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1. Enhanced recovery for liver transplantation: recommendations from the 2022 International Liver Transplantation Society consensus conference

Author

Mayr, Andreas, Dominguez, Beatriz, Muller, Elmi, Rando, Karina, Enoch, Mary Anne, Tamir, Noam, Healy, Pamela, Manser, Tanja, Briggs, Tim, Chaudhary, Abhideep, Humar, Abhinav, Jafarian, Ali, Soin, Arvinder Singh, Eghtesad, Bijan, Miller, Charles, Cherqui, Daniel, Samuel, Didier, Broering, Dieter, Pomfret, Elizabeth, Villamil, Federico, Durand, Francois, Berlakovich, Gabriela, McCaughan, Geoffrey, Auzinger, Georg, Testa, Giuliano, Klintmalm, Goran, Belghiti, Jacques, Findlay, James, Lai, Jennifer, Fung, John, Klinck, John, Roberts, John, Liu, Linda, Cattral, Mark, Ghobrial, Mark, Selzner, Markus, Ramsay, Michael, Rela, Mohamed, Ascher, Nancy, Man, Nancy Kwan, Selzner, Nazia, Burra, Patrizia, Friend, Peter, Busuttil, Ronald, Hwang, Shin, McCluskey, Stuart, Mas, Valeria, Vohra, Vijay, Vij, Vivek, Merritt, William, Tokat, Yaman, Kang, Yoogoo, Chan, Albert, Mazzola, Alessandra, Hessheimer, Amelia, Rammohan, Ashwin, Hogan, Brian, Vinaixa, Carmen, Nasralla, David, Victor, David, De Martin, Eleonora, Alconchel, Felipe, Roll, Garrett, Kabacam, Gokhan, Sapisochin, Gonzalo, Campos-Varela, Isabel, Liu, Jiang, Patel, Madhukar S., Izzy, Manhal, Kalisvaart, Marit, Adams, Megan, Goldaracena, Nicholas, Tinguely, Pascale, Hernandez-Alejandro, Roberto, Chadha, Ryan, Shaker, Tamer Mahmoud, Klair, Tarunjeet S., Pan, Terry, Tanaka, Tomohiro, Yoon, Uzung, Kirchner, Varvara, Hannon, Vivienne, Cheah, Yee Lee, Frola, Carlo, Morkane, Clare, Milliken, Don, Lurje, Georg, Potts, Jonathan, Fernandez, Thomas, Badenoch, Adam, Mukhtar, Ahmed, Zanetto, Alberto, Montano-Loza, Aldo, Chieh, Alfred Kow Wei, Shetty, Amol, DeWolf, Andre, Olmos, Andrea, Mrzljak, Anna, Blasi, Annabel, Berzigotti, Annalisa, Malik, Ashish, Rajakumar, Akila, Davidson, Brian, O'Farrell, Bryan, Kotton, Camille, Imber, Charles, Kwon, Choon Hyuck David, Wray, Christopher, Ahn, Chul-Soo, Krenn, Claus, Quintini, Cristiano, Maluf, Daniel, Mina, Daniel Santa, Sellers, Daniel, Balci, Deniz, Patel, Dhupal, Rudow, Dianne LaPointe, Monbaliu, Diethard, Bezinover, Dmitri, Krzanicki, Dominik, Kim, Dong-Sik, Brombosz, Elizabeth, Blumberg, Emily, Weiss, Emmanuel, Wey, Emmanuel, Kaldas, Fady, Saliba, Faouzi, Pittau, Gabriella, Wagener, Gebhard, Song, Gi-Won, Biancofiore, Gianni, Crespo, Gonzalo, Rodríguez, Gonzalo, Palli, Graciela Martinez, McKenna, Gregory, Petrowsky, Henrik, Egawa, Hiroto, Montasser, Iman, Pirenne, Jacques, Eason, James, Guarrera, James, Pomposelli, James, Lerut, Jan, Emond, Jean, Boehly, Jennifer, Towey, Jennifer, Hillingsø, Jens G, de Jonge, Jeroen, Caicedo, Juan, Heimbach, Julie, Emamaullee, Juliet Ann, Bartoszko, Justyna, Ma, Ka Wing, Kronish, Kate, Forkin, Katherine T., Chok, Kenneth Siu Ho, Olthoff, Kim, Reyntjens, Koen, Lee, Kwang-Woong, Suh, Kyung-Suk, Denehy, Linda, van der Laan, Luc J.W., McCormack, Lucas, Gorvin, Lucy, Ruffolo, Luis, Bhat, Mamatha, Ramírez, María Amalia Matamoros, Londoño, Maria-Carlota, Gitman, Marina, Levstik, Mark, de Santibañes, Martin, Lindsay, Martine, Parotto, Matteo, Armstrong, Matthew, Kasahara, Mureo, Schofield, Nick, Rizkalla, Nicole, Akamatsu, Nobuhisa, Scatton, Olivier, Keskin, Onur, Imventarza, Oscar, Andacoglu, Oya, Muiesan, Paolo, Giorgio, Patricia, Northup, Patrick, Matins, Paulo, Abt, Peter, Newsome, Philip N, Dutkowski, Philipp, Bhangui, Pooja, Bhangui, Prashant, Tandon, Puneeta, Brustia, Raffaele, Planinsic, Raymond, Brown, Robert, Porte, Robert, Barth, Rolf, Ciria, Rubén, Florman, Sander, Dharancy, Sebastien, Pai, Sher-Lu, Yagi, Shintaro, Nadalin, Silvio, Chinnakotla, Srinath, Forbes, Stuart J, Rahman, Suehana, Hong, Suk Kyun, Liying, Sun, Orloff, Susan, Rubman, Susan, Eguchi, Susumu, Ikegami, Toru, Reichman, Trevor, Settmacher, Utz, Aluvihare, Varuna, Xia, Victor, Yoon, Young-In, Soejima, Yuji, Genyk, Yuri, Jalal, Arif, Borakati, Aditya, Gustar, Adrian, Mohamed, Ahmed, Ramirez, Alejandro, Rothnie, Alex, Scott, Aneya, Sharma, Anika, Munro, Annalise, Mahay, Arun, Liew, Belle, Hidalgo, Camila, Crouch, Cara, Yan, Cheung Tsz, Tschuor, Christoph, Shaw, Conrad, Schizas, Dimitrios, Fritche, Dominic, Huda, Fabia Ferdousi, Wells, Gemma, Farrer, Giselle, Kwok, Hiu Tat, Kostakis, Ioannis, Mestre-Costa, Joao, Fan, Ka Hay, Fan, Ka Siu, Fraser, Kyra, Jeilani, Lelia, Pang, Li, Lenti, Lorenzo, Kathirvel, Manikandan, Zachiotis, Marinos, Vailas, Michail, Milan, Michele Mazza, Elnagar, Mohamed, Alradhawi, Mohammad, Dimitrokallis, Nikolaos, Machairas, Nikolaos, Morare, Nolitha, Yeung, Oscar, Khanal, Pragalva, Satish, Pranav, Ghani, Shahi Abdul, Makhdoom, Shahroo, Arulrajan, Sithhipratha, Bogan, Stephanie, Pericleous, Stephanos, Blakemore, Timon, Otti, Vanessa, Lam, Walter, Jackson, Whitney, Abdi, Zakee, Pollok, Joerg M, Berenguer, Marina, Niemann, Claus U, Raptis, Dimitri A, and Spiro, Michael

Published
2023
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3. Can we reduce ischemic cholangiopathy rates in donation after cardiac death liver transplantation after 10 years of practice? Canadian single-centre experience

Author

Tun-Abraham, Mauro Enrique, Wanis, Kerollos N., Garcia-Ochoa, Carlos, Sela, Nathalie, Sharma, Hemant, Hasan, Ibrahim Al, Quan, Douglas, Judaibi, Bandar Al-, Levstik, Mark, and Hernandez-Alejandro, Roberto

Subjects
International Business Machines Corp., Computer industry -- Analysis, Liver transplantation -- Analysis, Gifts -- Evaluation -- Analysis, Heart -- Analysis, Tissue donation -- Analysis, Organ transplant recipients -- Analysis, Purchasing, Death, Organ transplantation, Jewelry, Surgery, Ischemia, Brain death, Computer industry, Microcomputer industry, Health, Health care industry
Abstract

Background: Outcomes in liver transplantation with organs obtained via donation after cardiocirculatory death (DCD) have been suboptimal compared to donation after brain death, attributed mainly to the high incidence of ischemic cholangiopathy (IC). We evaluated the effect of a 10-year learning curve on IC rates among DCD liver graft recipients at a single centre.Methods: We analyzed all DCD liver transplantation procedures from July 2006 to July 2016. Patients were grouped into early (July 2006 to June 2011) and late (July 2011 to July 2016) eras. Those with less than 6 months of follow-up were excluded. Primary outcomes were IC incidence and IC-free survival rate.Results: Among the 73 DCD liver transplantation procedures performed, 70 recipients fulfilled the selection criteria, 32 in the early era and 38 in the late era. Biliary complications were diagnosed in 19 recipients (27%). Ischemic cholangiopathy was observed in 8 patients (25%) in the early era and 1 patient (3%) in the late era (p = 0.005). The IC-free survival rate was higher in the late era than the early era (98% v. 79%, p = 0.01). The warm ischemia time (27 v. 24 min, p = 0.049) and functional warm ischemia time (21 v. 17 min, p = 0.002) were significantly lower in the late era than the early era.Conclusion: We found a significant reduction in IC rates and improvement in IC-free survival among DCD liver transplantation recipients after a learning curve period that was marked by more judicious donor selection with shorter procurement times.Contexte : L'issue des greffes de foie suite a un don d'organe apres deces cardiocirculatoire (DDC) a ete sous-optimale comparativement aux dons suivant la mort cerebrale. Cela serait surtout attribuable a une forte incidence de cholangiopathie ischemique (CI). Nous avons evalue l'effet d'une courbe d'apprentissage echelonnee sur 10 ans sur les taux de CI chez des receveurs de greffe de foie apres DDC dans un seul centre.Methodes : Nous avons analyse toutes les greffes de foie consecutives a des DDC entre juillet 2006 et juillet 2016. Les patients ont ete regroupes en 2 epoques, la premiere, de juillet 2006 a juin 2011, et la seconde, de juillet 2011 a juillet 2016. Ceux pour lesquels on disposait de moins de 6 mois de suivi ont ete exclus. Les parametres principaux etaient l'incidence de CI et le taux de survie sans CI.Resultats : Parmi les 73 greffes de foie par suite de DDC, 70 receveurs repondaient aux criteres de selection, 32 pour la premiere epoque et 38 pour la seconde epoque. Des complications biliaires ont ete diagnostiquees chez 19 receveurs (27%). La cholangiopathie ischemique a ete observee chez 8 patients (25%) de la premiere epoque et 1 patient (3%) de la seconde (p = 0,005). Le taux de survie sans CI a ete plus eleve pendant la seconde epoque que pendant la premiere (98% c. 79%, p = 0,01). Le temps d'ischemie chaude (27 minutes c. 24, p = 0,049) et le temps d'ischemie chaude fonctionnelle (21 minutes c. 17, p = 0,002) ont ete significativement plus courts durant la seconde epoque que durant la premiere.Conclusion : Nous avons observe une reduction significative des taux de CI et une amelioration de la survie sans CI chez les receveurs de greffes de foie par DDC apres une courbe d'apprentissage qui a ete marquee par une selection plus judicieuse des donneurs et des delais d'obtention plus courts., Recommended strategies to expand the donor pool in liver transplantation and decrease waiting list mortality include using extended-criteria donors and living donation. Encompassed among extended-criteria donors is donation after cardiocirculatory [...]

Published
2019
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4. Optimizing associated liver partition and portal vein ligation for staged hepatectomy outcomes: Surgical experience or appropriate patient selection?

Author

Al Hasan, Ibrahim, Tun-Abraham, Mauro Enrique, Wanis, Kerollos N., Garcia-Ochoa, Carlos, Levstik, Mark A., Al-Judaibi, Bandar, and Hernandez-Alejandro, Roberto

Subjects
Digestive system surgery -- Patient outcomes, Liver diseases -- Care and treatment, Health, Health care industry
Abstract

Background: Early reports of associated liver partition and portal vein ligation for staged hepatectomy (ALPPS) outcomes have been suboptimal. The literature has confirmed that learning curves influence surgical outcomes. We [...]

Published
2017
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5. Enhanced recovery for liver transplantation: recommendations from the 2022 International Liver Transplantation Society consensus conference

Author

Pollok, Joerg M, primary, Tinguely, Pascale, additional, Berenguer, Marina, additional, Niemann, Claus U, additional, Raptis, Dimitri A, additional, Spiro, Michael, additional, Mayr, Andreas, additional, Dominguez, Beatriz, additional, Muller, Elmi, additional, Rando, Karina, additional, Enoch, Mary Anne, additional, Tamir, Noam, additional, Healy, Pamela, additional, Manser, Tanja, additional, Briggs, Tim, additional, Chaudhary, Abhideep, additional, Humar, Abhinav, additional, Jafarian, Ali, additional, Soin, Arvinder Singh, additional, Eghtesad, Bijan, additional, Miller, Charles, additional, Cherqui, Daniel, additional, Samuel, Didier, additional, Broering, Dieter, additional, Pomfret, Elizabeth, additional, Villamil, Federico, additional, Durand, Francois, additional, Berlakovich, Gabriela, additional, McCaughan, Geoffrey, additional, Auzinger, Georg, additional, Testa, Giuliano, additional, Klintmalm, Goran, additional, Belghiti, Jacques, additional, Findlay, James, additional, Lai, Jennifer, additional, Fung, John, additional, Klinck, John, additional, Roberts, John, additional, Liu, Linda, additional, Cattral, Mark, additional, Ghobrial, Mark, additional, Selzner, Markus, additional, Ramsay, Michael, additional, Rela, Mohamed, additional, Ascher, Nancy, additional, Man, Nancy Kwan, additional, Selzner, Nazia, additional, Burra, Patrizia, additional, Friend, Peter, additional, Busuttil, Ronald, additional, Hwang, Shin, additional, McCluskey, Stuart, additional, Mas, Valeria, additional, Vohra, Vijay, additional, Vij, Vivek, additional, Merritt, William, additional, Tokat, Yaman, additional, Kang, Yoogoo, additional, Chan, Albert, additional, Mazzola, Alessandra, additional, Hessheimer, Amelia, additional, Rammohan, Ashwin, additional, Hogan, Brian, additional, Vinaixa, Carmen, additional, Nasralla, David, additional, Victor, David, additional, De Martin, Eleonora, additional, Alconchel, Felipe, additional, Roll, Garrett, additional, Kabacam, Gokhan, additional, Sapisochin, Gonzalo, additional, Campos-Varela, Isabel, additional, Liu, Jiang, additional, Patel, Madhukar S., additional, Izzy, Manhal, additional, Kalisvaart, Marit, additional, Adams, Megan, additional, Goldaracena, Nicholas, additional, Hernandez-Alejandro, Roberto, additional, Chadha, Ryan, additional, Shaker, Tamer Mahmoud, additional, Klair, Tarunjeet S., additional, Pan, Terry, additional, Tanaka, Tomohiro, additional, Yoon, Uzung, additional, Kirchner, Varvara, additional, Hannon, Vivienne, additional, Cheah, Yee Lee, additional, Frola, Carlo, additional, Morkane, Clare, additional, Milliken, Don, additional, Lurje, Georg, additional, Potts, Jonathan, additional, Fernandez, Thomas, additional, Badenoch, Adam, additional, Mukhtar, Ahmed, additional, Zanetto, Alberto, additional, Montano-Loza, Aldo, additional, Chieh, Alfred Kow Wei, additional, Shetty, Amol, additional, DeWolf, Andre, additional, Olmos, Andrea, additional, Mrzljak, Anna, additional, Blasi, Annabel, additional, Berzigotti, Annalisa, additional, Malik, Ashish, additional, Rajakumar, Akila, additional, Davidson, Brian, additional, O'Farrell, Bryan, additional, Kotton, Camille, additional, Imber, Charles, additional, Kwon, Choon Hyuck David, additional, Wray, Christopher, additional, Ahn, Chul-Soo, additional, Krenn, Claus, additional, Quintini, Cristiano, additional, Maluf, Daniel, additional, Mina, Daniel Santa, additional, Sellers, Daniel, additional, Balci, Deniz, additional, Patel, Dhupal, additional, Rudow, Dianne LaPointe, additional, Monbaliu, Diethard, additional, Bezinover, Dmitri, additional, Krzanicki, Dominik, additional, Kim, Dong-Sik, additional, Brombosz, Elizabeth, additional, Blumberg, Emily, additional, Weiss, Emmanuel, additional, Wey, Emmanuel, additional, Kaldas, Fady, additional, Saliba, Faouzi, additional, Pittau, Gabriella, additional, Wagener, Gebhard, additional, Song, Gi-Won, additional, Biancofiore, Gianni, additional, Crespo, Gonzalo, additional, Rodríguez, Gonzalo, additional, Palli, Graciela Martinez, additional, McKenna, Gregory, additional, Petrowsky, Henrik, additional, Egawa, Hiroto, additional, Montasser, Iman, additional, Pirenne, Jacques, additional, Eason, James, additional, Guarrera, James, additional, Pomposelli, James, additional, Lerut, Jan, additional, Emond, Jean, additional, Boehly, Jennifer, additional, Towey, Jennifer, additional, Hillingsø, Jens G, additional, de Jonge, Jeroen, additional, Caicedo, Juan, additional, Heimbach, Julie, additional, Emamaullee, Juliet Ann, additional, Bartoszko, Justyna, additional, Ma, Ka Wing, additional, Kronish, Kate, additional, Forkin, Katherine T., additional, Chok, Kenneth Siu Ho, additional, Olthoff, Kim, additional, Reyntjens, Koen, additional, Lee, Kwang-Woong, additional, Suh, Kyung-Suk, additional, Denehy, Linda, additional, van der Laan, Luc J.W., additional, McCormack, Lucas, additional, Gorvin, Lucy, additional, Ruffolo, Luis, additional, Bhat, Mamatha, additional, Ramírez, María Amalia Matamoros, additional, Londoño, Maria-Carlota, additional, Gitman, Marina, additional, Levstik, Mark, additional, de Santibañes, Martin, additional, Lindsay, Martine, additional, Parotto, Matteo, additional, Armstrong, Matthew, additional, Kasahara, Mureo, additional, Schofield, Nick, additional, Rizkalla, Nicole, additional, Akamatsu, Nobuhisa, additional, Scatton, Olivier, additional, Keskin, Onur, additional, Imventarza, Oscar, additional, Andacoglu, Oya, additional, Muiesan, Paolo, additional, Giorgio, Patricia, additional, Northup, Patrick, additional, Matins, Paulo, additional, Abt, Peter, additional, Newsome, Philip N, additional, Dutkowski, Philipp, additional, Bhangui, Pooja, additional, Bhangui, Prashant, additional, Tandon, Puneeta, additional, Brustia, Raffaele, additional, Planinsic, Raymond, additional, Brown, Robert, additional, Porte, Robert, additional, Barth, Rolf, additional, Ciria, Rubén, additional, Florman, Sander, additional, Dharancy, Sebastien, additional, Pai, Sher-Lu, additional, Yagi, Shintaro, additional, Nadalin, Silvio, additional, Chinnakotla, Srinath, additional, Forbes, Stuart J, additional, Rahman, Suehana, additional, Hong, Suk Kyun, additional, Liying, Sun, additional, Orloff, Susan, additional, Rubman, Susan, additional, Eguchi, Susumu, additional, Ikegami, Toru, additional, Reichman, Trevor, additional, Settmacher, Utz, additional, Aluvihare, Varuna, additional, Xia, Victor, additional, Yoon, Young-In, additional, Soejima, Yuji, additional, Genyk, Yuri, additional, Jalal, Arif, additional, Borakati, Aditya, additional, Gustar, Adrian, additional, Mohamed, Ahmed, additional, Ramirez, Alejandro, additional, Rothnie, Alex, additional, Scott, Aneya, additional, Sharma, Anika, additional, Munro, Annalise, additional, Mahay, Arun, additional, Liew, Belle, additional, Hidalgo, Camila, additional, Crouch, Cara, additional, Yan, Cheung Tsz, additional, Tschuor, Christoph, additional, Shaw, Conrad, additional, Schizas, Dimitrios, additional, Fritche, Dominic, additional, Huda, Fabia Ferdousi, additional, Wells, Gemma, additional, Farrer, Giselle, additional, Kwok, Hiu Tat, additional, Kostakis, Ioannis, additional, Mestre-Costa, Joao, additional, Fan, Ka Hay, additional, Fan, Ka Siu, additional, Fraser, Kyra, additional, Jeilani, Lelia, additional, Pang, Li, additional, Lenti, Lorenzo, additional, Kathirvel, Manikandan, additional, Zachiotis, Marinos, additional, Vailas, Michail, additional, Milan, Michele Mazza, additional, Elnagar, Mohamed, additional, Alradhawi, Mohammad, additional, Dimitrokallis, Nikolaos, additional, Machairas, Nikolaos, additional, Morare, Nolitha, additional, Yeung, Oscar, additional, Khanal, Pragalva, additional, Satish, Pranav, additional, Ghani, Shahi Abdul, additional, Makhdoom, Shahroo, additional, Arulrajan, Sithhipratha, additional, Bogan, Stephanie, additional, Pericleous, Stephanos, additional, Blakemore, Timon, additional, Otti, Vanessa, additional, Lam, Walter, additional, Jackson, Whitney, additional, and Abdi, Zakee, additional

Published
2023
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10. What is the optimal prophylaxis against postoperative deep vein thrombosis in the living donor to avoid complications and enhance recovery? – A systematic review of the literature and expert panel recommendations.

Author

Ruffolo, Luis I., Levstik, Mark, Boehly, Jen, Spiro, Michael, Raptis, Dimitri A., Liu, Linda, and Hernandez‐Alejandro, Roberto

Subjects
*VENOUS thrombosis, *LOW-molecular-weight heparin, *PREVENTIVE medicine, *LIVER transplantation
Abstract

Background: Deep venous thrombosis (DVT) prophylaxis is often employed to prevent the potentially serious complication of pulmonary embolism (PE). However, little data exist regarding the optimal DVT prophylaxis strategy for living donors undergoing hepatectomy for living donor liver transplantation. Here we present our consensus statement on DVT prophylaxis for living donors undergoing hepatectomy. Objectives: To identify the optimal DVT prophylaxis strategy, which reduces, risk of complications in living liver donors, and enhances recovery. Methods: Systematic review following PRISMA guidelines and recommendations using the GRADE approach derived from an international expert panel. Of interest was the impact of DVT prophylaxis or lack of prophylaxis on living donors undergoing hepatectomy and subsequent rates of DVT, PE, and hemorrhagic complications. PROSPERO ID: CRD42021260720 Results: The review of the literature identified three studies, which directly addressed thrombogenesis following living donor hepatectomy. All studies were observational in nature without randomization into treatments. The rate of DVT‐PE in unscreened living donors with chemoprophylaxis was 5%. Furthermore, thromboelastography of living donors demonstrated sustained hypercoagulability for 50% of donors 10 days postoperatively. In line with CHEST (The American College of Chest Physicians) guidelines of chemoprophylaxis for surgical procedures with 3% or greater risk of DVT‐PE, we conclude that a minimum of 10 days of postoperative chemoprophylaxis with unfractionated heparin or low‐molecular weight heparin is recommended for patients undergoing living donor hepatectomy. The quality of evidence (QOE) for these recommendations based on the GRADE criteria is low, with a Grade of Recommendation of Strong. Conclusions: Chemoprophylaxis for DVT following living donor hepatectomy is associated with reduced adverse thrombotic events, (Quality of Evidence; Low | Grade of Recommendation; Strong). [ABSTRACT FROM AUTHOR]

Published
2022
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16. Interpreting Outcomes in DCDD Liver Transplantation

Author

Goldberg, David S., primary, Karp, Seth J., additional, McCauley, Maureen E., additional, Markmann, James F., additional, Croome, Kristopher P., additional, Taner, C. Burcin, additional, Heimbach, Julie K., additional, Leise, Michael D., additional, Fryer, Jonathan P., additional, Bohorquez, Humberto E., additional, Cohen, Ari J., additional, Gilroy, Richard K., additional, Kumer, Sean C., additional, Foley, David P., additional, Karim, Aos S., additional, Hernandez-Alejandro, Roberto, additional, Levstik, Mark A., additional, and Abt, Peter L., additional

Published
2017
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17. Hepatocellular adenoma(s) arising in nodular regenerative hyperplasia in a patient with systemic lupus erythematosus.

Author

Bell PD, Thung S, Weiss S, Levstik M, Zhang D, Liu X, and Liao X

Subjects
Adenoma, Liver Cell pathology, Adult, Biopsy, Female, Focal Nodular Hyperplasia pathology, Humans, Hyperplasia pathology, Liver diagnostic imaging, Liver pathology, Liver Neoplasms pathology, Liver Neoplasms virology, Lupus Erythematosus, Systemic pathology, Adenoma, Liver Cell diagnostic imaging, Focal Nodular Hyperplasia diagnostic imaging, Hyperplasia diet therapy, Liver Neoplasms diagnostic imaging, Lupus Erythematosus, Systemic complications
Abstract

Hepatocellular adenoma (HCA) is a rare benign tumor of the liver with low risk of malignant transformation. It is associated with oral contraceptives/anabolic steroid use, metabolic disease, and rarely, vascular abnormalities. We report an interesting case of HCA arising in a background of diffuse hepatic nodular regenerative hyperplasia (NRH) in a 40-year-old female patient with systemic lupus erythematosus (SLE). She presented with sudden-onset refractory ascites, elevated liver enzymes, diffuse hepatic nodularity and mass lesions on imaging concerning for malignancy. Targeted biopsies of the mass lesion were performed with inconclusive diagnoses. The patient ultimately underwent resection of the mass, which was confirmed as HCA, inflammatory type, arising in a background of NRH. It is not uncommon for SLE patients to have liver manifestations such as NRH, but HCA arising in NRH has not been previously reported. Our case reveals an unusual relationship between HCA and hepatic vasculopathy in the clinical context of a systemic inflammatory condition, the mechanism by which is not fully understood., Competing Interests: Declaration of Competing Interest The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article., (Copyright © 2019 Elsevier GmbH. All rights reserved.)

Published
2020
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