗
PubMed1991

[Resection of hepatocarcinomas in liver cirrhosis: the value of intraoperative echography].

In the last 3 years 21 cirrhotic patients with hepatocellular carcinoma were operated. All patients fulfilled the criteria of localized tumor and good liver function and underwent a laparotomy with the aim of resecting the tumor. Intraoperative ultrasound examination was essential to localize a non visible and non palpable tumor in 2 cases and it was useful to detect other nodules in 3 of the 16 patients who underwent a hepatic resection of the tumor. In 5 patients resection was considered not indicated. Therefore, the initial therapeutic approach of tumoral resection was changed in 23.8% of patients. Also, intraoperative ultrasonography was essential for performing a guided resection of hepatocellular carcinomas in cirrhotic liver with the aim of preserving as much liver parenchyma as possible.

Aged↗
PubMed1990

Influence of fat emulsions in parenteral nutrition on visceral protein synthesis: study in hepatectomized rats.

The aim of this study was to evaluate the effect of total parenteral nutrition (TPN) with 100% long-chain triglyceride (LCT) (group A) and 50/50% medium/long-chain triglyceride (MCT/LCT) (group B) fat emulsions on visceral protein synthesis in 70% hepatectomized rats. The rats were fed TPN continuously for 7 days posthepatectomy. Protein synthesis was measured in the liver and jejunal mucosa with the flooding dose method. All rats received the same caloric and nitrogen intake, without statistically significant differences. The only difference between the two groups was the proportion of MCT to LCT in the diets. Hepatic and jejunal mucosa protein synthesis were significantly higher in group B, fed 50/50% MCT/LCT. These results suggest that fat emulsions with 50/50% MCT/LCT significantly enhance visceral protein synthesis after partial hepatectomy.

Animals↗